U.S. Office of Special Counsel

1730 M Street NW, Suite 218

Washington, DC 20036-4505

certification@osc.gov

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 obligations of 5 U.S.C. § 2302(c), the Dr. Chris Kirkpatrick Whistleblower 

Protection Act, and the Office of Special Counsel Reauthorization Act of 2017. In addition to 

the existing requirements of the program, these statutes require agency heads to ensure that 

their employees receive yearly information about whistleblower protection laws and to 

provide annual supervisory training on how to respond to complaints involving whistleblower 

protections.

1 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 certification@osc.gov.

General Information

Agency or Office Certifying: 

Agency and 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: 

Email: 

Phone: 

Address (to send certificate): 

1. In addition to submitting this form to request certification and recertification (every three years), agencies 

will need to complete an annual certification checklist to ensure ongoing compliance.
 

Requirement Compliance Information

1. POSTINGS AT AGENCY LOCATIONS

Agencies should post the laws regarding prohibited personnel practices (PPPs), 

whistleblowing, and whistleblower retaliation. The posters should be displayed in all 

personnel and EEO offices and/or in other prominent places throughout the agency.

A. Please attach the posters displayed throughout the agency locations.

B. On what date(s) were posters displayed throughout agency locations: 

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 email. 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 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.

B. On what date and how (e.g., email) was this information provided to employees? 

4. SUPERVISORY TRAINING

Each agency, in consultation with OSC, should provide training every three years to all 

managers and supervisors to assure their understanding and implementation of their 

responsibilities under 5 U.S.C. § 2302. OSC offers in-person and virtual training to assist 

agencies with fulfilling this requirement.

Comprehensive PPP Training
X

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, please include the date on which OSC 

approved the materials. 

B. Approximate number of supervisors at your agency: 

C. Approximate number of supervisors trained: 

D. On what date(s) were supervisors trained? 

Annual Supervisory Training

The Dr. Chris Kirkpatrick Whistleblower Protection Act of 2017 requires agencies to train 

supervisors, in consultation with OSC, on how to respond to complaints alleging a violation 

of whistleblower protections. OSC has developed a new PowerPoint presentation and offers 

in-person and virtual training to satisfy this requirement.

A. What method was used to train supervisors? If possible, please attach a copy of the 

training materials. If the agency modified OSC’s slides or developed new materials, please 

include the date on which OSC approved the materials. 

B. Approximate number of supervisors trained:

C. On what date(s) were supervisors trained? 

5. LINK TO OSC’S WEBSITE

Each agency should provide a link from its public-facing website and intranet site to the OSC 

website: https://osc.gov. 

A. Provide the website address where employees can find a link to the OSC website and a 

screenshot of the link on the intranet page (if applicable). 

Confirmation of Completion

Signature of official responsible for 

implementing OSC’s Certification 

Program: