NIH Merit Promotion Certificate ISSUED BY: ISSUED TO: TYPE OF APPT: Permanent Temporary NTE TENURE: VACANCY ANNOUNCEMENT #: CERTIFICATE #: TITLE/SERIES/GRADE: # OF VACANCIES: PROMOTION POTENTIAL: DUTY LOCATION: DATE CERTIFICATE ISSUED: DATE CERTIFICATE EXPIRES: For additional information please contact: Phone: SIGNATURE OF ISSUING HR SPECIALIST: The candidates listed below are referred for your consideration under the NIH Merit Promotion Program. Please consider carefully the qualifications of each candidate. You may select any of the referred candidates. ACTION* NAME/ADDRESS/PHONE NUMBER REMARKS/EOD DATE SIGNATURE OF SELECTING OFFICIAL TITLE DATE SIGNATURE OF HR SPECIALIST UPON RECEIPT OF RETURNED CERTIFICATE DATE SIGNATURE OF AUDITING HR SPECIALIST AUDIT DATE *Use the following symbols in the Action Column: A=Selected; NS=Not Selected; D=Declined NIH 2265-1 (Rev. 5/14)