Time Limit And Mentoring Agreement {HUD-1013}

Time Limit and Mentoring Agreement (Supplemental form required with Phased Retirement Application) Part 1 ­ Applicant Information 1. Applicant Name U.S. Department of Housing and Urban Development Last 2. Work Address First Middle Initial Street 3. Work Telephone Number 4. E-mail Address City State Zip ( ) Office/Division/Branch (Do not abbreviate or use acronyms) 6. Pay Plan- Series ­ Grade (e.g. GS-343-09) 5. Official Position Title (e.g. Management Analyst) Part II ­ Time Limit Agreement Time Limit ­ An established period of time that an employee may participate in phased retirement, by mutual agreement between the supervisor and participating employee. Time limits are to be established for periods up to, but not exceeding one (1) year, in line with the expiration date of the pilot program. If the program is fully implemented, extensions may be granted for periods of up to one year at a time, not to exceed three (3) years, aggregately. Select ONE of the following options: _____ Initial Time Limit Agreement - This is applicant's first time limit agreement. Employees electing to enter phased retirement will be subject to a maximum period up to one (1) year for the pilot program. _____ Time Limit Extension ­ Select this option if you are under an active time limit agreement and are requesting an extension. The employee is to submit a request at least 30 days prior to expiration with written justification from the supervisor. Applicant must read and initial each of the following statements. I understand that: 1) _____ I may, with the permission of the approving official, return to regular employment status (prior to the expiration of this agreement), subject to 5 CFR § 831.1721, 5 U.S.C. 8336a(g), and by following the procedures outlined in HUD's Phased Retirement Policy and Procedures Handbook. _____ I have the right to elect to fully retire at any time (as provided in 5 CFR § 831.1731) or upon expiration of the time limit agreement. _____ I may accept a new appointment at another agency, with or without the new agency's approval for me to continue in phased employment, at any time before the expiration of this agreement or within 3 days of the expiration of the agreement. _____ If I return to regular employment status, I will be prohibited from reelecting phased retirement status. _____ When the agreed term of phased employment ends, I will be separated from employment and that such separation will be considered voluntary based on this agreement, unless I am approved to return to regular employment or accept a new appointment at another agency prior to expiration of this agreement. _____ If I am separated from phased employment and not employed within 3 days (i.e., a break in service of greater than 3 days), that I will be deemed to have elected full retirement. _____ A HUD authorized approving official may rescind an existing agreement, or approve the employee to enter into a new agreement to extend or reduce the term of phased employment agreed to in an existing agreement, by entering into a new written agreement before the expiration of the agreement currently in effect. _____ I understand that a HUD approving official may remove me from phased retirement prior to the end of the time limit agreement due to budget restrictions, performance, or conduct and will use existing workforce authorities such as removal for performance or conduct; transfer of function or reduction in force; as appropriate. Date (mm/dd/yyyy) 2) 3) 4) 5) 6) 7) 8) Employee's Signature Supervisor's Signature Date (mm/dd/yyyy) Last revision 8/18/15 1 HUD Form 1013 American LegalNet, Inc. www.FormsWorkFlow.com Time Limit and Mentoring Agreement (Supplemental form required with Phased Retirement Application) Part III ­ Mentoring (This section is to be completed by the Supervisor.) U.S. Department of Housing and Urban Development Phased retirees are required to provide approved mentoring activities for 20% (i.e. 8 hours) of their work hours each biweekly pay period. 1. The Supervisor is to select the style(s) of mentoring for which the phased retiree is willing and capable of performing. _____ Traditional ­ senior employee mentors a lower-graded employee. _____ Situational ­ focus is on a specific situation (e.g. to solve a problem). _____ Peer-to- Peer ­ mentoring of another individual who will carry out the duties of the phased retiree. _____ Group Mentoring ­ mentoring of two or more individuals. 2. The Supervisor is to select at least one of the following. The mentoring activities will be used for: _____ Knowledge transfer - Sharing of information by professionals and experts in a field. _____ Knowledge management ­ Cataloguing and storing information in a database. It also captures, develops, and effectively uses organizational knowledge and information. Phased retiree mentors can share their strategies and processes used during their work experience and lessons learned as a strategic asset for the organization. _____ Succession Planning ­ Identifying and developing staff members who have the potential to fill key leadership positions. Phased retiree mentors help the organization develop the competencies of potential future leaders within the agency. _____ Career Development ­ Providing advice and guidance to an individual that will help develop their career. It may involve discussing training, job assignment, work balance, and / or focusing on areas needing improvement (e.g. writing skills). 3. Use the space below to provide a detailed description of the mentoring activities that the phased employee will perform. (A continuation sheet may be attached if necessary.) Last revision 8/18/15 2 HUD Form 1013 American LegalNet, Inc. www.FormsWorkFlow.com Time Limit and Mentoring Agreement (Supplemental form required with Phased Retirement Application) Part IV ­ Applicant Acknowledgement U.S. Department of Housing and Urban Development The employee must initial EACH of the following statements affirming the employee has read and understands each statement. As a Phased Retiree: 1) 2) 3) 4) ______ As a condition for approval to participate in phased retirement, I agree to spend a minimum of 20% (8 hours) of my working hours each biweekly pay period performing mentoring activities detailed in this mentoring agreement. ______ I am not permitted to work more than 40 hours each bi-weekly pay period (50% of current work hours) and no more than 8 hours a day unless on an approved alternate work schedule. ______ I und