U.S. Army MEDCOM VERA VSIP FY23 Application Form
The U.S. Army MEDCOM VERA VSIP FY23 Application Form is for employees seeking Voluntary Early Retirement Authority (VERA) or Voluntary Separation Incentive Pay (VSIP). It is used to apply for workforce downsizing or restructuring. Ensure all sections are filled correctly and communicate with your supervisor before submission.
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How do I fill this out?
To fill out this form, start by completing Part I, the Employee Section. Ensure all required fields are filled accurately. Lastly, submit the form to your supervisor for completion of Part II.

How to fill out the U.S. Army MEDCOM VERA VSIP FY23 Application Form?
1
Fill out Part I, the Employee Section.
2
Provide all requested personal and work information.
3
Review the declaration and payment terms.
4
Sign and date the form.
5
Submit to your supervisor for Part II completion.
Who needs the U.S. Army MEDCOM VERA VSIP FY23 Application Form?
1
An employee eligible for VERA seeking early retirement.
2
An employee eligible for VSIP seeking separation benefit.
3
A supervisor needing to approve and process the employee's application.
4
HR personnel managing workforce downsizing or restructuring.
5
Commanders or activity heads providing final approval.
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What are the instructions for submitting this form?
Submit your completed form through your servicing Civilian Personnel Advisory Center (CPAC). You can send it via email, fax, or mail. Ensure you have communicated with your supervisor before submission for proper approval and workflow. Emails and fax numbers can be obtained from your local CPAC. It is advisable to keep copies of all submitted documents for your records.
What are the important dates for this form in 2024 and 2025?
Ensure your anticipated retirement/separation date is as early as possible but no later than September 30 for the fiscal year application.

What is the purpose of this form?
The U.S. Army MEDCOM VERA VSIP FY23 Application Form is designed to facilitate workforce downsizing or restructuring. It helps employees seeking early retirement or separation benefits to apply for and receive approval for these incentives. This form ensures proper documentation and workflow for both the employee and the management, leading to efficient and effective workforce management.

Tell me about this form and its components and fields line-by-line.

- 1. Full Legal Name: Employee's complete legal name.
- 2. Pay Plan-Series-Grade: Employee's current pay plan, series, and grade.
- 3. Organization: Current organization or department the employee is part of.
- 4. VERA or VERA/VSIP: Type of retirement or separation being applied for.
- 5. Work Telephone Number: Employee's work contact number.
- 6. Position Title: Employee's current job title.
- 7. Duty Station/City/State: Employee's current duty station location.
- 8. Anticipated Retirement/Separation Date: Expected date of retirement or separation, not later than September 30.
- 9. Retirement System (CSRS or FERS): Indicate the retirement system the employee is under (CSRS or FERS).
- 10. Date Eligible for Retirement: The date the employee becomes eligible for retirement.
- 11. Servicing CPAC: Civilian Personnel Advisory Center servicing the employee.
- 12. Waiver Required for: Indicate if a waiver is required for specific conditions.
- 13. Declaration: Employee's acknowledgment and agreement to the terms and conditions of the incentive.
- 14. Employee Signature: Employee's signature validating the application.
- 15. Date: Date of the application submission.
- 16. Management Section: Section to be completed by the supervisor or management.
- 17. Supervisor Recommendation: Supervisor's recommendation and approval or disapproval.
- 18. Printed Name: Supervisor's printed name.
- 19. Signature: Supervisor's signature validating their recommendation.
What happens if I fail to submit this form?
If you fail to submit this form, you may miss the opportunity to receive VERA or VSIP benefits.
- Missed Incentive: Failure to apply will result in missing out on potential buyout incentives.
- Ineligibility for Benefits: Without submission, you remain ineligible for voluntary early retirement or separation benefits.
How do I know when to use this form?

- 1. Workforce Downsizing: Use when the organization is reducing its workforce.
- 2. Restructuring: Apply when the job position is being restructured.
- 3. Early Retirement: Submit for VERA to apply for early retirement.
- 4. Separation Incentives: Request separation incentives under VSIP.
- 5. Approval Workflow: Required for the approval process involving supervisors and management.
Frequently Asked Questions
How do I fill out the Army MEDCOM VERA VSIP Form?
Complete Part I with your personal and work information, review the declaration, sign, and submit to your supervisor for Part II completion.
Can I edit the form before submitting?
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Use PrintFriendly's digital signature tool to apply your signature electronically.
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Who needs to fill out this form?
Employees seeking early retirement or separation benefits, supervisors, HR personnel, and commanders or activity heads.
What information is required in Part I?
Personal and work information, retirement/separation details, and your signature.
What happens after I submit the form to my supervisor?
Your supervisor will complete Part II and submit it for further approval by command authorities.
How can I ensure my form is approved?
Communicate with your supervisor and ensure all required fields are accurately filled and all necessary approvals are obtained.
Is the buyout amount negotiable?
No, the buyout amount is based on the lesser of $25,000 or the severance pay formula and is not negotiable.
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