Date of Revision

The revised form is dated April 2000.

Purpose of Revision

We rewrote the form in plain language and added blocks for the authorized agency official to give his/her email address and fax number.

When Available

As soon as the revised OPM Form 1482 is available, the old form will be obsolete. Agencies may locally reproduce the form. Agencies should download the form from our website www.opm.gov/insure/life in PDF-fillable and FormFlow-fillable versions. In the event an agency does not have access to the Internet, the agency headquarters insurance officer may fax a request for copies from OPM's Forms Analysis and Design Team at (202) 606-0910. This form is not available through GSA, GPO, or the OPM Rider.

Previous Editions

Previous editions are not usable.

Abby L. Block, Chief Insurance Policy    and Information Division

Download Letter as PDF File: