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CODE.SOFTWARE CODE - FORM TITLE -
REVISION DATE
Building 36 AHCS
- 36NSCHKL.PDF
- NINDS/NIDCD Animal Study Proposal Check List - None
Animal and Plant Health
Inspection
Service
Award Forms
- AWCASHCL.PDF
- Cash Award for Recruitment of Clerical and Stay-in-School Clerical
Employees - 9/89
- AWMERITG.PDF - Nomination for NIH Merit Award - Group - None
- AWMERITI.PDF
- Nomination for NIH Merit Award - Individual -
None
- AWSMPUR.PDF
- Nominations for Outstanding Service in Small Purchases - None
- AP2000.PDF
- APHS-2000 - USDA Application for Permit or Courtesy Permit Under 7
CFR 340 - 7/89
- CD -
Commerce Department - Link to forms website.
- CDC75_3.PDF
- CDC-75-3 - Application for Permit to Import or Transport Agents or
Vectors of Human Disease - 9/91
- CDCEA101.PDF
- CDC-EA-101 - Transfer of Select Agent - 7/97
- CKLISTOVER2500.PDF
- Documentation For
Simplified/Commercial Item Acquisitions Actions Greater Than $2,500 -
1/02 - Entire form, no electronic
fill-in. The following three files contain all 10 pages, and have
electronic fill-in capability:
- CKLISTOVER2500_1.PDF
- Documentation For
Simplified/Commercial Item Acquisitions Actions Greater Than $2,500 -
1/02 - Pages 1 and 2 only.
- CKLISTOVER2500_2.PDF
- Documentation For
Simplified/Commercial Item Acquisitions Actions Greater Than $2,500 -
1/02 - Pages 3 through 6 only.
- CKLISTOVER2500_3.PDF
- Documentation For
Simplified/Commercial Item Acquisitions Actions Greater Than $2,500 -
1/02 - Pages 7 through 10 only.
- CKLSRVAC.PDF - Checklist for Service Acquisitions -
None
CIT Forms
NIDDK Forms
- DKPNKSHT.PDF
- NIDDK Pink Sheet - None
- DKPRTCL.PDF
- NIDDK Animal Study Proposal - None
- ENRGYSTR.PDF - NIH OIRM Energy Star Exemption Report -
None
- EXTGRWRK.PDF
- Application for Workshop on Extramural
Programs and Grant Support - None
NEI Forms
Ethics Forms
- ETHICS FORMS - For all
ethics forms used at NIH, go to the NIH Ethics Program website.
FAES Forms
- FAF.PDF
- Request to FAES for Administration for
Fellowship - 8/1/91
- FAFELLOW.PDF
- FAES Fellowship Program - Fellowships - None
- FAG.PDF
- Request to FAES for Administration for
Fellowship - 8/1/91
- FAMENTOR.PDF
- FAES Fellowship Program - Mentor-Based Fellowships - None
- FASUMGRT.PDF
- Application for FAES Summer Student Grant -
None
- FAX.PDF
- FAX Transmittal Sheet - None
Fogarty Center Forms
- FCJVERC.PDF
- Fogarty Center Request for Extension of J-1 Visa by DOS - 3/21/00
- FCNH590.PDF - Fogarty Center Special Volunteer and
Guest Research Assignment (for use with Professional Services) - 5/96
- FCNOTINT.PDF - Fogarty
International Center Notification of International Travel - None
- FCTERM.PDF
- Fogarty Center Program Termination - 12/14/90
- FCVISA.PDF
- Fogarty Center Supporting Documentation for
Non-NIH Visiting Program Participant - 1/13/97
- FCVISA01.PDF
- Fogarty Center Supporting Documentation for
Non-NIH Visiting Program Participant - 2/09/96
FEGLI Forms
- FE6.PDF -
FEGLI - Claim for Death Benefits (Link takes you to OPM's website)
- FE6DEP.PDF
- FEGLI - Settlement of Claim; Option C -- Family Life Insurance (Link takes you to OPM's
website)
- FE7.PDF -
FEGLI - Claim for Dismemberment Benefits (Link takes you to OPM's website)
- FILCLNUP.PDF
- Files Cleanup Campaign - None
- FIPAWARD.PDF - FIP Contract Award Data Sheet - None
- FIPCHKLS.PDF - OIRM FIP Justification Checklist - None
- GE201.PDF - OGE-201 - Request to Inspect or Receive
Copies of SF 278 Executive Branch Personnel Public Financial Disclosure
Report or Other Covered Record - 7/96
- GE202.PDF - OGE-202 - Notification of Conflict of
Interest Referral - 7/98
- GE203.PDF - OGE-203 - Senior Appointee Pledge - 1/93
- GE450.PDF
- OGE-450 - Office of Government Ethics
Executive Branch Confidential Financial Disclosure Report - 2/96
- GE450A.PDF
- OGE-450A - Confidential Certificate
of No New Interests (Executive Branch) - 4/97
- GFTFNDIN.PDF
- Initiative for the Use of Gift Funds - None
- GRAGREE.PDF
- Guest Researcher Agreement - None
GSA Forms
- GSA - General Services Administration - Link to Web Site
NICHD Forms
- HDMANCLR.PDF
- NICHD Publication and Abstract Clearance Form - 4/00
- HDFORTRVL.PDF - NICHD Individual Foreign Trip Travel
Request - None
- HDPRFPLN.PDF
- NICHD Performance Plan - None
- HDPROFSV.PDF
- NICHD Professional Services Contract Worksheet - None
- HDRPRNT.PDF -
NICHD Reprint Order - None
- HEALTH
INSURANCE - Link to OPM's Web Site
- HISTOBJART.PDF - DeWitt Stetten, Jr., Museum of Medical
Research Background Information on Artifacts - None
- HISTOBJINS.PDF - DeWitt Stetten, Jr., Museum of Medical
Research Background Information on Instruments - None
HHS Forms
Many links go to the Health
and
Human Service's forms websites, http://www.hhs.gov/forms
and http://intranet.hhs.gov/forms.
- HS1.PDF - HHS-1 - Travel Order - 7/89 - Use ONLY when the NBS system is down.
- HS16.PDF - HHS-16 -
Request to Use Government Furnished Vehicle for Transportation Between
Domicile and Place of Employment - 6/83
- HS22.PDF - HHS-22 - Request for Property Action - 4/98
- HS33.PDF
- HHS-33 - Probationary Employee Certification and Recommendation - New
Appointments - 9/80
- HS33A.PDF
- HHS-33A - Probationary Employee Certification and Recommendation -
Supervisors/Managers - 9/80
- HS68.PDF - Obsolete - HHS-68 - Request for Staff Manual
Materials and Mailing List Changes - 4/91
- HS99.PDF
- HHS-99 - Authorization to Attend Non-Government Sponsored Meetings -
9/82
- HS170.PDF
- HHS-171 - DHHS Employee Suggestion Form - 12/87
- HS171.PDF
- HHS-171 - DHHS Recommendation for Cash Award -
12/87
- HS311.PDF
- HHS-311 - Official Personnel Folder
Transmittal - 1/81
- HS330.PDF - HHS-330 - Intra-Departmental Delegation of
Authority (IDDA) - 8/00
- HS342.PDF - HHS-342 - Report of Survey (Link goes to
HHS's website)
- HS348.PDF - HHS-348 - Request for Approval for
Acceptance of Payment of Travel Expenses in cash or In Kind - 9/76
- HS348CKL.PDF - HHS-348 Checklist - 9/76
- HS355.PDF
- HHS-355 - DHHS Employment Agreement for
Transfers to and Within the Continental United States - 3/81
- HS355A.PDF
- HHS-355A - DHHS Employment Agreement for
Transfers and Appointments Overseas - 2/83
- HS355B.PDF
- HHS-355B - DHHS Employment Agreement for
Manpower Shortage Positions in the 50 States and the District of
Columbia - 3/81
- HS357.PDF
- HHS-357 - DHHS Notification of U.S. Savings
Bond Action, Series EE - 3/95
- HS402.PDF - HHS-402 - Requisition for Equipment and
Supplies - None
- HS410.PDF
- HHS-410 - DHHS Supplemental Information -
Expert or Consultant - 12/77
- HS411A.PDF -
HHS-411A - Leave Error Notice (Link goes to
HHS's website)
- HS411B.PDF -
HHS-411B - Leave Error Notice (Link goes to
HHS's website)
- HS419.PDF
- HHS-419 - Clearance of Personnel for
Separation or Transfer - 7/90
- HS420.PDF
- HHS-420 - Timekeeper's Signature Card - 3/81
- HS441.PDF - Obsolete - HHS-441 - Assurance of Compliance
with the Department of Health and Human services Regulation Under Title
VI fo the Civil Rights Act of 1964 - 12/82
- HS441A.PDF - Obsolete - HHS-441A -
Explanation of HHS Form No. 441, Assurance of Compliance with the
Department of Health and Human Services Regualtion Under Title VI of
the Civil Rights Act of 1964 - 3/81
- HS474.PDF - Obsolete -
HHS-474 - Confidential Statement of Employment and Financial Interests
- 3/77 - Superseded by
OGE Form 450 - “Confidential Financial Disclosure Report�
- HS476.PDF
- HHS-476 - DHHS Record of Home Address - 1/90
- HS477.PDF -
HHS-477 - Timekeeper Number Change - 3/66
- HS478.PDF
- HHS-478 - Payroll Number Correction - 11/83
- HS481.PDF
- HHS-481 - Employee Claim for Loss or
Damage to Personal Property - 3/81
- HS520.PDF - HHS-520 -
Request for Approval of Outside Activity - Link goes to the NIH Ethics Program
website.
