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 You are in: Under Secretary for Management > Bureau of Administration > Office of Directives Management > Official Forms  
Bureau of Administration
Office of Directives Management
Official Forms
Employment / Benefits
  

Employment/Benefits

--  CA-1 Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation  [34 Kb]
--  CA-2 Notice of Occupational Disease and Claim for Compensation  [33 Kb]
--  CA-2-A Notice of Recurrence  [32 Kb]
--  CA-5 Claim for Compensation by Widow, Widower, and/or Children  [33 Kb]
--  CA-5-B Claim for Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren  [34 Kb]
--  CA-6 Official Superior's Report of Employee's Death  [34 Kb]
--  CA-7 Claim for Compensation  [31 Kb]
--  CA-7-A Time Analysis Form  [32 Kb]
--  CA-7-B Leave Buy Back (LBB) Worksheet/Certification and Election  [33 Kb]
--  CA-12 Claim for Continuance of Compensation under the Federal Employees' Compensation Act  [33 Kb]
--  CA-17 Duty Status Report  [33 Kb]
--  CA-20 Attending Physician's Report  [33 Kb]
--  CA-35 Evidence Required in Support of a Claim for Occupational Disease  [34 Kb]
--  DS-578 Danger Pay Factors Form  [398 Kb]
--  DS-765 Foreign Service Retirement and Disability System Participant Record  [382 Kb]
--  DS-1416 Conversion to Foreign Service Retirement and Disability System  [269 Kb]
--  DS-1622 Medical History and Examination for Foreign Service (for children 11 years and under)  [398 Kb]
--  DS-1843 Medical History and Examination for Foreign Service (for persons 12 years and over)  [130 Kb]
--  DS-1950 Application for Employment  [534 Kb]
--  DS-2008 Notice of Termination of Diplomatic, Consular, or Foreign Government Employment  [189 Kb]
--  DS-3076 Application for Child Care Subsidy Program  [261 Kb]
--  DS-4002 Disclosure and Authorization Pertaining to Consumer Reports  [181 Kb]
--  DS-4017 Statement of Interest Foreign Service Officer  [125 Kb]
--  DS-4018 Statement of Interest Student Employment  [44 Kb]
--  DS-4095 Subsistence Expense Allowance Application  [265 Kb]
--  JF-62 Personal Services Contracting Action  [235 Kb]
--  JF-62-A Personal Services Agreement Action  [447 Kb]
--  OF-126 Foreign Service Residence and Dependency Report  [130 Kb]
--  OF-306 Declaration for Federal Employment  [33 Kb]
--  OPM-71 Request for Leave or Approved Absence  [33 Kb]
--  OPM-630 Application to Become a Leave Recipient Under the Voluntary Leave Transfer Program  [35 Kb]
--  OPM-630-A Request to Donate Annual Leave to Leave Recipient Under the Voluntary Leave Transfer Program  [39 Kb]
--  OPM-630-B Request to Donate Annual Leave to Leave Recipient Under the Voluntary Leave Transfer Program  [39 Kb]
--  OPM-630-C Transfer of Leave Records for Leave Recipient Covered by the Voluntary Leave Transfer Program  [38 Kb]
--  OPM-1637 Application to Become a Leave Recipient Under the Emergency Leave Transfer Program  [35 Kb]
--  OPM-1638 Request to Donate Annual Leave Under the Emergency Leave Transfer Program  [35 Kb]
--  OPM-1639 Transfer of Donated Annual Leave To or From the Emergency Leave Transfer Program  [35 Kb]
--  OWCP-5-B Work Capacity Evaluation for Cardiovascular/Pulmonary Conditions  [36 Kb]
--  OWCP-5-C Work Capacity Evaluation for Musculoskeletal Conditions  [34 Kb]
--  OWCP-16 Rehabilitation Plan and Award  [33 Kb]
--  OWCP-17 Rehabilitation Maintenance Certificate  [33 Kb]
--  OWCP-20 Overpayment Recovery Questionnaire  [34 Kb]
--  OWCP-44 Rehabilitation Action Report  [33 Kb]
--  OWCP-915 Claim for Medical Reimbursement  [34 Kb]
--  OWCP-957 Medical Travel Refund Request  [34 Kb]
--  OWCP-1500 Health Insurance Claim Form  [33 Kb]
--  SF-61 Appointment Affidavits  [31 Kb]
--  SF-85 Questionnaire for Non-Sensitive Positions  [32 Kb]
--  SF-85-P Questionnaire for Public Trust Positions  [33 Kb]
--  SF-85-P-S Supplemental Questionnaire for Selected Positions  [33 Kb]
--  SF-86 Questionnaire for National Security Positions  [34 Kb]
--  SF-86-A Continuation Sheet for Questionnaires SF 86, SF 85P, AND SF 85  [34 Kb]
--  SF-144 Statement of Prior Federal Service  [32 Kb]
--  SF-256 Self-Identification of Handicap  [32 Kb]
--  SF-1190 Foreign Allowances Application  [63 Kb]
--  UB-04 Medicare Claims Processing  [41 Kb]
--  W-4 Employee's Withholding Allowance Certificate  [33 Kb]
--  WH-380 Certification of Health Care Provider  [24 Kb]

  
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