	Human Capital Management

	#210113-D14C-01
	Supplemental Questionnaire


Last Name	First Name

Please check all types of accounts with which you have direct work experience.

Fixed assests accounts

Revenue accounts

Expenditure accounts

Payable accounts

Receivable accounts

I have no experience with any of the listed account types.

Please list the employer and job title where you gained your experience as indicated in the response above. If you indicated "no experience", then please type N/A below.

What experience do you have reconciling accounts?

I have performed this task independently as a regular part of my job.

I have performed this task as a regular part of my job with some supervision.

I am familiar with this task or have received some training on it.

I have no experience with this task.

Please list the employer and job title where you gained your experience as indicated in the response above. If you indicated "no experience", then please type N/A below.

What experience do you have auditing accounts?

I have performed this task independently as a regular part of my job.

I have performed this task as a regular part of my job with some supervision.

I am familiar with this task or have received some training on it.

I have no experience with this task.

Please list the employer and job title where you gained your experience as indicated in the response above. If you indicated "no experience", then please type N/A below.

What experience do you have with budgeting?

I have performed this task independently as a regular part of my job.

I have performed this task as a regular part of my job with some supervision.

I am familiar with this task or have received some training on it.

I have no experience with this task.

Please list the employer and job title where you gained your experience as indicated in the response above. If you indicated "no experience", then please type N/A below.

What is the highest level of work experience you have applying accounting principles?

I have made decisions on the application of accounting principles.

I have recommended the application of accounting principles to others.

I have consulted with a supervisor about the application of accounting principles.

I have independently researched accounting principles.

I have no experience applying accounting principles.

Please list the employer and job title where you gained your experience as indicated in the response above. If you indicated "no experience", then please type N/A below.

What experience do you have making decisions on projects and daily work functions?

I have performed this task independently as a regular part of my job.

I have performed this task as a regular part of my job with some supervision.

I am familiar with this task or have received some training on it.

I have no experience with this task.

Please list the employer and job title where you gained your experience as indicated in the response above. If you indicated "no experience", then please type N/A below.

What is your highest level of experience with government accounting standards?

I have made decisions based on government accounting standards.

I have recommended the application of government accounting standards.

I have consulted with a supervisor about the application of government accounting procedures.

I have independently researched government accounting standards.

I have no experience with government accounting.

Please list the employer and job title where you gained your experience as indicated in the response above. If you indicated "no experience", then please type N/A below.

What experience do you have managing non-recurring or extraordinary entries?

I have performed this task independently as a regular part of my job.

I have performed this task as a regular part of my job with some supervision.

I am familiar with this task or have received some training on it.

I have no experience with this task.

Please list the employer and job title where you gained your experience as indicated in the response above. If you indicated "no experience", then please type N/A below.

What experience do you have educating or training others on policies and procedures?

I have provided education and training on policies and procedures for five years or more.

I have provided education and training on policies and procedures for three to four years.

I have provided education and training on policies and procedures for one to two years.

I have provided education and training on policies and procedures for less than a year.

I have no experience providing education and training on policies and procedures.

Please list the employer and job title where you gained your experience as indicated in the response above. If you indicated "no experience", then please type N/A below.

10.

What experience do you have reviewing the work of other employees?

I have performed this task independently as a regular part of my job.

I have performed this task as a regular part of my job with some supervision.

I am familiar with this task or have received some training on it.

I have no experience with this task.

Please list the employer and job title where you gained your experience as indicated in the response above. If you indicated "no experience", then please type N/A below.

11.

What experience do you have directly supervising an accounting unit, project, or program?

I have performed this task independently as a regular part of my job.

I have performed this task as a regular part of my job with some supervision.

I am familiar with this task or have received some training on it.

I have no experience with this task.

Please list the employer and job title where you gained your experience as indicated in the response above. If you indicated "no experience", then please type N/A below.

12.

Please check the following tasks with which you have experience.

Approving Time and leave

Conducting employee performance evaluations

Coaching or mentoring employees

Using progressive discipline or corrective action with an employee

Personnel functions (FMLA, Workers Compensation, Benefits, EEOC)

Hiring or interviewing employees or job applicants

I have no experience with any of these tasks.

Please list the employer and job title where you gained your experience as indicated in the response above. If you indicated "no experience", then please type N/A below.