- HS521.PDF - HHS-521 -
Annual Report of Outside Activity - Link goes to the NIH Ethics Program
website.
- HS532.PDF
- HHS-532 - DHHS Request for Approval of
Nominees for Public Advisory Committees - 1/82
- HS565.PDF
- HHS-565 - DHHS Report
of Accountable Personal Property - 9/98
- HS581.PDF
- HHS-581 - DHHS Recommendation for Quality
Increase - 3/86
- HS596.PDF
- HHS-596 - DHHS Protection of Human Subjects
Assurance/Certification/Declaration - 1/82
- HS639A.PDF - Obsolete - HHS-639A -
Assurance of Compliance with Title IX of the Education Amendments of
1972 and the Regulation Issued by the Department of Health and Human
services Implementation Thereof - 3/77
- HS651.PDF
- HHS-651 - DHHS Initial Interview and
Information EEO Counseling Report - 1/8
- HS652.PDF
- HHS-652 - DHHS Final EEO Counseling Report -
1/88
- HS653.PDF- Revised - HHS-653 - HHS Small Business Review Form - Please use the Microsoft Word version, dated 1/08
- HS690.PDF - HHS-690 - Assurance of Compliance - 5/97
- HS691.PDF
- HHS-691 - Request for Special Pay for Physicians and Dentists - 6/98
- HS691_1.PDF
- HHS-691-1 - Employee Agreement to Receive Special Pay for Physicians
and Dentists Under Title 38 - 6/98
- HS697.PDF
- HHS-697 - Foreign Activities Questionnaire - Link goes to the NIH Ethics Program
website.
- HS717_1 - HHS-717-1 - Confidential
Report of Financial Interests in Substantially Affected
Organizations for Employees of the NIH - Link goes to the
NIH Ethics Program website.
- HSPROOBL.PDF
- DHHS Procurement Officials Certification of
Continuing Obligation - 8/20/97
- HSRPYAGR.PDF
- DHHS Installment Repayment Agreement for
Transferring Personnel - 8/20/97
- HTLTAX.PDF - Hotel
Occupancy Tax Exemption Certificate - 10/86
- HOTEL
TAX - Travel Management Policy State Tax Exemption Web Site
- HUSBREV.PDF
- Request for Review of Research Activity Involving Human Subjects -
None
- HUSBSLPR.PDF
- Request for Single Project Assurance Negotiation - None
- IMAPPL.PDF - Impac Purchase Card Application Form - Replaced by PURCH-NEW.PDF
- IMMSC.PDF
- Level IV MSC Security Statement - 5/12/95
- IMUSER.PDF
- Level IV User Security Statement - 5/12/95
- INS - Link to Web Site for Immigration
and Naturalization Service Forms
- INFECMTRL.PDF
- Registration of Materials (Potentially) Infectious for Humans - 6/99
- IMMUNREQ.PDF - Travel
Immunization Request Form - None
- INTLLVWAIV.PDF - NEW - NIH International Travel Waiver Form -
5/06
- INVEMREC.PDF
- Inventory of Emergency Operating Records - None
- IRS8233.PDF
- IRS-8233 - Exemption from Withholding on Compensation for Independent
(and Certain Dependent) Personal Services of a Nonresident Alien
Individual - 10/96
IRTA Forms
- IRTAAGRE.PDF
- NIH Intramural Research Training Award Program
IRTA Fellowship Agreement - 3/13/98
- IRTAPROV.PDF
- NIH Intramural Research Training Award Program
Program Provisions - 3/13/98
- IRTASPAG.PDF - Obsolete - NIH Intramural
Research Training Award Program Supplemental IRTA Fellowship Agreement
- None
- IRTASTAG.PDF - Obsolete - NIH Student
Support IRTA Program Student Support IRTA Fellowship Agreement - 11/1/94
- I-9.PDF
- I-9 - Employment Eligibility Verification - 11/21/91
- LEAVE_REC 2008.PDF
- Personal Leave Record for 2008
- MANLOG.PDF
- Manual Log Voluntary Leave Transfer - None
- MVA - All
States - Link to Web Site
- MVA
- Maryland - Link to Web Site
NCI Forms
- NCIASP.PDF
- NCI Animal Study Proposal (NIH 2643-1) - 4/02
NIH Forms
- NH29_2.PDF - NIH 29-2 - Revised
- Request for Safety Glasses - 10/06
- NH69.PDF - NIH 69 - Request for Services - 4/77
- NH75.PDF
- NIH 75 - Request for Translating Service - 10/04
- NH79_3.PDF
- NIH 79-3 - NIH Centralized Animal Order Request - 10/90
- NH88_1.PDF
- NIH 88-1 - Request for Purchase and Use of Radioactive Materials -
7/00
- NH88_12.PDF - NIH 88-12 - Monthly Laboratory
Contamination Survey - 12/99
- NH88_16 - NIH-88-16 - Isotope Receipt,
Utilization and Disposal Record - Obsolete
- NH88_22.PDF - NIH 88-22 - Radiation Safety Branch
User Registration Record - Obsolete
- NH88_37.PDF
- NIH 88-37 - Radiation Safety Training Orientation Documentation - Obsolete
- NH145_2.PDF
- NIH 145-2 - Request for Official Personnel
Folder (OPF) - 2/87
- NH254.PDF - NIH-254 - Report of Loss or Damage
of Property - 5/92 - Obsolete and
replaced by HHS 342, Report of Survey
- NH356.PDF
- NIH 356 - NIH Visiting Program Acceptance
Notice - 3/03
- NH368.PDF - NIH 368 - Property Pass - 11/86
- NH414_5.PDF
- Obsolete - NIH 414-5 -
Request for NIH Manual Issuances - 8/88
- NH414_6.PDF
- Revised - NIH 414-6 - NIH Manual Chapter Review Record - 6/08
- NH414_7.PDF
- NIH 414-7 - NIH Manual Chapter Concurrence and Approval Record - 7/04
- NH433.PDF - NIH 433 - Request to Change NIH
Directory Information - 7/94
- NH465_1.PDF
- NIH-465-1 - Application for Radionuclide Authorization - 9/05 - Includes Prospective Authorized User Information page.
- NH465_2.PDF
- NIH 465-2 - Prospective Authorized User Information - Obsolete
- NH489_1.PDF
- NIH 489-1 - Nomination for NIH-Sponsored Courses - 11/88
- NH552_2.PDF - NIH 552-2 - Transportation Section
Moving Data Record - 12/64
- NH590.PDF
- NIH 590 - Special Volunteer and Guest Researcher Assignment - 1/99 (Note: Includes a version for use with the
Courtesy Contract and a version for NICHD.)
