Retirement And Insurance Forms


fe6, Claim for Death Benefits

This claim must be completed thoroughly after following the instructions stated therein. For death of a Federal employee, annuitant, or compensationer, use this form for claiming for death benefits. See this page for requirements and guidance materials.

ri 38-107, URGENT – Reply Required Within 30 Days to Avoid Interruption of Your Payment

The purpose of this form is for the Office of the Personnel Management to verify the records of the survivor. This is to ensure that the annuity payment, as well as informational correspondence, are received by the rightful survivor. It is the information that is being verified,


ri20-7, Representative Payee Application

The purpose of soliciting the required information is to determine the representative payee’s  relationship with the annuitant. It also features the extent of the representative’s  ability to take care of the  annuitant’s financial affairs. The  representative is  advised to answer all of the questions.

ri30-1, Request for Information

In order for the Retirement Services Publications Team of the Office of Personnel Management to determine your entitlement to continuation of disability annuity payments, there is a need for you to ask your physician or treating medical facility to provide relevant information as enumerated in the form itself.

ri38-122, Alternative Annuity and Rollover Election

For you to complete this form, you need to read the Alternative Annuity Election Information for Employees.  The complete alternative annuity election package from the Office of the Personnel Management  is necessary for you to make an alternative annuity election.  Provide your certification which states that you have no former spouse who is entitled to receive a portion of your annuity or your annuity. For the rollover election, choose one option as indicated in the form itself.


ri38-124, Voluntary Contributions Election

Please read carefully all the information provided in this form  which pertain making voluntary contributions election, before completing it. There are line instructions for you to be guided in answering all questions accurately.


Ri79-9,Health Benefits Cancellation/Suspension Confirmation

This form can be completed and filed by Civil Service Retirement System and Federal Employee Retirement System  annuitants,  survivor annuitants, and former spouse annuitants. The applicants can decide to cancel or suspend enrollment in the Federal   Employee Health Benefits Program. They are advised to read  the front and back of the form.


ri92,-19, Application for Deferment or Postponement Retirement

This application is to be completed by a former Federal employee who was covered by the Federal Employee Retirement  System. The applicant is advised to read carefully  the instructions pertaining to  retirement annuity.

ri10-125, Federal Employee Retirement Coverage Correction Act (FERCCA)

The employee fills out information as indicated. The employee has received sufficient information to make an informed decision or final and irrevocable election. The election is based on the Federal Employee Retirement Coverage Corrections Act. Likewise, the decision is made pursuant to the FERCCA Election Summary material.


ri_30-10_june_2010_508, Disabled Dependent Questionnaire

Whatever pertinent answers you will provide on this Disabled Dependent Questionnaire, the same will be used to collect sufficient confirmation. The medical condition and evidence capacity would be the bases of the Office of Personnel Management to check whether a disabled adult child is eligible for continued benefits: health benefits coverage and survivor annuity payments. These 2 reasons are under the Civil Service Retirement System or the Federal Employees Retirement System.