OMB Number 1105-00 Request Organization Input Part 4

OMB Number 1105-0086. Expires xx/xx/xxxx

Attorney Student Loan Repayment Program (2010)

Organization Input - New Requests

Part 4:

Validation and Certification of Eligibility (For Department use).

Information in Part 4 must be signed by the Executive Officer of the component (or equivalent), or
designate.

Attorney's Name:
Please review Part 2 (Justification), Item 2 (High or Unique Qualifications Relevant to DOJ Duties
- or - Special Need of the Department).
In this part of the review, components are asked to recommend the points to be awarded to the applicant
in two key areas of the Justification he or she submitted in Part 2 of the Request for Consideration. The
Justification consists of five areas the attorney must address: Education, High or Unique Qualifications
Relevant to DOJ Duties or Special Need of the Department, Demonstrated Potential Based on Objective
Accomplishments, Basis for a Determination of Recruitment/Retention Difficulty, and a Short Essay.
In the blocks below, components may recommend the number of points to be awarded for two of those
areas. To assist reviewers and applicants, detailed guidance on the relevant areas of interest for each
part of the Justification is provided online in the "Form for New Requesters" at www.usdoj.gov/oarm/aslrp/
requestforconsideration.pdf.
The areas are:
1. “High or Unique Qualifications Relevant to DOJ Duties or Special Need of the Department” (Item 2 of
the Justification)
2. Demonstrated Potential Based on Objective Accomplishments (Item 3 of the Justification).
In summary, areas of interest for Item 2 may include component-identified qualifications or criteria, judicial
clerkship (if relevant to current duties); other knowledge, skills, experience, education, prior employment
or training that contributes to effectiveness as a DOJ attorney, and the manner in which the attorney
contributes to accomplishment of one or more DOJ Strategic Goals.

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2

If attorney based all or part of Part 2 (Justification), Item 2 on specific
component-identified qualifications or criteria listed in Appendix A for
2010, do you agree that he/she meets the requirement? (Please check “N/A” if
the component did not list qualifications or criteria in Appendix A.)

YES
NO
NA

Please recommend a numeric score (from 1 to 40) for Part 2, Item 2
for this attorney. The maximum score is 40. Please note that an attorney's
justification may or may not rely on component-specific criteria. Some components
do not list specific criteria and, for those that do, some attorneys may not qualify.
In any case, the requester's justification must establish "High or Unique
Qualifications Relevant to DOJ Duties" or "Special Need of the Department.")

Please review Part 2 (Justification), Item 3 (Demonstrated Potential Based on Objective
Accomplishments).
Item 3 focuses on overall potential as demonstrated by performance, activities, and
accomplishments. (Incoming attorneys may base their response on current employment or law
school environment). Areas of interest include performance evaluations, ability to train or
mentor others, pro bono or other volunteer or public service activities, other service to the
Department or component, and demonstrated leadership.
Please recommend a numeric score (from 1 to 10) for Part 2, Item 3
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for this attorney. The maximum score is 10.

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Attorney Student Loan Repayment Program (2010)

Organization Input - New Requests

Attorney's Name:
Please review Part 2 (Justification), Item 4 (Basis for a Determination of Recruitment or
Retention Difficulty)
Does Item 4 address the extent to which the attorney's departure would affect
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the Department's ability to carry out an activity or perform a mission-essential
function? (Applies to current DOJ attorneys only. Incoming attorneys are not subject
to this requirement.)

If the answer to this question is "no," do not forward to OARM at this
time. Notify attorney for correction and resubmission. No exceptions

to the receipt deadline at OARM are authorized based on such corrective action.

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YES
NO
N/A

I am the Executive Officer (or equivalent) of
Name of Component, Bureau, Office, Board, or Division

or an authorized designate.

I certify that the attorney's last evaluation was at least at the Fully Successful level under Part 430
of Title 5, CFR, or a similar level of performance under another applicable performance
management system; or that the attorney has been with the Department less than one year and
has not qualified for an evaluation; or, that the attorney is a new hire who has not entered on duty
- ASLRP, if approved, will be based on recruitment.
I certify that the attorney meets the requirements to receive ASLRP (OARM will validate loan data)
[This certification neither endorses nor refutes the justification - Components may attach any
substantive comments it wishes the Panel to consider to the request prior to forwarding to OARM].

Typed name

mm/dd/yy

Signature

Organizations:
• Attach one copy of Parts 3 and 4 to the OARM Packet .
• Attach any component comments for Panel review.
• Forward the entire OARM Packet (Parts 1-4, with Tabs and attachments (as required)),
through OARM (Attention: Deana Willis), to the Program Administration Panel for action.
•

Retain the Component Packet.

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