- NH590-2.PDF
- NIH 590 - NIH Special Volunteer Agreement - 3/98
- NH649.PDF - NIH 649 - Report of Property Transfer -
7/91
- NH649_1.PDF - NIH 649-1 - Shipping/Transfer Order and
Receipt Document - Contract Property - 8/85
- NH649_2.PDF - NIH 649-2 - Report of Loss, Damage or
Destruction of Property - 5/78
- NH649_3.PDF
- NIH 649-3 - Donation of Contractor-Acquired Property - 1/92
- NH649_4.PDF - NIH 649-4 - Transfer of Government
Property Title to SBIR Contractor-Awardee - 12/86
- NH649_6.PDF - NIH 649-6 - Report of Lease Property
Returned to Vendor - 12/94
- NH750_2.PDF
- NIH 750-2 - Request for Medical Determination and Report of Findings
- 6/98
- NH750_3.PDF
- NIH 750-3 - Medical Qualification
Determination Questionnaire - None
- NH827.PDF - NIH 827 - Request for Conference Room -
9/92
- NH827_1.PDF
- Revised - NIH-827-1 - Request for Acquisition of Temporary Commercial Conference Space - 4/08
- NH827_2.PDF
- NIH 827-2 - Request for Use of Lister Hill Auditorium - 6/03
- NH829_1.PDF
- NIH 829-1 - Request for Appointment to NIH
Visiting Program - 3/99
- NH829_2.PDF
- NIH 829-2 - Request for NIH Visiting
Fellowship Award - 3/98
- NH829_5.PDF
- NIH 829-5 - Notification of Termination of
Visiting Program Participation - 1/90
- NH829_6.PDF
- NIH 829-6 - J-1 Exchange Visitor
Program--Certification of Health Insurance Coverage - 4/04
- NH829_6.PDF
- NIH 829-6 - J-1 Visa Program Certification of
Health Insurance Coverage - 5/02
- NH829_7.PDF
- NIH 829-7 - Request for NIH Supplemental
Visiting Fellowship Award - 5/95
- NH1154_3.PDF
- NEW - NIH 1154-3 - Final Certification of
Acceptable Costs - 1/07
- NH1192.PDF
- NIH 1192 - Animal Health and Shipping Certificate - 11/80
- NH1382_2.PDF
- NIH 1382-2 - Motor Vehicle Trip Ticket - 9/93
- NH1531_1.PDF
- NIH 1531-1 - Request for Special Report from
Taps - 12/81
- NH1533.PDF - Obsolete - NIH
1533 - Nomination for DCRT Computer Training - 12/90
- NH1590.PDF -
NIH 1590 - Acquisition Worksheet - 9/92
- NH1616_1.PDF - NIH 1616-1 - Request for Publication
and Speech Clearance - 9/96
- NH1616_2.PDF
- NIH 1616-2 - Request for Publication and Speech Clearance - 11/73 (Note - Includes NICHD version)
- NH1616_3.PDF - NIH 1616-3 - Request for NIAID Approval
of Publication or Presentation - 7/92
- NH1616_4.PDF
- NIH 1616-4 - Request for Approval of Publication or
Presentation - 5/84
- NH1625.PDF
- NIH 1625 - Equipment Temperature Record - 3/70
- NH1688_1.PDF - NIH 1688-1 - Project Objectives - 9/02
- NH1742.PDF
- NIH 1742 - Agency Agreement and Clearance -
7/99
- NH1757_1.PDF
- Obsolete - Justification for Other than Full and Open Competition
(JOFOC) - Please see the Office of Acquisition Management and Policy (OAMP) website.
- NH1757_7.PDF
- Obsolete - Justification for Other than Full and Open Competition
(JOFOC) - Please see the Office of Acquisition Management and Policy (OAMP) website.
- NH1767_1.PDF - NIH 1767-1 - DCRT Account Authorization - Please see the CIT
Account Forms website.
- NH1767_2.PDF - Obsolete - NIH 1767-2 - DCRT Information Change
Notice
- NH1767_3.PDF - NIH 1767-3 -
DCRT Outside Account Authorization Interagency Agreement - Please see the CIT
Account Forms website.
- NH1767_4.PDF - NIH 1767-4 -
Interagency Agreement for Annual Renewal of DCRT Outside Account
Authorization - Please see the CIT
Account Forms website.
- NH1767_5.PDF - NIH 1767-5 -
Deregistration Official Authorization for DCRT Accounts - Please see the CIT
Account Forms website.
- NH1820.PDF - NIH 1820
- Notification of Proposal to Make an Award - 1/96
- NH1861_1.PDF
- Revised - NIH-1861-1 - Purchase Request - 3/08
- NH1861_3.PDF - NIH 1861-3 - Requisition Worksheet -
11/89
- NH1861_9.PDF
- NIH 1861-9 - Requisition Worksheet - 10/92
- NH1872.PDF - NIH
1872 - Request for Trade-in or Exchange of Government-Owned Property -
1/96
- NH1884 - Note - This form
should not be done in electronic format. Shipping requests will soon be
done via DelPro and these forms have unique Serial Numbers which are
needed in the shipping unit's tracking system. This system can not
accept duplicate Serial Numbers.
- NH1884_1.PDF - NIH 1884-1 - Commercial Invoice - 12/89
- NH1962_1.PDF
- NIH 1962-1 - Request for and Authorization (or Approval) of Overtime
Work - 7/72
- NH1962_2.PDF
- NIH 1962-2 - Overtime Request and Approval Record - 4/86
- NH1962_8.PDF
- NIH 1962-8 - Request for Approval and Authorization of Overtime
- NH1964_1.PDF
- NIH 1964-1 - Record of Witness of Disposal of Controlled Substances -
8/92
- NH2010.PDF
- NIH 2010 - Notice of Financial Action on
Fellowship Award - 3/93
- NH2027.PDF - NIH 2027 - Report of Leave as Shown in
Itinerary of Travel Voucher - 12/72
- NH2028.PDF
- NIH 2028 - Request for Permanent Change of
Station Orders--Civilian Personnel and Other Appointed Persons - 10/02,
pamphlet revised 1/03
- NH2028-1.PDF
- NIH 2028 - Request for Permanent Change of
Station Orders--Non-FTE Persons - 10/02
- NH2066.PDF - NIH 2066 - Record of Personal Appeal
Items - 10/81
- NH2138.PDF
- NIH 2138 - Key/Lock Work Request - 1/89
- NH2144.PDF
- NIH 2144 - Fellowship Termination Notification
- 7/90
- NH2179.PDF - NIH 2179 - Agreement for the Loan of
Property to NIH - 9/91
- NH2245.PDF
- NIH 2245 - Application for Continuing
Education Program Staff Training in Extramural Programs (STEP) - 9/95
- NH2252_1.PDF
- NIH 2252-1 - Knowledges, Skills, and Abilities
(KSA) Job Analysis - 3/91
- NH2252_2.PDF
- NIH 2252-2 - Knowledges, Skills, and Abilities
(KSA) Crediting Plan - 3/91
- NH2252_3.PDF
- NIH 2252-3 - Knowledges, Skills, and Abilities
(KSA) Supplemental Form - 3/91
- NH2272.PDF
- NIH 2272 - Record of Congressional
Inquiry Received by Telephone - None
- NH2298.PDF
- NIH 2298 - Authorization to Release Student
Information - 5/95
- NH2333.PDF - NIH 2333 - NRSA Special Action/Change
Notice - 3/86
- NH2345.PDF - NIH 2345 - Report of Rental Equipment
and Services Received - 7/81
- NH2369_1.PDF
- NIH 2369-1 - Application for Permit to Introduce Rodents and Rodent
Products - 8/04
- NH2369_2.PDF
- New - NIH 2369-2 - Rodent
Quarantine Release - 8/05
- NH2386_3.PDF
- NIH 2386-3 - Administrative Time and Leave Record - 1/80
- NH2388.PDF - Revised
- NIH 2388 - Declaration for Exportation of Biologic Materials - 11/06
- NH2408.PDF
- NIH 2408 - Request for Use of Gift
Funds (for Other than Entertainment Expenses) - 2/04
- NH2408_1.PDF
- NIH 2408-1 - Request for Use of
Appropriated Funds/Gift Funds for Light Refreshments/Meals and Other
Entertainment Expenses - 2/04
- NH2489.PDF - Personal Property Loan Record - Obsolete and replaced by NIH 2489-2 and NIH 2489-3
below.
