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OSD/WHS PERSONNEL OUT-PROCESSING CHECKLIST
PRIVACY ACT STATEMENT
AUTHORITY: 5 U.S.C. 301; Director Washington Headquarters Services Memorandum of February 12, 2008 and subsequent WHS Administrative Instruction. PRINCIPAL PURPOSE(S): Used for out-processing of civilian employees, experts, consultants, detailed IPA's, PEEPS, and military personnel, of Office of the Secretary of Defense and all other activities deriving Human Resources Directorate support from Washington Headquarters Services. Out-processing coordination on this form is required for certification of the return of government property and absence of any indebtedness to the government. Additionally, exit briefing coordinations are requested at the separating individual's duty station, Dept. of Defense General Counsel, Defense Facilities Directorate, Financial Management Directorate, and Human Resources Directorate are included as necessary and appropriate. ROUTINE USE(S): None. DISCLOSURE: Voluntary; however, certifications, as provided on this form, that the individual has returned accountable property and satisfied obligations owed the U.S. Government may expedite payment or payments due the individual. Social Security Number is no longer required on this form. 1. EMPLOYEE NAME (Last, First, Middle Initial) 3. ORGANIZATION 6. NEW EMPLOYER/AGENCY/ACTIVITY 8. TELEPHONE NUMBER (Include Area Code) 4. CHECKOUT DATE (YYYYMMDD) 2. SERIES/GRADE/PAY BAND 5. REASON FOR DEPARTURE

7. FORWARDING ADDRESS (Include Zip Code)

CHECKLIST
Please use this checklist for the items below, for certification of the return of property, the absence of indebtedness, and for exit briefings. A. ITEM 1. Duty Activity Clearance a. Administrative Officer (respective employee's organization) (1) Security (see separate checklist) (2) Parking Permit (if Pentagon) (3) NCR Mass Transit Subsidy (if transferring outside DoD) (4) Notification to Defense Travel System (DTS) Administrator (5) Government Cards (all Government travel cards to include travel, IMPAC, etc.) (6) Organizational Metro Card Program (7) Property pass/hand receipt (if needed for personal items) (8) Settlement of SecDef Mess Bills (9) Return of assigned self-propelled vehicles (if appropriate) (10) Other inventory-related/accountable items returned b. Emergency Planning (COOP Administrator) (1) Return of Escape Mask Equipment (2) Remove employee from emergency notification system and COOP status (3) Remove employee information from DFD Emergency Preparedness List c. Supervisor (1) Timekeeper notification (2) Telephone password and voice mail message resets (3) Ensure access accounts are deactivated (to include DCPDS access, DCIPS
access, 419 access, 474 access, ICE Manager access, FMD access, auto reply for email, access for supervisor to retrieve email, and notification to ITMD for deactivation of network account)

B. PRINT NAME/INITIAL/DATE Room:

Room:

Room:

(4) Initiate change to any on-line subscriptions received by employee and funded by WHS (5) Personal equipment/property audit (6) Close-out of performance plan (should be done well in advance of departure) d. Information Technology (employee's respective IT domain manager) (1) Return of computer laptop, BlackBerry, cell phone, pager, thumb drive, etc. (2) Deactivate network account (to include user ID) (3) Data directory cleanup (4) Remove address from organizational lists and global address list (5) Mailbox cleanup 2. Office of General Counsel a. Standards of Conduct exit briefing (call for appointment) (1) DoD General Counsel: (703) 695-3422 - Pentagon (2) WHS General Counsel: (703) 693-7374 - Pentagon Room:

SD FORM 225, OCT 2008

PREVIOUS EDITION IS OBSOLETE

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CHECKLIST (Continued)
A. ITEM 3. Pentagon Library (Bldg PLC2 across Corridor 8 bridge) (if materials checked out) 4. Human Resources Directorate a. Military Personnel Only - Pentagon: (703) 697-1886, Room 5E565 (1) Field Military 201 File and Allied Records (2) Evaluations (3) Army Finance From (YYYYMMDD): b. Civilian Personnel Only (1) Learning & Development Division (training agreements, college courses, etc.) - contact the LDD Customer Satisfaction Center at (703) 604-6852 (2) Benefits Branch (for resignations only - retirements completed in advance of checkout) - contact Benefits Branch at (703) 604-6774 (a) Verify that either resignation or retirement paperwork has been submitted (b) Refer to Benefits Branch regarding entitlements, if not already done To (YYYYMMDD): B. PRINT NAME/INITIAL/DATE

VERIFICATION
1.a. EMPLOYEE SIGNATURE b. DATE (YYYYMMDD)

2.a. ADMINISTRATIVE OFFICER SIGNATURE

b. DATE (YYYYMMDD)

USE THIS SPACE FOR ADDITIONAL REMARKS, IF NECESSARY.

SD FORM 225 (BACK), OCT 2008

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