AF IMT Form 3902 Application and Approval for off-Duty Employment

AF IMT Form 3902 is a U.S. Air Force IMT (Information Management Tool) form also known as the "Application And Approval For Off-duty Employment". The latest edition of the form was released in March 1, 1995 and is available for digital filing.

Download a PDF version of the AF IMT Form 3902 down below or find it on U.S. Air Force IMT (Information Management Tool) Forms website.

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APPLICATION AND APPROVAL FOR OFF-DUTY EMPLOYMENT
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 974; 10 U.S.C. 8013; Executive Order 9397; DoD 5500.7-R, Sections 2-206 and 2-303.
Provide information for commanders to evaluate proposed off-duty employment, grant approval, and determine impact on duty
PRINCIPAL PURPOSE(S):
performance.
ROUTINE USE(S): Records may be disclosed for any of the blanket routine uses published by the Air Force.
DISCLOSURE: Disclosure of SSN is voluntary. Failure to provide the information could result in disapproval of request for off-duty employment.
SECTION I
1. LAST NAME, FIRST NAME, MIDDLE INITIAL
2. GRADE
3. SSN
4. AFSC
5. ORGANIZATION OFFICE SYMBOL ADDRESS
6. DUTY PHONE
7. DUTY TITLE
8a. NAME OF EMPLOYER
8b. BUSINESS ADDRESS
8c. IS EMPLOYER A DEPARTMENT OF DEFENSE CONTRACTOR?
8d. PHONE NUMBER
(1) YES
(2) NO
(3) DON'T KNOW
9. TITLE OF POSITION OF OFF-DUTY EMPLOYMENT
10. OFF-DUTY PERIODS OF EMPLOYMENT (Days per week; hours per day)
11. JOB DESCRIPTION (Continue on reverse side)
12. NORMAL PERIODS OF MILITARY DUTY (Days per week; hours per day)
I certify that I understand the applicable provisions of the Joint Ethics Regulation (DoD 5500.7-R). I further certify that the
off-duty employment for which I am applying (Mark applicable block): (Note: explain in detail on the reverse of this form any
answer that results in checking a box "will." Checking a box "will" does not automatically result in disapproval, but does require
an explanation).
WILL
a.
b.
13. Bring discredit upon the Air Force, Department of Defense or U.S. Government.
14. Interfere with or be incompatible with my government duties.
16. Require absences during normal military duty hours.
17. Involve any expense to the Air Force or use of government facilities, property or manpower.
18. Endanger my safety or health.
19. Involve the use of my military title or representation before any federal agency.
20. Involve employment with an organization now involved in a strike.
21. Place me in a position that might be incompatible with my rank, position or assignment.
23. Appear to involve a conflict of interest.
25. Violate any U.S., state or local law; ordinance; or Air Force regulation or instruction.
26a. DATE SIGNED
26b. SIGNATURE OF APPLICANT
SECTION II
SUPERVISOR'S RECOMMENDATION
27. RECOMMEND APPROVAL. I HAVE PERSONALLY INTERVIEWED THE APPLICANT AND I HAVE NO OBJECTION TO THE REQUESTED OFF-DUTY
EMPLOYMENT.
29a. DATE SIGNED
29b. NAME AND GRADE OF SUPERVISOR
29c. SIGNATURE
SECTION III
JUDGE ADVOCATE RECOMMENDATION
30. APPROVAL
31. DISAPPROVAL
33a. DATE SIGNED
33b. NAME AND GRADE
33c. SIGNATURE
SECTION IV
34. APPROVED
35. DISAPPROVED
37a. DATE SIGNED
37b. NAME, GRADE AND TITLE
37c. SIGNATURE
AF IMT 3902, 19950301, V3
APPLICATION AND APPROVAL FOR OFF-DUTY EMPLOYMENT
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 974; 10 U.S.C. 8013; Executive Order 9397; DoD 5500.7-R, Sections 2-206 and 2-303.
Provide information for commanders to evaluate proposed off-duty employment, grant approval, and determine impact on duty
PRINCIPAL PURPOSE(S):
performance.
ROUTINE USE(S): Records may be disclosed for any of the blanket routine uses published by the Air Force.
DISCLOSURE: Disclosure of SSN is voluntary. Failure to provide the information could result in disapproval of request for off-duty employment.
SECTION I
1. LAST NAME, FIRST NAME, MIDDLE INITIAL
2. GRADE
3. SSN
4. AFSC
5. ORGANIZATION OFFICE SYMBOL ADDRESS
6. DUTY PHONE
7. DUTY TITLE
8a. NAME OF EMPLOYER
8b. BUSINESS ADDRESS
8c. IS EMPLOYER A DEPARTMENT OF DEFENSE CONTRACTOR?
8d. PHONE NUMBER
(1) YES
(2) NO
(3) DON'T KNOW
9. TITLE OF POSITION OF OFF-DUTY EMPLOYMENT
10. OFF-DUTY PERIODS OF EMPLOYMENT (Days per week; hours per day)
11. JOB DESCRIPTION (Continue on reverse side)
12. NORMAL PERIODS OF MILITARY DUTY (Days per week; hours per day)
I certify that I understand the applicable provisions of the Joint Ethics Regulation (DoD 5500.7-R). I further certify that the
off-duty employment for which I am applying (Mark applicable block): (Note: explain in detail on the reverse of this form any
answer that results in checking a box "will." Checking a box "will" does not automatically result in disapproval, but does require
an explanation).
WILL
a.
b.
13. Bring discredit upon the Air Force, Department of Defense or U.S. Government.
14. Interfere with or be incompatible with my government duties.
16. Require absences during normal military duty hours.
17. Involve any expense to the Air Force or use of government facilities, property or manpower.
18. Endanger my safety or health.
19. Involve the use of my military title or representation before any federal agency.
20. Involve employment with an organization now involved in a strike.
21. Place me in a position that might be incompatible with my rank, position or assignment.
23. Appear to involve a conflict of interest.
25. Violate any U.S., state or local law; ordinance; or Air Force regulation or instruction.
26a. DATE SIGNED
26b. SIGNATURE OF APPLICANT
SECTION II
SUPERVISOR'S RECOMMENDATION
27. RECOMMEND APPROVAL. I HAVE PERSONALLY INTERVIEWED THE APPLICANT AND I HAVE NO OBJECTION TO THE REQUESTED OFF-DUTY
EMPLOYMENT.
29a. DATE SIGNED
29b. NAME AND GRADE OF SUPERVISOR
29c. SIGNATURE
SECTION III
JUDGE ADVOCATE RECOMMENDATION
30. APPROVAL
31. DISAPPROVAL
33a. DATE SIGNED
33b. NAME AND GRADE
33c. SIGNATURE
SECTION IV
34. APPROVED
35. DISAPPROVED
37a. DATE SIGNED
37b. NAME, GRADE AND TITLE
37c. SIGNATURE
AF IMT 3902, 19950301, V3
AF IMT 3902, 19950301 - CONTINUATION SHEET

Download AF IMT Form 3902 Application and Approval for off-Duty Employment

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