- NH2489_1.PDF - NIH 2489-1 - Record of Loan-Donation of
Personal Property to Foreign Countries - 6/94
- NH2489-2.PDF - NIH 2489-2 - Record of Personal
Property Loan to Non-Federal Government Organizations or Individuals -
10/99
- NH2489-3.PDF - NIH 2489-3 - Record of Personal
Property Loan to Federal Organizations or Individuals - 10/99
- NH2500.PDF - NIH 2500
- Notification of Organization Change - 9/04
- NH2512_2.PDF
- NIH 2512-2 - Request for Organization
Change - 8/90
- NH2513.PDF - NIH 2513 - Record of Expenses for
Travel Reimbursement - 6/82
- NH2539_4.PDF
- NIH 2539-4 - Acknowledgment of Application and
Report of Action Taken - 11/90
- NH2542_1.PDF - NIH 2542-1 -
Election of Health Insurance Plan Through FAES - 5/90 (Electronic
versions of this form are unacceptable. If your Administrative Office
does not have a copy, contact OFM at 496-5635, 31-B1B06.)
- NH2542_2.PDF - NIH 2542-2 - Election of Health Insurance
Plan Through Private Company - 7/90 (Electronic versions of this form
are unacceptable. If your Administrative Office does not have a copy,
contact OFM at 496-5635, 31-B1B06.)
- NH2544.PDF - NIH 2544 - Professional Services
Acquisitions - 11/85
- NH2555.PDF - NIH 2555 - Order for Supplies or
Services - 12/94
- NH2555_1.PDF - NIH 2555-1 - Purchase Order Terms and
Conditions for Supplies and Services - 11/91
- NH2555_4.PDF
- NIH 2555-4 - Addendum to Terms and Conditions of Purchase Order -
11/91
- NH2558.PDF
- OMS Medical Evaluation of Functional Activities - 4/04
- NH2560.PDF
- NIH 2560 - Request for Restoration of Annual Leave - 11/84
- NH2562.PDF
- NIH 2562 - Report of Joint Endeavor Between NIH and Commercial,
For-Profit Organizations - 9/88
- NH2570.PDF - NIH 2570 - Checklist for Microfilming
Projects - 11/90
- NH2573.PDF - NIH 2573 - Request for Mailing and
Distribution Services - 7/85
- NH2581.PDF - NIH 2581 - Tentative Estimate of Foreign Area
Allowances and Differentials - 5/86
- NH2582.PDF - NIH 2582 - Contractor's Release for All
Contracts - 6/86
- NH2585.PDF - Obsolete - NIH 2585 -
Individual Performance Plan - 10/90
- NH2590.PDF
- NIH 2590 - Request for Intramural Research Training Award (IRTA) -
5/97
- NH2590_1.PDF
- NIH 2590-1 - Verification of U.S. Citizenship
or Permanent Residency Status NIH Intramural Research Training Award
(IRTA) Program - 2/88
- NH2590_2.PDF
- NIH 2590-2 - Request for Supplemental Intramural Research Training
Award (Supplemental IRTA) - 6/97
- NH2590_3.PDF
- NIH 2590-3 - Request for Student Support
Intramural Research Training Award (Student Support IRTA) - 11/94
- NH2590_4.PDF
- NIH 2590-4 - Request for Technical Intramural Research Training Award
(Technical IRTA) - 7/95
- NH2604.PDF
- NIH 2604 - Delegation of Acquisition Authority - 4/01
- NH2604_1.PDF
- NIH 2604-1 - Request for Ordering Official Authority - 4/01
- NH2619.PDF - NIH 2619 - Request for Transmission of
Telegraphic Message - 3/87
- NH2652.PDF
- NIH 2652 - Code Sheet for the NIH Special Volunteer Program and Guest
Researcher Assignment - 4/88
- NH2657.PDF - NIH 2657 - Supplemental Information to Form HHS 520 - Link goes to the
NIH Ethics Program website.
- NH2666.PDF
- NIH 2666 - Request for Summer Intramural
Research Training Award (Summer IRTA) - 3/90
- NH2674.PDF - NIH Loan Repayment Programs forms - Please see the NIH
Loan Repayment Programs website for all forms.
- NH2676_1.PDF
- NIH 2676-1 - DHHS Employee Emergency Payment Request Promissory
Repayment Agreement, and Salary Offset Authorization - 12/90
- NH2676_2.PDF
- NIH 2676-2 - DHHS Amendment to Employee Emergency Payment Request
Promissory Repayment Agreement, and Salary Offset Authorization - 12/90
- NH2680_1.PDF
- NIH 2680-1 - Manuscript Transmittal Sheet - 11/91
- NH2683.PDF - NIH 2683 - Certification that Property
is Free from Hazards - 2/00
- NH2684.PDF - NIH 2684 - Approval for Use of Foreign
Flag Carrier - 8/02
- NH2685_1.PDF
- NIH 2685-1 - Notification of Mailing Address for Non-Employee Workers
- 08/90
- NH2690.PDF
- NIH 2690 - Registration Document for Recombinant DNA Experiments -
8/90
- NH2696.PDF
- NIH 2696 - Evaluation of Employee Suggestion -
6/91
- NH2705_1.PDF
- Revised - NIH 2705-1 - NIH
Transhare Program--Application - 3/06
- NH2705_3.PDF
- NIH 2705-3 - NIH Transhare Program--Receipt of Fare Media - 7/03
- NH2705_4.PDF
- NIH 2705-4 - NIH Transhare Program--Program Renewal - 7/03
- NH2705_5.PDF
- NIH 2705-5 - NIH Transhare Program--Termination - 7/03
- NH2705_6.PDF
- NIH 2705-6 - NIH Transhare Program--Vanpool Group Renewal - 7/03
- NH2705_7.PDF - Obsolete -
NIH 2705-7 - NIH Transhare Program--Bi-Monthly Commuting Cost
Certification - replaced by NH2831_1.PDF and
NH2831_2.PDF
- NH2709.PDF - NIH 2709 - Ridefinders Network
Application (Carpool--Vanpool) - 6/04
- NH2735.PDF
- Revised - NIH-2735 - Hand-Carry
Delivery Slip - 3/06
- NH2736_1.PDF
- NIH 2736-1 - Justification for Temporary
Limited Appointment - 11/93
- NH2736_2.PDF
- NIH 2736-2 - Request for Certification of
Eligibles for Temporary Limited Positions - 11/93
- NH2736_3.PDF
- NIH 2736-3 - Employee's Statement of
Understanding Regarding Temporary Appointment - 11/93
- NH2737.PDF - NIH-2737 - Administrative Exit Checklist - Please use NIH 2737-2 below.
- NH2737_1.PDF - NIH-2737-1 - Clearance of Personnel for
Separation or Transfer - Please use NIH 2737-2
below.
- NH2737_2.PDF
- NIH 2737-2 - Clearance of Personnel for Separation or Transfer - 8/97
- NH2741.PDF - NIH 2741 - Request to Cannibalize
Personal Property - 12/93
- NH2760.PDF - NIH 2760 - NIH Excess (Surplus)
Personal Property Screening Record - 3/96
- NH2765_1.PDF
- Revised - NIH-2765-1 - Request for Controlled Substances for Nonhuman Use - 4/08
- NH2765_2.PDF
- Revised - NIH-2765-2 - Controlled Substance Record for Nonhuman Use - 4/08
- NH2765_3.PDF
- Revised - NIH-2765-3 - Intra-Institute Controlled Substance Transfer Notification - 4/08
- NH2778.PDF
- NIH 2778 - Senior Executive Service Performance Plan - 11/97
- NH2788_1.PDF
- Revised - NIH 2788-1 - Renewal
For Parking Permits (for General Permits, Off-Campus Permits, Red
Permits, and Satellite Permits) - 8/06
- NH2788_2.PDF
- NIH 2788-2 - Request for Campus Parking Permit for Contract Employees
- 7/04
- NH2788_3.PDF
- NIH 2788-3 - Mail-in Renewal for Carpool Permits - 5/04
- NH2798.PDF
- NIH 2798 - Request to Establish or Change Property Custodial Account
Data - 10/03
- NH2805.PDF
- NIH 2805 - Inventory of Vital Records -
11/04
- NH2818.PDF
- NIH 2818 - Notification of Receipt of Personal Property - 4/03
- NH2831_1.PDF
- NIH 2831-1 - NIH TRANSHARE Program--Commuting Cost Declaration (For
use in May through October) - 7/03
- NH2831_2.PDF
- NIH 2831-2 - NIH TRANSHARE Program--Commuting Cost Declaration (For
use in November through April) - 7/03
- NH2833.doc
- NIH 2833 - NIH Award Nomination
(Link to MS Word file on OHR Website)
- NH2835_1.PDF
- NIH 2835-1 - Telework Application and Agreement - 10/03
- NH2835_2.PDF
- NIH 2835-2 - Telework Equipment Inventory - 10/03
- NH2835_3.PDF
- NIH 2835-3 - Telework Office Evaluation - 10/03
- NH2835_4.PDF
- NIH 2835-4 - Sample Pre-Telework Worksheet - 10/03
- NH2839.PDF
- NIH 2839 - Personal Custody Pass - 3/05
- NH2850.PDF -
NIH 2850 - Non-Compliance Referral for Ethics Violations - Link goes to the
NIH Ethics Program website.
