Date of Revision

The revised form is dated April 2000.

Purpose of Revision

We redesigned the form to: 

1) Clarify that it is an assignment form and not a designation of beneficiary form; 
2) Add more room for additional assignees; 
3) Make clear who is submitting the form -- the Insured or an Assignee (reassignment); 
4) Provide examples of sample assignments, and; 
5) Use plain language and question and answer format.

When Available

As soon as the revised RI 76-10 is available, the old form will be obsolete. Agencies can order the form using the OPM Retirement and Insurance Service Rider. The next opportunity to order products from a Retirement and Insurance Service Rider is mid to late June. Agencies can also download the form from the FEGLI website (http://www.opm.gov/insure/life/forms.htm) in PDF-fillable and Forms Flow versions. This form is not available from GSA.

Previous Editions

Previous editions are not usable.

Abby L. Block, Chief Insurance Policy    and Information Division

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