Training Authorization and Evaluation U.S.

Department of Labor
Instructions: Part A is to be completed by employee/authorizing officials for all courses. Part B is to be completed only if there is a direct cost
associated with the training. Part C is to be completed by the employee/supervisor upon course completion. (Detailed instructions on reverse side.)

A. Required Information

1. Name of Employee (Last, First, Middle) 2. Social Security Number

3. Agency, Contact Name and Phone 4. Full Course Title

5. Personnel Office (CCPO) Code: 6. Date Course (Month/Day/Year)

V Begins: Ends: Total Hours:

7. DOL Training Activity/Source

Code Course Cat. Source Code

8. Comments/Special Instructions: 9. Employee Responsibility and Agreement:

I agree to reimburse any training expenses if I do not satisfactorily

complete this course.

I agree to continued service requirements, if applicable (Non-Govt

training over 80 hours).

I certify that I have read and understand the statements on the reverse

Employee signature Date

10. Authorizing Official Signature(s)/Resource Manager(s)

B. Cost Only
11. Training Vendor Name, Address, Telephone & Fax Number 12. Direct Cost (Dollars Only) 13. Vendor (EIN)

Tuition
Books
city state zip
Other
phone fax Total

14. Geographic Location of Training (City/State): city state

15. Training Vendor Submits Invoice to: 16. Agency Location Code (ALC)

17. Accounting Classification Code (22-Digits)

18. Obligating Document Number (completed by Agency)

C. Course Completion Certification

I certify that I did did not complete this course.

19. Employee Signature and Date Supervisor Signature and Date (Agency discretion)

Exception to SF-1 82 Approved by GSA/ITC DL Form 1-101 (Jan/99) Previous editions obsolete

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 TRAINING AUTHORIZATION AND EVALUATION FORM

THE DL1-101 IS TO BE USED TO REQUEST, APPROVE, AND RECORD ALL TRAINING. THE DL1-101 MAY BE USED AS A PAYMENT
DOCUMENT FOR A SCHEDULED INDIVIDUAL COURSE. A MANAGER OR SUPERVISOR WHO WANTS TO PURCHASE AN OFF-
THE-SHELF COURSE OR HAVE A CONSULTANT DESIGN A COURSE FOR A GROUP OF EMPLOYEES MUST FOLLOW STANDARD
PROCUREMENT PROCEDURES FOR OBTAINING AND PAYING FOR SUCH TRAINING. THIS REQUIRES THAT A DL1-1
(DEPARTMENT OF LABOR REQUISITION FOR EQUIPMENT, SUPPLIES OR SERVICES) BE USED TO REQUEST THE APPROPRIATE
PROCUREMENT ACTION. MANAGERS AND SUPERVISORS SHOULD CONSULT THEIR SERVICING PROCUREMENT OR
FINANCIAL SERVICES OFFICE FOR FURTHER GUIDANCE. COMPLETION OF A DL1-101 IS ALSO REQUIRED FOR ALL TRAINING
PROCURED THROUGH A DL1-1.
COMPLETION INSTRUCTIONS
A. REQUIRED INFORMATION 1. Through 4. Self explanatory.

5. PERSONNEL OFFICE CODE - Select appropriate Servicing Personnel Office CODE:

VA=BOS VC=PHIL VE=CHI VG=KC VI=SF VK=CPSC VM=ETA VP=MSHA VS=SOL

VB=NY VD=ATL VF=DAL VH=DEN VJ=SEA VL=ESA VN=BLS VR=OSHA VZ=OIG
6. DATE COURSE BEGINS AND ENDS AND TOTAL HOURS: Assure that all dates are filled in using the sequence - Month/Day/Year (e.g.,
01/09/03 for January 9, 2003).
7. DOL TRAINING ACTIVITY/SOURCE CODE: Select a code which best describes the Course Category and Source of Training.
______________1st Block=Course Category_______________ ____________2nd Block =Training Source Category____________

E=Executive A=Administrative/Office Skills I=Internal/OHR/CLCMC L=College, Professional Ass.

M=Managerial/Supervisory O=Other J=Other Internal DOL Training M=Private Industry or Other
P=Professional/Technical K=Inter-Agency (e.g., OPM)
8. COMMENTS/SPECIAL INSTRUCTIONS: This block should include such things as special accommodations; designate training procured
through DL 1-1 and any agency-specific requirements.

9. EMPLOYEE RESPONSIBILITY AND AGREEMENT: I agree to satisfactorily complete the training for which I am being nominated.
(Satisfactory completion means: ungraded courses--satisfactory completion of necessary course work and attendance requirements; graded courses--
the final grade received must be one which is acceptable for academic credit by the facility.) I understand that if I fail to satisfactorily complete the
training, withdraw for unacceptable reasons or change from credit to audit without prior approval, I will be responsible for reimbursing the
Department for any funds (excluding salary) expended for the training.

Agreement to Continue in Service: In consideration of the Department’s paying my training expenses, I hereby agree to complete the training
described herein. Upon completing the training, I agree to continue serving in the Department for at least three times the number of hours spent in
training, unless I am involuntarily separated from the Department. In addition, I agree to give the head of my Agency or office at least ten workdays’
notice in writing if I decide to enter the service of another agency of the Federal Government before completing this period of service. If I fail to
give the required advance notice before entering the service of another Federal agency, or if I otherwise leave the service of the Department
voluntarily before completing the agreed period of service, I agree to refund to the Department any sums that have been paid by the Department in
connection with the training (other than salary), unless waived in whole or in part by the parent agency.

10. AUTHORIZING OFFICIAL SIGNATURE(S)/RESOURCE MANAGER(S): Signature authority is at agency discretion. More than one
signature may be necessary to meet agency requirements, i.e., supervisory signature to approve training, authorizing official and/or human resource
manager to certify availability of funds. Check with your Administrative Office for specific requirements for your agency.
B. COST ONLY 11. Self explanatory
12. DIRECT COSTS: All Direct Cost must be reported. Do not include Travel, Per Diem or any cost related to Indirect Cost on this form.
13. VENDOR EIN: Completed by Agency Administrative Office or Training Office. For each Direct Cost, enter either the vendor’s Federal
Employer Identification or Social Security number, as applicable.

14. LOCATION OF TRAINING: City or State where training actually takes place.
15. TRAINING VENDOR SUBMITS INVOICE TO: Completed by Agency Administrative Office or Training Office.
16. AGENCY LOCATION CODE (ALC): Central Personnel Services Center (CPSC)& SOL = 16012014
BLS = 16012011 OSHA = 16012012 NY = 16012002 CHI = 16012005 DEN = 16012008
ESA = 16012013 MSHA = 16120001 PHIL = 16012003 DAL = 16012006 SF = 16012009
ETA = 16012016 BOS = 16012001 ATL = 16012004 KC = 16012007 SA = 16012010
17. ACCOUNTING CLASSIFICATION CODE: Self explanatory.
18. OBLIGATING DOCUMENT NUMBER: Completed by Agency Administrative Office or Training Office.
C. COURSE COMPLETION 19. Employee signature required, Supervisor signature is at Agency discretion.
CERTIFICATION