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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 / Benefit Forms
  

Employment/Benefits

-- CA-0001 Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay

-- CA-0002 Notice of Occupational Disease and Claim for Compensation

-- CA-0002-A Notice of Recurrence

-- CA-0005 Claim for Compensation by Widow, Widower, and / or Children

-- CA-0005-B Claim for Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren

-- CA-0006 Official Superior's Report of Employee's Death

-- CA-0007 Claim for Compensation

-- CA-0007-A Time Analysis

-- CA-0007-B Leave Buy Back (LBB) Worksheet / Certification and Election

-- CA-0012 Claim for Continuance of Compensation under the Federal Employees' Compensation Act

-- CA-0017 Duty Status Report

-- CA-0020 Attending Physician's Report

-- CA-0035 Evidence Required in Support of a Claim for Occupational Disease

-- OF-0306 Declaration for Federal Employment

-- OPM-0071 Request for Leave or Approved Absence

-- OPM-0630 Application to Become a Leave Recipient under the Voluntary Leave Transfer Program

-- OPM-0630-A Request to Donate Annual Leave to Leave Recipient under the Voluntary Leave Transfer

-- OPM-0630-B Request to Donate Annual Leave to Leave Recipient under the Voluntary Leave Transfer

-- OPM-0630-C Transfer of Leave Records for Leave Recipient Covered by the Voluntary Leave

-- OPM-1637 Application to Become a Leave Recipient under the Emergency Leave Transfer Program

-- OPM-1638 Request to Donate Annual Leave under the Emergency Leave Transfer Program

-- OPM-1639 Transfer of Donated Annual Leave To or From the Emergency Leave Transfer Program

-- OWCP-0005-B Work Capacity Evaluation Cardiovascular / Pulmonary Conditions

-- OWCP-0005-C Work Capacity Evaluation Musculoskeletal Conditions

-- OWCP-0016 Rehabilitation Plan and Award

-- OWCP-0017 Rehabilitation Maintenance Certificate

-- OWCP-0020 Overpayment Recovery Questionaire

-- OWCP-0044 Rehabilitation Action Report

-- OWCP-0915 Claim for Medical Reimbursement

-- OWCP-0957 Medical Travel Refund Request

-- OWCP-1500 Health Insurance Claim Form

-- SF-0061 Appointment Affidavits

-- SF-0085 Questionnaire for Non-Sensitive Positions

-- SF-0085-P Questionnaire for Public Trust Positions

-- SF-0085-PS Supplemental Questionnaire for Selected Positions

-- SF-0086 Questionnaire for National Security Positions

-- SF-0086-A Continuation Sheet for Questionnaires SF-85, SF-85P, and SF-86

-- SF-0144 Statement of Prior Federal Service

-- SF-0256 Self-Identification of Reportable Handicap

-- UB-0092 Uniform Health Insurance Claim Form

-- W-0004 Employee's Withholding Allowance Certificate

-- WH-0380 Certification of Health Care Provider

--  DS-0578 Danger Pay Factors Form [ 398 Kb]
--  DS-0765 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 [ 466 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 [ 152 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-0062 Personal Services Contracting Action [ 235 Kb]
--  JF-0062a Personal Services Agreement Action [ 447 Kb]
--  OF-0126 Foreign Service Residence and Dependency Report [ 130 Kb]
--  SF-1190 Foreign Allowances Application  [ 63 Kb]

  
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