- NH2851_1.PDF - Revised - NIH 2851-1 - Request For Student Loan Repayment Benefit - 8/08
- NH2851_2.PDF - Revised - NIH 2851-2 - Student Loan Repayment Program Service Agreement - 12/08
- NH2851_3.PDF - NIH 2851-3 - Outstanding Loan Information - 3/06
- NH2851_4.PDF - NIH 2851-4 - Waiver of Student Loan Indebtedness - 3/06
- NH2866.PDF
- Revised - NIH-2866 - Position Sensitivity Worksheet - 12/31/08
- NH2866-Instr.PDF
- Revised - Instructions Page for Form NIH 2866 - 12/31/08
- NHFACIL.PDF - Occasional Use of NIH-Controlled
Facilities by the Public - None
- NHPRTCL.PDF
- NIH Animal Study Proposal - 3/02
- NIH_AWARD_NOM.PDF - NIH Award Nomination - Replaced by NH2833.PDF.
NINDS Forms
- NSAWCASH.PDF
- NINDS Cash Award Program for Clerical and
Administrative Support Referral Form - None
- NSAWEMMO.PDF
- NINDS Employee of the Month Nomination Form -
None
- NSAWSCHG.PDF
- NINDS Documentation for Change in AWS Day Off - None
- NSBNSEP.PDF
- NINDS Clearance of Personnel for Separation or
Transfer - None
- NSBNPTRN.PDF - NINDS Training Request Authorization Form - None
- NSDEVPLN.PDF -
NINDS Individual Development Plan - 8/98
- NSGRNTCH.PDF -
NINDS Change Request on Extramural Program Application or Grant/Award -
None
- NSIRTANW.PDF
- NINDS New IRTA Package Form - None
- NSMNCNTR.PDF
- NINDS Maintenance Contracts - None
- NSMNHRCH.PDF
- NINDS Man-Hours Chart - None
- NSPRFPLN.PDF
- NINDS Performance Appraisal System - 4/96
- NSPRFSRV.PDF - NINDS Professional Services Request
Form - None
- NSPRGRPT.PDF - NINDS
Annual Progress Report Abstract - None
- NSPRTCL.PDF - NINDS Animal Study Proposal - 3/99
- No longer available in Adobe Acrobat. Use
Filemaker Pro version - NSPRTCL.FP3
- NSPSNEVL.PDF
- NINDS Factor Evalaution System Position Evaluation Statement - None
- NSSERPRT.PDF - NINDS Rental of Serp Equipment - None
- NSSPVLAG.PDF
- NINDS Special Volunteer Program Service
Agreement - None
- NSTEMPPO.PDF -
NINDS Applicant Supply File Referral Temporary Positions - None
- NSTRAIN.PDF - NINDS Training Request/Authorization
Form - None
- NSTRNEVL.PDF - NINDS Training Course Evaluation - None
- NSVOLEML.PDF
- NINDS Employer's Special Volunteer Agreement -
None
- NSWOMCLN.PDF
- NINDS Tracking of Women & Minorities in Clinical Studies - 3/8/96
- OBCCAUTH.PDF - Obsolete - Ober United Travel Agency Charge Card
Authorization -
- OBFSTFAX.PDF - Ober FastRes Fax Form - 6/9/98 - Replaced by WTSFSTFX.PDF
- OBFRQTRV.PDF - Ober United Travel Agency Very Important
Traveler Profile - Replaced by WTSFRQTR.PDF
Optional Forms
- OF5.PDF
- OF-5 - Inquiry as to Availability - 3/82
- OF8.PDF
- OF-8 - Position Description - 1/85 (Link takes you to GSA's website)
- OF11.PDF - OF-11 -
Reference Request - Federal Records Centers - 7/87
- OF41.PDF -
OF-41 - Routing and Transmittal Slip - 1/94
- OF41-lg.PDF -
OF-41 - Routing and Transmittal Slip (full
page) 1/94
- OF69-HHS.PDF
- OF-69 - HHS Assignment Agreement IPA - no date
- OF108.PDF
- OF-108 - Daily Vehicle Use Record - 10/92
- OF132.PDF - OF-132 - Property Disposal
Authorization and Survey Report - 8/90
- OF306.PDF
- OF-306 - Declaration for Federal Employment - 9/94
- OF310.PDF
- OF-310 - Protection of Human Subjects - Assurance
Identification/Certification/Declaration - 9/92
- OF311.PDF
- OF-311 - Application for Federal Employee Commercial Garnishment -
3/97
- OF333.PDF -
Obsolete - OF-333 - Procurement
Integrity Certification for Procurement Officials - 10/92
- OF363.PDF
- OF-363 - Memorandum of Call - 7/94
- OF510.PDF
- OF-510 - Privacy and Public Burden Statements
- 9/94
- OF612.PDF - OF-612 - Optional
Application for Federal Employment (Link takes
you to OPM's website)
- OF630.PDF
- OF-630 - Leave Recipient Application Under the Voluntary Leave
Transfer Program - 6/89
- OF630A.PDF
- OF-630A - Request to Donate Annual Leave to Leave Recipient (Within
Agency) Under the Leave Transfer Program - 6/89
- OF630B.PDF
- OF-630B - Request to Donate Annual Leave to Leave Recipient (Outside
Agency) Under the Leave Transfer Program - 6/89
- OGE450 -
OGE 450 - Confidential Financial Disclosure Reports - Link goes to the
NIH Ethics Program website.
- OM0990_31.PDF
- OMB-0090-31 - DHHS Applicant Background Survey
- None
OPM Forms
- OP913B.PDF -
OPM-913B - Change Form - Recognitions and Agreements - 7/94
- OP117017.PDF - Obsolete - OPM-1170/17 -
Supplemental Qualifications Statement List of College Courses and
Certificate of Scholastic Achievement - None
- OP117029.PDF - Obsolete - OPM-1170/29 -
Supplemental Qualifications Statement Medical and Dental Officer - 6/79
- OP1390.PDF
- OPM-1390 - Executive Personnel Transaction - 4/79
- OP1397.PDF
- OPM-1397 - U.S. OPM Worksheet for Special Salary Rate Requests - 5/98
- OP1482.PDF -
OPM-1482 - FEGLI Agency Certification of Status of Reemployed
Annuitants - 2/93
- OP1510.PDF
- OPM-1510 - Certification of Agency Offer of Position and Required
Documentation (for Discontinued Service Retirement Under CSRS or FERS)
- 10/94
- OP1515.PDF
- OPM-1515 - Military Service Deposit Election - 12/00
- OP1519.PDF
- OPM-1519 - Survivor's Military Service
Election Deceased Employee Covered by CSRS or CSRS Offset - 1/93
- OP1537.PDF
- OPM-1537 - Current/Former Spouse's
Notification of Application for Refund of Retirement Deductions - 5/85
- OP1555.PDF
- OPM-1555 - Election of Coverage Federal
Employees Retirement System - 6/87
- OP1635.PDF - OPM-1635 - Welfare to Work Program - 4/97
- OS544.PDF
- OS-544 - Sign-in/Sign-out Sheet - 12/85
PHS Forms
Many
links go to the Health and Human
Service's websites, http://www.hhs.gov/forms
and http://intranet.hhs.gov/forms.
- PH50.PDF - PHS-50 -
Application for Appointment as a Commissioned Officer in the U.S.
