**2/12/2003** - DRAFT Copy -- Revision in progress

bobbie.g.wood@jsc.nasa.gov

+----------------------------------+----+---+---+---+---+---+--------------+
| Employee Clearance               |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| 1\. Name of Employee             | 2  |   |   |   |   |   |              |
|                                  | \. |   |   |   |   |   |              |
|                                  | Or |   |   |   |   |   |              |
|                                  | ga |   |   |   |   |   |              |
|                                  | ni |   |   |   |   |   |              |
|                                  | za |   |   |   |   |   |              |
|                                  | ti |   |   |   |   |   |              |
|                                  | on |   |   |   |   |   |              |
|                                  | Co |   |   |   |   |   |              |
|                                  | de |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
|                                  |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| 3\. Forwarding Address           |    |   |   |   | 4 |   |              |
|                                  |    |   |   |   | \ |   |              |
|                                  |    |   |   |   | . |   |              |
|                                  |    |   |   |   | E |   |              |
|                                  |    |   |   |   | f |   |              |
|                                  |    |   |   |   | f |   |              |
|                                  |    |   |   |   | e |   |              |
|                                  |    |   |   |   | c |   |              |
|                                  |    |   |   |   | t |   |              |
|                                  |    |   |   |   | i |   |              |
|                                  |    |   |   |   | v |   |              |
|                                  |    |   |   |   | e |   |              |
|                                  |    |   |   |   | D |   |              |
|                                  |    |   |   |   | a |   |              |
|                                  |    |   |   |   | t |   |              |
|                                  |    |   |   |   | e |   |              |
|                                  |    |   |   |   | o |   |              |
|                                  |    |   |   |   | f |   |              |
|                                  |    |   |   |   | S |   |              |
|                                  |    |   |   |   | e |   |              |
|                                  |    |   |   |   | p |   |              |
|                                  |    |   |   |   | a |   |              |
|                                  |    |   |   |   | r |   |              |
|                                  |    |   |   |   | a |   |              |
|                                  |    |   |   |   | t |   |              |
|                                  |    |   |   |   | i |   |              |
|                                  |    |   |   |   | o |   |              |
|                                  |    |   |   |   | n |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
|                                  |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| Part 1 - Activities              |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| Please read instructions before  |    |   |   |   |   |   |              |
| beginning phone clearances       |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| Activities to be cleared by      |    | P |   | C |   |   | Name of      |
| phone before last day:           |    | h |   | l |   |   | Person       |
|                                  |    | o |   | e |   |   |              |
|                                  |    | n |   | a |   |   | Granting     |
|                                  |    | e |   | r |   |   | Clearance    |
|                                  |    |   |   | e |   |   |              |
|                                  |    | N |   | d |   |   |              |
|                                  |    | u |   |   |   |   |              |
|                                  |    | m |   | Y |   |   |              |
|                                  |    | b |   | e |   |   |              |
|                                  |    | e |   | s |   |   |              |
|                                  |    | r |   | N |   |   |              |
|                                  |    | s |   | o |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| > Transportation (Turn in        |    | 3 |   |   |   |   | N/A          |
| > passport)                      |    | 0 |   |   |   |   |              |
|                                  |    | 3 |   |   |   |   |              |
|                                  |    | 3 |   |   |   |   |              |
|                                  |    | 1 |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| > STI Center (Library) (requires |    | 3 |   |   |   |   |              |
| > 24-hour notice)                |    | 4 |   |   |   |   |              |
|                                  |    | 2 |   |   |   |   |              |
|                                  |    | 4 |   |   |   |   |              |
|                                  |    | 5 |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| > Flight Records (Applies only   |    | 4 |   |   |   |   | N/A          |
| > to flight crew members:        |    | 9 |   |   |   |   |              |
| > example- pilots, astronauts*)* |    | 6 |   |   |   |   |              |
|                                  |    | 4 |   |   |   |   |              |
|                                  |    | 4 |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| > Personal Equipment - EAFB      |    | 4 |   |   |   |   | N/A          |
| > (Applies only to flight crew   |    | 9 |   |   |   |   |              |
| > members*)*                     |    | 6 |   |   |   |   |              |
|                                  |    | 4 |   |   |   |   |              |
|                                  |    | 1 |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| > ISD Customer Support Office    |    | 4 |   |   |   |   |              |
| > (PKI, Pagers/Cell Phones)      |    | 6 |   |   |   |   |              |
|                                  |    | 3 |   |   |   |   |              |
|                                  |    | 6 |   |   |   |   |              |
|                                  |    | 7 |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| > ODIN Integrated Control Center |    | 3 |   |   |   |   |              |
| > computer ID                    |    | 4 |   |   |   |   |              |
| > Clearance*(formerly the Help   |    | 8 |   |   |   |   |              |
