File:Form OF-109 - State-USIA Separation Statement.pdf
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Summary
| Description | Form OF-109 -- filled out by employees upon separation from United States Department of State. |
| Date | |
| Source | http://www.gsa.gov/portal/forms/download/115326 |
| Author | United States Information Agency |
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This work is in the public domain in the United States because it is a work prepared by an officer or employee of the United States Government as part of that person’s official duties under the terms of Title 17, Chapter 1, Section 105 of the US Code.
Note: This only applies to original works of the Federal Government and not to the work of any individual U.S. state, territory, commonwealth, county, municipality, or any other subdivision. This template also does not apply to postage stamp designs published by the United States Postal Service since 1978. (See § 313.6(C)(1) of Compendium of U.S. Copyright Office Practices). It also does not apply to certain US coins; see The US Mint Terms of Use.
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| Date/Time | Thumbnail | Dimensions | User | Comment | |
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| current | 17:20, 12 March 2015 |  | 1,275 × 1,650 (549 KB) | Cirt | {{Information |Description=Formed filled out by employees upon separation from {{w|United States Department of State}} |Source=http://www.gsa.gov/portal/forms/download/115326 |Date=1994-09 |Author={{w|United States Information Agency}} |Permission= |ot... |
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