Public Health Service Commissioned Corps - 7/97
- PH398BIO.PDF -
PHS-398 - Biographical Sketch (Biography page
ONLY. For intramural use) - 5/95
- PH416_1.PDF
- PHS-416-1 - Individual National Research Service Award Application (Link to NIH Grants Website)
- PH416_5.PDF
- PHS-416-5 - Research Fellowship Activation
Notice (Link to NIH Grants Website)
- PH488.PDF
- PHS-488 - Claim for Temporary Lodging Allowance (TLA) - 5/99
- PH838.PDF -
PHS-838 - Commissioned Officers' Effectiveness Report - 11/01
- PH1345.PDF
- PHS-1345 - Request and Authority for Leave of Absence - 9/77
- PH1485.PDF
- PHS-1485 - DHHS Grant Continuation - 6/83
- PH1558.PDF - PHS-1558 - Request for Travel
Reservations - 8/75
- PH1637_1.PDF
- PHS-1637-1 - Public Health Service Commissioned Officer's Request for
Dependency Determination - 4/92
- PH1637_3.PDF
- PHS-1637-3 - DHHS, PHS Parent's Dependency Affidavit - 09/81
- PH1662.PDF
- Request for Personnel Action - Commissioned Officer - 6/97
- PH1813.PDF
- PHS-1813 - Reference Request for Applicants to the U.S. Public Health
Service Commissioned Corps - 7/97
- PH2977.PDF
- PHS-2977 - Quarters Allowance Certificate PHS Commissioned Officer
Without Dependents - 5/90
- PH2988.PDF
- PHS-2988 - Voucher for Reimbursement for Travel - Dependents of PHS
Commissioned Officers - 9/92
- PH4392.PDF
- PHS-4392 - Billet Description - 11/94
- PH4392_1.PDF
- PHS-4392 - Billet Description - 11/94
- PH4469_1.PDF
- PHS-4469-1 - Junior Commissioned Officer
Student Training and Extern Program (JRCOSTEP) Evaluation Questionnaire
- 6/94
- PH4772.PDF
- PHS-4772 - Junior Commissioned Officer Student Training and Extern
Program (JRCOSTEP) Status Report - 10/93
- PH5141.PDF -
PHS-5141 - Appointment Affidavit - 2/92
PH5141_1.PDF -
PHS-5141-1 - Appointment Affidavit Reserve Corps - 2/00
- PH6040.PDF
- PHS-6040 - Notice of Intramural Research Project - 5/92
- PH6059.PDF
- PHS-6059 - Request for Overseas Station Allowances - 6/99
- PH6106.PDF
- PHS-6106 - Agreement to Receive an Allowance Under the Federal
Physicians Comparability Allowance Program - 9/88
- PH6127.PDF
- PHS-6127 - Commissioned Corps Inactive Reserve Corps Questionnaire -
11/96
- PH6186.PDF
- PHS-6186 - Request for Advance of Station Housing Allowance - 11/91
- PH6342_1.PDF
- PHS-6342-1 - PHS Unit Honor Award Nomination Record - 2/97
- PH6342_2.PDF
- PHS-6342-2 - PHS Individual Honor Award Nomination Record - 2/97
- PH6349.PDF
- PH-6349 - Annual Report on Possible Misconduct in Science - 10/91
- PH6353_1.PDF
- PH-6353-1 - Request for Voluntary State Income Tax Withhholding from
Retired Pay - 5/96
- PH6363.PDF - PHS-6363 - DHHS-PHS-Commissioned Corps
Request to Establish/Change Mailing Address - 3/97
- PH6373.PDF
- PHS-6373 - DHHS, PSC, Extramural Training Agreement - 9/96
- PH6374.PDF
- PHS-6374 - DHHS, PSC, Intramural Training Agreement - 9/96
- PH6385.PDF
- PHS-6385 - Status Report on Commissioned Corps
Officers During Probation - 3/93
- PH7017.PDF
- PHS-7017 - Reeemployment Priority List Registration - 7/94
- PH7017-1.PDF
- PHS-7017-1 - Reemployment Priority List Employee Disposition Record -
7/94
- PH7034.PDF
- PHS-7034 -
Application for Assimilation into the Regular Corps - 2/98
- PH7036.PDF
- PHS-7036 -
Reimbursement Request for Adoption Expenses - 4/98
- POTERMS.PDF - Purchase Order Terms and Conditions 8/96
- PPQ526.PDF
- PPQ-526 - USDA Application and Permit to Move Live Plant Pests or
Noxious Weeds - 9/95
- PREMAPP7.PDF - Revised 8/08 - Request For Premium Class
Common Carrier Travel Accommodations For Employees With Medical Conditions
- PREMAPP8.PDF -
Individual Trip Authorization (Non-Medical) - Authorization For Use of
First-Class or Premium-Class Other Than First-Class (PCotFC) Travel
Accommodations
- PROPCODE.PDF - Request for Property
Classification/Property Manufacturer Codes - None
- PRSMDHST.PDF
- Personal Medical History - None
Purchase Card Program
- PURCH-NEW - Request For New Purchase Cardholder - 10/07
- PURCH-NEWCAO - Request For New Purchase Card Approving Official - 10/07
- PURCH-CAOCHG - CAO Change Request Form - 11/07
- PURCH-CHKS - Request For Convenience Checks - 10/07
- PURCH-CANCEL
- NIH Purchase Card Program Cancellation Request Form - 11/08
- IMDISPUT.PDF
- I.M.P.A.C. Cardholder Statement of Questioned Item - 9/98
- IMRCPTST.PDF
- Impac Statement for Recipients of Purchase Card Check Issued
for a Professional Service Order - None
- PSADDCHG
- Postal Service Change of Address Forms Note -
This is a web link only to the Postal Services web site.
- RADBADGE.PDF - Obsolete - Film Badge Registration Form,
Radiation Safety Branch
- RADDISC.PDF - Radioactive Materials Package
Discrepancy/Problem Reporting Form - None
- RADORNT.PDF
- Authorized User Acknowledgement Form - None
- RETIRANU.PDF
- Retirement Annuity Estimate - None
- RI38_124.PDF
- RI 38-124 - Voluntary Contributions Election - 9/94 (includes
Employee Information pages)
- RI38_128.PDF
- RI 38-128 - Direct Deposit
- RI76_10.PDF
- RI 76-10 - FEGLI Assignment of Federal Employees' Group Life
Insurance - 1/95
- RI83_011.PDF
- RI 83-011 - Booklet - Thinking About Retirement
- RSACCHND.PDF
- Reasonable Accommodations for Handicapped Employees During Inclement
Weather - None
- RSTANNLV.PDF
- Request for Restoration of Annual Leave - None
- RWHSLST.PDF
- R&W Rental Listing Form - 7/30/99
- SAVINGS
BONDS - U.S. Savings Bond Forms - Note - This is a web link
only to the Treasury Dept. bonds web site
- SB2253E.PDF
- Authorization for Purchase and Request for Change United States
Inflation-Indexed Savings Bonds - None
- SERPPUR.PDF - Request for Purchase of Rented
Equipment - None
- SESRECRT.PDF
- DHHS, NIH, Senior Executive Service
Recertification Form - None
Standard Forms
- SF8.PDF
- SF-8 - Notice to Federal Employee About
Unemployment Insurance - 6/87
- SF15.PDF
- SF-15 - Application for 10-Point Veteran Preference - 2/90
- SF18.PDF - SF-18 - Request for Quotation - 6/95
- SF26.PDF - SF-26 - Award/Contract - 4/85
- SF30.PDF - SF-30 - Amendment of
Solicitation/Modification of Contract - 10/83
- SF39.PDF - SF-39 -
Request for Referral of Eligibles - 11/88
- SF33.PDF - SF-33
- Solicitation, Offer and Award - 9/97
- SF52.PDF
- SF-52 - Request for Personnel Action - 6/30/93
(Link takes you to GSA's website)
- SF59.PDF - SF-59 -
Request for Approval of Noncompetitive Action - 1/79
- SF61.PDF - SF-61 -
Appointment Affidavits - 6/96
- SF62.PDF - SF-62 -
Agency Request to Pass Over a Preference Eligible or Object to an
Eligible - 10/79
- SF71.PDF
- SF-71 - Application for Leave - 12/98
- SF75.PDF
- SF-75 - Request for Preliminary Employment Data - 8/98
- SF78.PDF
- SF-78 - U.S. Civil Service Commission
Certificate of Medical Examination - 10/69
- SF81.PDF
- SF-81 - Request for Space - 2/89
- SF85P_S.PDF -
SF-85P-S - Supplemental Questionnaire for Selected Positions - 9/95
- SF88.PDF - SF-88 -
Report of Medical Examination - 3/89
- SF93.PDF - SF-93 - Report of Medical History - 6/96
- SF113A.PDF -
SF-113A - Monthly Report of Federal Civilian Employment - 8/94
- SF115.PDF
- SF-115 - Request for Records Disposition Authority - 3/91
- SF115A.PDF
- SF-115A - Request for Records Disposition Authority - Continuation -
3/91
- SF120.PDF - SF-120 - Report
of Excess Personal Property - 4/57
- SF120A.PDF - SF-120A - Report
of Excess Personal Property Continuation Sheet - 4/57
- SF121.PDF - Annual Report of Utilization and Disposal of Excess
and Surplus Personal Property - 5/96
- SF122.PDF - SF-122 - Transfer Order Excess Personal
Property - 6/74
- SF123A.PDF
- SF-123A - Transfer Order Supplies Personal Property Continuation
Sheet - 5/98
- SF123A.PDF
- SF-123A - Transfer Order Supplies Personal Property Continuation
Sheet - 10/77
- SF126.PDF - SF-126 - Report of Personal Property
for Sale - 7/78
- SF126A.PDF - SF-126-A - Report of Personal Property
for Sale Continuation Sheet - 2/65
- SF135.PDF
- SF-135 - Records Transmittal and Receipt - 7/85
- SF135A.PDF
- F-135A - Records Transmittal and Receipt (Continuation) - 7/85
- SF152.PDF
- SF-152 - Request for Clearance or Cancellation of a Standard or
Optional Form - 2/96
- SF171.PDF - SF-171
- Application for Federal Employment - 6/88 (Obsolete)
- SF180.PDF - SF-180
- Request Pertaining to Military Records - 7/86
- SF181.PDF
- SF-181 - Ethnicity and Race Identification - 8/05
(Link takes you to GSA's Standard
Forms website)
- SF256.PDF - SF-256
- Self-Identification of Handicap - 8/87
- SF258.PDF - SF-258 -
Request to Transfer, Approval, and Receipt of Records to National
Archives of the United States - 9/95
- SF278.PDF
- SF-278 - Public Financial Disclosure Reports - Link goes to the Office of Government Ethics. Check with your IC Ethics Office for instructions
before using the form.