| > Desk)*                         |    | 0 |   |   |   |   |              |
|                                  |    | 0 |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| > Legal Office (For              |    | 3 |   |   |   |   | N/A          |
| > post-employment counseling --  |    | 3 |   |   |   |   |              |
| > Mandatory for                  |    | 0 |   |   |   |   |              |
| >                                |    | 2 |   |   |   |   |              |
| > GS/GM-15\'s and above;         |    | 1 |   |   |   |   |              |
| > optional for GS/GM-14\'s and   |    |   |   |   |   |   |              |
| > below)                         |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| > Federal Telephone Calling Card |    | 3 |   |   |   |   | N/A          |
|                                  |    | 9 |   |   |   |   |              |
|                                  |    | 9 |   |   |   |   |              |
|                                  |    | 1 |   |   |   |   |              |
|                                  |    | 8 |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| > Bankcard Program Coordinator   |    | 3 |   |   |   |   | N/A          |
|                                  |    | 7 |   |   |   |   |              |
|                                  |    | 6 |   |   |   |   |              |
|                                  |    | 0 |   |   |   |   |              |
|                                  |    | 1 |   |   |   |   |              |
|                                  |    | o |   |   |   |   |              |
|                                  |    | r |   |   |   |   |              |
|                                  |    | 3 |   |   |   |   |              |
|                                  |    | 4 |   |   |   |   |              |
|                                  |    | 2 |   |   |   |   |              |
|                                  |    | 0 |   |   |   |   |              |
|                                  |    | 2 |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| Records Management               |    | 3 |   |   |   |   |              |
|                                  |    | 4 |   |   |   |   |              |
|                                  |    | 0 |   |   |   |   |              |
|                                  |    | 0 |   |   |   |   |              |
|                                  |    | 6 |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| > Organizational Classified      |    |   |   |   |   |   |              |
| > Materials Custodian *(*For     |    |   |   |   |   |   |              |
| > classified material*)*         |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| > Organization Property          |    |   |   |   |   |   |              |
| > Custodian                      |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| > Human Resources                |    |   |   |   |   |   | N/A          |
| > Representative - Schedule Exit |    |   |   |   |   |   |              |
| > Interview                      |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
|                                  |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| **NEBA:** If you wish to convert |    |   |   |   |   |   |              |
| your NEBA policy, call the       |    |   |   |   |   |   |              |
| representative at 713-644-5575.  |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
|                                  |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| 5\. Name of Representative Who   | 6  |   |   |   |   |   |              |
| Obtained Telephone Clearances    | \. |   |   |   |   |   |              |
|                                  | S  |   |   |   |   |   |              |
|                                  | ig |   |   |   |   |   |              |
|                                  | na |   |   |   |   |   |              |
|                                  | tu |   |   |   |   |   |              |
|                                  | re |   |   |   |   |   |              |
|                                  | of |   |   |   |   |   |              |
|                                  | Re |   |   |   |   |   |              |
|                                  | pr |   |   |   |   |   |              |
|                                  | es |   |   |   |   |   |              |
|                                  | en |   |   |   |   |   |              |
|                                  | ta |   |   |   |   |   |              |
|                                  | ti |   |   |   |   |   |              |
|                                  | ve |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
|                                  |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| 7\. Name of Supervisor           | 8  |   |   |   |   |   |              |
|                                  | \. |   |   |   |   |   |              |
|                                  | S  |   |   |   |   |   |              |
|                                  | ig |   |   |   |   |   |              |
|                                  | na |   |   |   |   |   |              |
|                                  | tu |   |   |   |   |   |              |
|                                  | re |   |   |   |   |   |              |
|                                  | of |   |   |   |   |   |              |
|                                  | Su |   |   |   |   |   |              |
|                                  | pe |   |   |   |   |   |              |
|                                  | rv |   |   |   |   |   |              |
|                                  | is |   |   |   |   |   |              |
|                                  | or |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
|                                  |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| Part II - Personal Clearances    |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| Please read instructions before  |    |   |   |   |   |   |              |
| beginning personal clearances    |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| Activities to be cleared in      |    | B | R | C |   |   | Signature of |
| person:                          |    | l | m | l |   |   | Person       |
|                                  |    | d | . | e |   |   |              |
|                                  |    | g |   | a |   |   | Granting     |
|                                  |    | . |   | r |   |   | Clearance    |
|                                  |    |   |   | e |   |   |              |
|                                  |    |   |   | d |   |   |              |
|                                  |    |   |   |   |   |   |              |
|                                  |    |   |   | Y |   |   |              |
|                                  |    |   |   | e |   |   |              |
|                                  |    |   |   | s |   |   |              |
