U.S. Office of Special Counsel's Certification Program Compliance Form

This United States-specific printable "U.S. Office of Special Counsel's Certification Program Compliance Form" is a part of the legal paperwork issued by the U.S. Office of Special Counsel.

Download the up-to-date PDF by clicking the link below and mail it as per the guidelines provided by the department.

ADVERTISEMENT
U.S. OFFICE OF SPECIAL COUNSEL
1730 M Street, N.W., Suite 218
Washington, D.C. 20036-4505
certification@osc.gov
(202) 804-7163
U.S. OFFICE OF SPECIAL COUNSEL'S
CERTIFICATION PROGRAM COMPLIANCE FORM
The U.S. Office of Special Counsel's (OSC) Certification Program allows federal agencies to
meet the statutory obligation to inform their workforces about the rights and remedies available
to them under the prohibited personnel practice and whistleblower retaliation protection
1
provisions of 5 U.S.C. § 2302.
Using this form, please explain how the certifying agency has
met the requirements of OSC's Certification Program. The completed form should be emailed
to certification@osc.gov. Questions about completing this form should be directed to OSC’s
Diversity, Outreach, and Training Unit, which can be reached at 202-804-7163 or
certification@osc.gov.
General Information
Agency or Office Certifying:
Agency & OIG
Agency
OIG
Component (please indicate parent agency):
Contact Information
Please provide the contact information for the official responsible for implementing OSC's
Certification Program (the individual’s name and phone number will be placed on OSC’s
website as the point of contact once the agency is certified).
Name:
Title:
E-mail:
Phone:
Address (to send certificate):
U.S. OFFICE OF SPECIAL COUNSEL
1730 M Street, N.W., Suite 218
Washington, D.C. 20036-4505
certification@osc.gov
(202) 804-7163
U.S. OFFICE OF SPECIAL COUNSEL'S
CERTIFICATION PROGRAM COMPLIANCE FORM
The U.S. Office of Special Counsel's (OSC) Certification Program allows federal agencies to
meet the statutory obligation to inform their workforces about the rights and remedies available
to them under the prohibited personnel practice and whistleblower retaliation protection
1
provisions of 5 U.S.C. § 2302.
Using this form, please explain how the certifying agency has
met the requirements of OSC's Certification Program. The completed form should be emailed
to certification@osc.gov. Questions about completing this form should be directed to OSC’s
Diversity, Outreach, and Training Unit, which can be reached at 202-804-7163 or
certification@osc.gov.
General Information
Agency or Office Certifying:
Agency & OIG
Agency
OIG
Component (please indicate parent agency):
Contact Information
Please provide the contact information for the official responsible for implementing OSC's
Certification Program (the individual’s name and phone number will be placed on OSC’s
website as the point of contact once the agency is certified).
Name:
Title:
E-mail:
Phone:
Address (to send certificate):
Requirement Compliance Information
1. POSTINGS AT AGENCY LOCATIONS
Agencies should post the laws regarding
prohibited personnel practices
(PPPs),
whistleblowers, and
whistleblower
retaliation. The posters should be displayed in all personnel
and EEO offices and in other prominent places throughout the agency.
A. How many PPP posters were placed in your agency and at which specific locations were
they placed?
B. How many whistleblowing posters were placed in your agency and at which specific
locations were they placed?
C. How many whistleblower retaliation posters were placed in your agency and at which
specific locations were they placed?
2. NEW EMPLOYEE NOTIFICATIONS
Written materials on the PPPs and filing whistleblower disclosures and OSC’s role in enforcing
the laws within its jurisdiction should be provided in new employee orientation packets within
180 days of employment. OSC has created an outline of PPP rights and remedies that can be
printed or sent via e-mail. The materials are available on OSC’s website.
A. Please attach the written materials that you are providing to new employees in their
orientation packets.
B. On what date were materials were added to orientation packets?
3. ANNUAL EMPLOYEE NOTIFICATION
Agencies shall provide annual notice to all employees on rights and remedies regarding PPPs
and filing whistleblower disclosures along with access to written materials (described above). An
example of an agency head’s letter sent to agency employees is available on the OSC website.
A. Please attach the annual notice that was provided to all employees, including the method
in by which the materials were provided (e.g., links, agency website, etc.)
B. On what date was this information given to employees?
4. SUPERVISORY TRAINING
Each agency, in consultation with OSC, should provide annual training to managers and
supervisors to assure their understanding and implementation of their responsibilities under 5
U.S.C. § 2302. OSC has developed several options to aid agencies in fulfilling this
requirement of the program, including in-person training for executives/managers or larger
groups of employees and a training quiz.
A. What method was used to train supervisors? If possible, please attach a copy of the
training materials. If OSC did not provide the training or materials, please include the date
the materials used were approved by OSC.
B. Number of supervisors at your agency:
C. Number of supervisors trained (training is required for all supervisors):
D. On what dates were supervisor(s) trained?
5. LINK TO OSC’S WEBSITE
Each agency should provide a link from its own website or intranet site to the
OSC website: www.osc.gov.
A. Provide the website address where employees can find a link to the OSC website or a
screenshot of the link on the intranet page.
Confirmation of Completion
Signature of Official Responsible
Date
for Implementing OSC's
Certification Program
Print
Submit to OSC
1. To meet the new annual requirements, agencies will need to submit a one-page checklist to certify their continued
compliance efforts. Agencies will only need to include supporting documentation when submitting their
compliance form every three years.

Download U.S. Office of Special Counsel's Certification Program Compliance Form

467 times
Rate
4.4(4.4 / 5) 33 votes
ADVERTISEMENT
Page of 3