- SF282.PDF - SF-282 - Mandatory Title Check - 4/79
- SF293.PDF
- SF-293 - Notice to Separated Employee
Concerning Disposition of Official Personnel Folder/Merged Records
Personnel Folder and Employee Medical Folder - 7/89
- SF298.PDF - SF-298 - Report Documentation Page -
2/89
- SF308.PDF - SF-308
- Request for Wage Determination and Response to Request - 5/85
- SF326.PDF - SF-326 - Semiannual Report of Payments Accepted from a
Non-Federal Source - Link goes to the NIH Ethics Program
website.
-
- SF326A.PDF - SF-326A - Semiannual Report of Payments Accepted from a
Non-Federal Source (Continuation Sheet) - Link goes to the NIH Ethics Program
website.
- SF329.PDF
- SF-329 - Administrative Wage Garnishment Form - 11/98
- SF364.PDF - SF-364 - Report of Discrepancy - 2/80
- SF424.PDF - SF-424 - Application for Federal Assistance
- 4/92
- SF424A.PDF
- SF-424A - Budget Information - Non-construction Programs - 4/92
- SF424B.PDF - SF-424B
- Assurances -- Non-Construction Programs - 4/92
- SF424C.PDF
- SF-424C - Budget Information - Construction Programs - 4/92
- SF424D.PDF - SF-424D
- Assurances -- Construction Programs - 4/92
- SF450.PDF - Obsolete - SF-450
- This has been replaced by form OGE-450
-
SF510.PDF - SF 510 - Nursing Notes - 7/91
(Link takes you to GSA's website)
- SF813.PDF
- SF-813 - Verification of a Military Retiree's Service in Nonwartime
Campaigns or Expeditions (Link takes you to
OPM's website)
- SF1012.PDF
- SF-1012 - Travel Voucher - 10/77
- SF1034.PDF -
SF-1034 - Public Voucher for Purchases and Services other than Personal
- 10/67
- SF1035.PDF -
SF-1035 - Public Voucher for Purchases and Services other than Personal
(Continuation Sheet) - 9/73
- SF1035A.PDF -
SF-1035A - Public Voucher for Purchases and Services other than
Personal - Memorandum - (Continuation Sheet) - 9/73
- SF1038.PDF
- SF-1038 - Advance of Funds Application and Account - 10/77
- SF1081.PDF -
SF-1081 - Voucher and Schedule of Withdrawals and Credits - 9/82
- SF1152.PDF
- SF-1152 - Designation of Beneficiary Unpaid Compensation of Deceased
Civilian Employee - 11/91
- SF1153.PDF
- SF-1153 - Claim for Unpaid Compensation of Deceased Civilian Employee
- 4/82
- SF1154.PDF
- SF-1154 - Public Voucher for Unpaid Compensation Due A Deceased
Civilian Employee - 9/67
- SF1187.PDF
- SF-1187 - Request for Payroll Deductions for Labor Organization Dues
- 3/89
- SF1190.PDF
- SF-1190 - Foreign Allowances Application, Grant and Report -
1/98
- SF1199A.PDF
- SF-1199A - Direct Deposit Sign-up Form - 6/87
- SF1303.PDF -
SF-1303 - Request for Federal Cataloging/Supply Support Action - 4/94
- SF1449.PDF
- SF-1449 - Solicitation/Contract/Order for Commercial Items - 4/02 (Link takes you to GSA's website)
- SF2800.PDF
- SF-2800 - CSRS Application for Death Benefits - 3/92
- SF2801.PDF
- SF-2801 - CSRS Application for Immediate Retirement Under the Civil
Service Retirement System - 1/90
- SF2801_1.PDF
- SF-2801-1 - CSRS Certified Summary of Federal Service - 1/90
- SF2801_2.PDF
- SF-2801-2 - CSRS Spouse's Consent to Survivor Election - (no date)
- SF2801_3.PDF
- SF-2801-3 - CSRS Election of Former Spouse Survivor annuity or
Combination Current/Former Spouse Annuity - 1/90
- SF2801D.PDF -
SF-2801-Schedule D - CSRS Agency Checklist of Immediate Retirement
Procedures - 1/90
- SF2802.PDF
- SF-2802 - CSRS Application for Refund of Retirement Deductions - 1/91
- SF2802B.PDF -
SF-2802B - CSRS Current/Former Spouse's Notification of Application for
Refund of Retirement Deductions Under the Civil Service Retirement
System - 1/91
- SF2803.PDF
- SF-2803 - FEGLI Application to Make Deposit or Redeposit - 6/92
- SF2804.PDF
- SF-2804 - Application to Make Voluntary Contributions, Civil Service
Retirement System - 2/99
- SF2805.PDF -
SF-2805 - Request for Recovery of Debt Due the United States - 4/80
- SF2806.PDF -
SF-2806 - CSRS Individual Retirement Record - 2/80
- SF2806_1.PDF -
SF-2806 - CSRS Notice of Correction of Individual Retirement Record -
2/80
- SF2807.PDF
- SF-2807 - Register of Separations and Transfers Civilian Service
Retirement System - 7/80
- SF2808.PDF
- SF-2808 - Designation of Beneficiary - 2/99
- SF2809.PDF
- SF-2809 - FEHB Health Benefits Registration Form - 7/99 (Link takes you to GSA's website)
- SF2809_1.PDF -
SF-2809-1 - FEHB Health Benefits Election Form - 7/99
- SF2809A.PDF - Obsolete - SF-2809A -
FEHB Information for Federal Civilian Employees and U.S. Postal Service
Employees - 6/90
- SF2810.PDF
- SF-2810 - FEHB Notice of Change in Health Benefits Enrollment - 6/95
- SF2811.PDF - SF-2811 - Transmittal and Sumary Report to
Carrier - 6/84
- SF2812A.PDF -
SF-2812A - Report of Withholding and Contributions for Health Benefits
by Enrollment Code - 12/21/98
- SF2817.PDF
- SF-2817 - FEGLI Life Insurance Election - 4/99
- SF2818.PDF
- Continuation of Life Insurance
Coverage as an Annuitant or Compensationer - 5/01
- SF2819.PDF -
SF-2819 - FEGLI Notice of Conversion Privilege - 5/95
- SF2820.PDF -
SF-2820 - FEGLI Certification Of Insured Employee's Retired Status -
8/94
- SF2821.PDF -
SF-2821 - Agency Certification of Insurance Status - 5/95
- SF2822.PDF
- SF-2822 - FEGLI Request for Insurance - 1/93
- SF2823.PDF
- SF-2823 - FEGLI Designation of Beneficiary - 4/01(Link
takes you to GSA's website)
- SF2824.PDF - Obsolete - SF-2824 - CSRS
Documentation in Support of Disability Retirement Application - 1/91
- SF2824A.PDF
- SF-2824A - CSRS Applicant's Statement of Disability - 3/31/93
- SF2824B.PDF
- SF-2824B - CSRS Supervisor's Statement - 1/91
- SF2824C.PDF - Obsolete - SF-2824C -
CSRS Physician's Statement - 1/91
- SF2824D.PDF
- SF-2824D - FEGLI Agency Certification of Reassignment and
Accommodation Efforts - 1/91
- SF2824E.PDF
- SF-2824E - FEGLI Disability Retirement Application Checklist - 1/91
- SF3100A.PDF -
SF-3100-A - FERS Individual Retirement Record - 1/87
- SF3101.PDF - SF-3101 - FERS Notice of
Correction of Individual Retirement Record - 2/87
- SF3102.PDF -
SF-3102 - FERS Designation of Beneficiary - 12/93