|                                  |    |   |   | N |   |   |              |
|                                  |    |   |   | o |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| Supply and Equipment Management  |    | 4 | 1 |   |   |   |              |
| Officer (You must bring Forms    |    | 1 | 1 |   |   |   |              |
| 1602 signed by organization      |    | 9 | 4 |   |   |   |              |
| property custodian)              |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| Collection Agent (Money owed for |    | 1 | 2 |   |   |   |              |
| travel, telephone bills, etc*.)* |    | 2 | 5 |   |   |   |              |
|                                  |    |   | 7 |   |   |   |              |
|                                  |    |   | A |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| Government-issued Travel Charge  |    | 1 | 1 |   |   |   |              |
| Card*(*Turn in card)             |    | 2 | 3 |   |   |   |              |
|                                  |    |   | 1 |   |   |   |              |
| Outstanding Travel Advances &    |    |   |   |   |   |   |              |
| Vouchers (Turn in)               |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| Payroll -- TLC must be verified  |    | 1 | 1 |   |   |   |              |
| and certified before going to    |    | 2 | 6 |   |   |   |              |
| Payroll office.                  |    |   | 1 |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| NASA Office of Inspector General |    | 4 | 1 |   |   |   | N/A          |
| (Clearance is optional)          |    | 1 | 1 |   |   |   |              |
|                                  |    | 6 | 4 |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| Security (keys, badge, car       |    | 1 | 1 |   |   |   |              |
| decals)                          |    | 1 | 1 |   |   |   |              |
|                                  |    | 0 | 9 |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| > Last Stop: Employee Services,  |    | 1 | 1 |   |   |   | Last Stop:   |
| > Human Resources Office (Bring  |    | 2 | 0 |   |   |   | Co-op Office |
| > most recent Performance        |    |   | 5 |   |   |   |              |
| > Appraisals; GS/GM bring 4 most |    |   |   |   |   |   |              |
| > recent; SES bring 5 most       |    |   |   |   |   |   |              |
| > recent.)                       |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| > As indicated in the above      |    |   |   |   |   |   |              |
| > clearance list, all Government |    |   |   |   |   |   |              |
| > property charged to me and any |    |   |   |   |   |   |              |
| > funds advanced to me have been |    |   |   |   |   |   |              |
| > returned, repaid, or necessary |    |   |   |   |   |   |              |
| > arrangements to do so have     |    |   |   |   |   |   |              |
| > been made.                     |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| 9\. Signature of Employee        | 10 |   |   |   |   |   |              |
|                                  | \. |   |   |   |   |   |              |
|                                  | Da |   |   |   |   |   |              |
|                                  | te |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
|                                  |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| Assistance in converting health  |    |   |   |   |   |   |              |
| insurance and Federal Employees  |    |   |   |   |   |   |              |
| Group Life Insurance (FEGLI) may |    |   |   |   |   |   |              |
| be obtained from Human           |    |   |   |   |   |   |              |
| Resources,                       |    |   |   |   |   |   |              |
|                                  |    |   |   |   |   |   |              |
| Building 12 Room 105 or x30476.  |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+
| JSC Form 537 (Rev )(MS Word Aug  |    |   |   |   |   |   |              |
| 96)                              |    |   |   |   |   |   |              |
+----------------------------------+----+---+---+---+---+---+--------------+

+-----------------------------------------------------------------------+
| Instructions for Completing JSC Form 537                              |
+-----------------------------------------------------------------------+
|                                                                       |
+-----------------------------------------------------------------------+
| Part I \-- Phone Clearances                                           |
+-----------------------------------------------------------------------+
| On or before your last day of work, you or a representative of your   |
| organization (the office secretary or administrative assistant) must  |
| obtain telephone clearances from all listed offices. When this has    |
| been done, you or the representative will complete blocks numbered 5, |
| 6, 7, and obtain the supervisor\'s signature in block number 8.       |
| Employees who have outstanding travel vouchers should submit them to  |
| the Travel Group/LF221, prior to requesting telephone clearance from  |
| the Travel Group.                                                     |
+-----------------------------------------------------------------------+
| Part II - Personal Clearances                                         |
+-----------------------------------------------------------------------+
| On your last day of work, you must personally clear all the offices   |
| listed. Clearances must be obtained for the Government-issued Travel  |
| Charge Card and from the JSC Supply and Equipment Management Officer  |
| and the Collection Agent before clearing the Payroll Office. You must |
| clear these offices in the order listed. Sign your name in block      |
| number 9 and complete the date in block number 10.                    |
|                                                                       |
| Special Instructions for Military Detailees                           |
|                                                                       |
| Activities to be cleared in person by military detailees are the      |
| organization property custodian, the JSC Collection Agent, the JSC    |
| Supply and Equipment Management Officer, and the Security Branch.     |
| *Military personnel are not required to clear through the NASA/JSC    |
| Payroll or Human Resources Offices*. The final clearing office for    |
| military detailees is the USAF Military Personnel Liaison             |
|                                                                       |
| Office (NASA/JSC), Building 4 South, Room 6919.                       |
+-----------------------------------------------------------------------+

Office (NASA/JSC), Building 4 South, Room 6919.