Notice of Decision to Remove (Performance)

NOTE 1: Normally the first level supervisor will sign and issue the proposal and the second level supervisor will be responsible for receiving and considering the employee's answer and making a final decision on the matter by issuing a notice of decision.

This sample letter is a decision by a SECOND LEVEL SUPERVISOR to remove an employee for unacceptable performance. Minor editorial changes may be required if other than the immediate supervisor is the proposing official for this action.

NOTE 2: The CPAC is the primary local source of authoritative information and interpretation of policy and procedures concerning civilian discipline and adverse actions and shares in management's responsibility to ensure that actions have merit and comply with governing requirements. Accordingly, written notices of proposed disciplinary, adverse and performance-based actions must be coordinated with the CPAC before delivery to employees.

NOTE 3: Notices of final decisions for adverse actions are coordinated with the Office of the Judge Advocate General (JAG) by the CPAC before delivery to employees by the supervisor. The JAG reviews for legal sufficiency, including whether there appears to be sufficient evidence to support the action.

NOTE 4: Ensure the employee initials and dates receipt of this notice and the original copy is provided to the employee, a copy is retained by the supervisor, and a copy is provided to the CPAC for maintenance in the case folder and to the CPOC for retention in the employee's Official Personnel Folder.

FROM: **Supervisor**
**Office Symbol**

SUBJECT: Notice of Decision to Remove

TO: **Employee**
**Office Symbol**

1. Reference is made to the Notice of Proposed Removal dated **------**,
proposing your removal from the position of **-------------------------** for
**must specify the unacceptable performance on which the removal is based**.
The Notice of Proposed Removal was delivered to you on **------**.

2. You were afforded 30 calendar days in which to reply orally, in writing,
or both to the Notice of Proposed Removal.

**Select the option and paragraph (either a or b) which applies**

a. I received your oral reply on **------**; your written reply on **------**;
your oral and written replies on **------**. I have carefully considered
your reply and the reasons contained in the Notice of Proposed Removal fully
and impartially. I find that the performance problem(s) described in
paragraph **__** of the Notice of Proposed Removal are fully supported,
are sustained, and warrant your removal.

b. You did not reply. In the absence of any reply, I have carefully considered
the reasons contained in the Notice of Proposed Removal fully and
impartially. I find that the performance problem(s) described in paragraph
**__** of the Notice of Proposed Removal are fully supported,
are sustained, and warrant your removal.

3. It is my decision that you be removed effective **contact the CPAC for
effective date** for **same as paragraph 1**. A Standard Form 50,
Notification of Personnel Action, effecting this action is **attached or
forthcoming under separate correspondence**.

4. You may file an appeal with the following Merit Systems Protection Board (MSPB) office by personal or commercial delivery, by facsimile, or by mail: (provide the address, phone and facsimile numbers of the appropriate Board office for filing the appeal). In the alternative, as of October 20, 2003, an appeal may be filed electronically by using the Internet filing option available at the Board's website: For your convenience, a copy of the MSPB appeal procedures is at Attachment 2. Also, a copy of the MSPB appeal form which you may use to file your appeal is at Attachment 3 **a copy
of the form is at 5CFR Part 1201, Appendix I or can be downloaded from MSPB's
homepage at**. If you elect to appeal, you may be represented
by a representative of your choice in filing an appeal. The time limit for
filing an appeal begins the day after the effective date of your removal and
ends 30 days later. This 30-day time frame will be extended if you
and this activity mutually agree, in writing, to attempt to resolve this
matter through an alternative dispute resolution process. This written
agreement must be completed prior to the end of the initial 30-day time
frame for filing an appeal and prior to your filing a timely appeal.

5. **Additional paragraph for employees covered by a negotiated grievance procedure.**

If you do not wish to appeal this action to the MSPB, you have the right to
have this action reviewed under the negotiated grievance procedure. You may
submit a written grievance under the ** name of union** Union-Management
Agreement. If you submit a grievance under the negotiated grievance procedure,
you must file it in accordance with the time frames and procdures specified
in Article **--** of the negotitated agreement. Your grievance should be
presented to **identify the appropriate management official and his/her office symbol**.
You have the right to Union representation at any stage of a grievance related
to this action.

Once you present an appeal of your removal to the MSPB you may not submit a grievance on the same matter; if you decide to submit a grievance regarding your removal you may not submit an appeal to the MSPB.

6. If you wish to read regulations pertinent to this decision or obtain further information about your procedural rights, you may contact **CPAC POC**, Building **------**, Room **------**, telephone number **---------**.

3 Atch **Supervisor's Signature"
**Signature Block**
1. SF-50 **if completed**
2. MSPB Appeal Procedures
3. MSPB Appeal Form

**Management Official Signature** **Date**
**Signature Block**

Employee's Initials and Date of Receipt ________________

Note: All proposed or notice of decisions on disciplinary actions must be reviewed by the CPAC prior to issuances.

Content last reviewed: 6/20/2006-FMJ


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This page was last revised: 7/19/2007