- SF3104.PDF
- SF-3104 - FERS Application for Death Benefits - 5/98
- SF3104A.PDF
- SF-3104A - FERS Survivor Supplement - 12/91
- SF3104B.PDF
- SF-3104B - FERS Documentation and Elections in Support of Application
for Death Benefits when Deceased was an Employee at the Time of Death -
5/98
- SF3105.PDF - Obsolete - SF-3105 - FERS
Documentation in Support of Disability Retirement Application - 8/87
- SF3105A.PDF
- SF-3105A - FERS Applicant's Statement of Disability - 8/87
- SF3105B.PDF
- SF-3105B - FERS Supervisor's Statement - 8/87
- SF3105C.PDF - Obsolete - SF-3105C -
FERS Physician's Statement - 8/87
- SF3105D.PDF
- SF-3105D - FERS Agency Certification of Reassignment and
Accommodation Efforts - 8/87
- SF3105E.PDF
- SF-3105E - FERS Disability Retirement Application Checklist - 8/87
- SF3106.PDF
- SF-3106 - Application for Refund of Retirement Deductions Federal
Employees Retirement System - 3/96
- SF3106A.PDF
- SF-3106A - Current/Former Spouse's Notification of Application for
Refund of Retirement Deductions Under the Federal Employee's Retirement
System - 2/97
- SF3107.PDF
- SF-3107 - FERS Application for Immediate Retirement - 4/00
- SF3107_1.PDF -
SF-3107-1 - FERS Certified Summary of Federal Service - 1/97
- SF3107_2.PDF
- SF-3107-2 - FERS Spouse's Consent to Survivor Election - 3/88
- SF3108.PDF
- SF-3108 - Application to Make Service Credit Payment for Civilian
Service - 5/88
- SF3109.PDF
- SF-3109 - FERS Election of Coverage - 7/89
- SF3110.PDF
- SF-3110 - FERS Former Spouse's Consent to FERS Election - 6/90
- SF3111.PDF
- SF-3111 - FERS Request for Waiver, Extension, or Search 6/90
- SF3112.PDF
- SF-3112 - Applicant's Statement of Disability In Connection With
Disability Retirement Under the Civil Service Retirement System or the
Federal Employees Retirement System - 12/95
- SF3112-1.PDF
- SF-3112-1 - Information about Disability Retirement (CSRS) - 3/96
- SF3112-2.PDF
- SF-3112-2 - Information about Disability Retirement (FERS) - 3/96
- SF3112A.PDF -
SF-3112A - CSRS/FERS Applicant's Statement of Disability - 11/96
- SF3112B.PDF
- SF-3112B - CSRS/FERS Supervisor's Statement In Connection With
Disability Retirement Under the Civil Service Retirement System and the
Federal Employees' Retirement System - 11/96
- SF3112C.PDF
- SF-3112C - CSRS/FERS Physician's Statement In Connection With
Disability Retirement Under the Civil Service Retirement System and the
Federal Employees' Retirement Ssytem - 11/96
- SF3112D.PDF
- SF-3112D - CSRS/FERS Agency Certification of Reassignment and
Accommodation Efforts In Connection With Disability Retirement Under
the Civil Service Retirement System and the Federal Employees'
Retirement Ssytem - 11/96
- SF3112E.PDF -
SF-3112E - CSRS/FERS Disability Retirement Application Checklist - 11/96
- SF3881-NIHonly.PDF
- SF-3881 - ACH Vendor/Miscellaneous Payment Enrollment Form - 2/03 - FOR NIH USE ONLY. The "Agency Information"
section has been completed with NIH data.
- SF3881.PDF -
SF-3881 - ACH Vendor/Miscellaneous Payment Enrollment Form - 2/03 - For use outside NIH.
- SFLLL.PDF - SF-LLL -
Disclosure of Lobbying Activities - None
- SFLLLA.PDF - SF-LLL-A
- Disclosure of Lobbying Activities Continuation Sheet - None
Social Security Administration
Forms
TAIMS
Forms
Thrift Savings Plan Forms
- THRIFT SAVINGS
PLAN - Link to Web Site
- TSP1.PDF
- TSP-1 - Thrift Savings Plan - Election Form - 5/01
- TSP3.PDF
- TSP-3 - Thrift Savings Plan Designation of Beneficiary - 10/96
- TSP9.PDF
- TSP-9 - Thrift Savings Plan Change of Address for Separated
Participants - 6/94
- TSP16.PDF
- TSP-16 - Thrift Savings Plan Exception to Spousal Requirements - 10/97
- TSP17.PDF
- TSP-17 - Federal Retirement Thrift Savings Plan Application for
Account Balance of Deceased Participant - 3/98
- TSP20.PDF
- TSP-20 - Thrift Savings Plan Loan Application - 2/98
- TSP30.PDF
- TSP-30 - Thrift Savings Plan Interfund Transfer Request - 9/98
- TSP32.PDF
- TSP-32 - Thrift Savings Plan Acknowledgement of Risk for Thriftline
Interfund Transfers - 11/94
- TSP70.PDF -
TSP-70 - Thrift Savings Plan Withdrawal Request - 3/01
- TSP70T.PDF
- TSP-70-T - Thrift Savings Plan Transfer Information - 11/94
- TSP75.PDF
- TSP-75 - Thrift Savings Plan Age Based In-Service Withdrawal Request
- 05/98
- TSP75T.PDF
- TSP-75 - Thrift Savings Plan Transfer of In-Service Withdrawal - 05/98
- TSP76.PDF
- TSP-76 - Thrift Savings Plan Financial Hardship In-Service Withdrawal
Package - 05/98
- TSP1013.PDF
- TSP-1013 - Important Tax Information About TSP In-Service Withdrawal
Payments - 05/98
- TSPBK02.PDF - TSP
Booklet 02 - TSP Withdrawal - 2/02
- TSPBK05.PDF - TSP
Booklet 05 - TSP Annuities - 1/02
U.S. Bank Forms
- USIMMNT.PDF - US Bank Cardholder
Maintenance - 11/98 (Note - Obtain this form from your Administrative Officer.
Do NOT create this form electronically. US Bank wishes to control
distribution.)
- USIMSET.PDF - US Bank Cardholder
Setup - 11/98 (Note - Obtain this form from your Administrative Officer.
Do NOT create this form electronically. US Bank wishes to control
distribution.)
USDA
Veterinary Services Forms
- VS16_3.PDF
- VS-16-3 - USDA Application to Import Controlled Material Import or
Transport Organisms or Vectors - 3/95
- VS16_7.PDF
- VS-16-7 - USDA Additional Information for Cell Cultures and Their
Products - 3/95
- VS17_129.PDF
- VS-17-129 - USDA Application for Import or in Transit Permit - 5/96
- VFSUPAGR.PDF -
NIH Supplemental Visiting Fellow Award Program Supplemental Fellowship
Agreement - 7/17/95
- VFSUPPRV.PDF -
NIH Supplemental Visiting Fellow Award Program Statement of
Supplemental Program Provisions - 7/17/95
- VMQWKCHG.PDF
- Revised - Voice Mail System
Quick Change Request - Released 10/12/06
- VOLAGREE.PDF - NIH Special
Volunteer Agreement - None
- VOTER REGISTRATION -
By Mail - Link to National Web Site
- Y2KComp.PDF
- Biomedical and Information Technology Equipment Year 2000 Compliance
Certificate
- W9.PDF
- W-9 - Request for Taxpayer Identification Number and Certification -
12/96