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Privacy & Other Notices

Employment/Benefits Forms
CA-1 Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay / Compensation
CA-2 Notice of Occupational Disease and Claim for Compensation
CA-2-A Notice of Recurrence
CA-5 Claim for Compensation by Widow, Widower, and / or Children
CA-5-B Claim for Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren
CA-6 Official Superior's Report of Employee's Death
CA-7 Claim for Compensation
CA-7-A Time Analysis
CA-7-B Leave Buy Back (LBB) Worksheet / Certification and Election
CA-12 Claim for Continuance of Compensation under the Federal Employees' Compensation Act
CA-17 Duty Status Report
CA-20 Attending Physician's Report
CA-35 Evidence Required in Support of a Claim for Occupational Disease
DS-578 Danger Pay Factors Form
DS-765 Foreign Service Retirement and Disability System Participant Record
DS-1416 Conversion to Foreign Service Retirement and Disability System
DS-1622 Medical History and Examination for Foreign Service (for children 11 years and under)
DS-1843 Medical History and Examination for Foreign Service (for persons 12 years and over)
DS-1950 Application for Employment
DS-2008 Notice of Termination of Diplomatic, Consular, or Foreign Government Employment
DS-3076 Application for Child Care Subsidy Program
DS-4002 Disclosure and Authorization Pertaining to Consumer Reports
DS-4017 Statement of Interest Foreign Service Officer
DS-4018 Statement of Interest Student Employment
DS-4095 Subsistence Expense Allowance Application
I-9 Employment Eligibility Verification
JF-62 Personal Services Contracting Action
JF-62a Personal Services Agreement Action
OF-126 Foreign Service Residence and Dependency Report
OF-306 Declaration for Federal Employment
OPM-71 Request for Leave or Approved Absence
OPM-630 Application to Become a Leave Recipient under teh Voluntary Leave Transfer Program
OPM-630-A Request to Donate Annual Leave to Leave Recipient under the Voluntary Leave Transfer Program (Leave Donor)
OPM-630-B Request to Donate Annual Leave to Leave Recipient under the Voluntary Leave Transfer Program (Outside Agency)
OPM-630-C Transfer of Leave Records for Leave Recipient Covered by the Voluntary Leave Transfer Program
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-5-B Work Capacity Evaluation Cardiovascular / Pulmonary Conditions
OWCP-5-C Work Capacity Evaluation Musculoskeletal Conditions
OWCP-16 Rehabilitation Plan and Award
OWCP-17 Rehabilitation Maintenance Certificate
OWCP-20 Overpayment Recovery Questionaire
OWCP-44 Rehabilitation Action Report
OWCP-915 Claim for Medical Reimbursement
OWCP-957 Medical Travel Refund Request
OWCP-1500 Health Insurance Claim Form
SF-61 Appointment Affidavits
SF-85 Questionnaire for Non-Sensitive Positions
SF-85-P  Questionnaire for Public Trust Positions
SF-85-PS  Supplemental Questionnaire for Selected Positions
SF-86 Questionnaire for National Security Positions
SF-86-A Continuation Sheet for Questionnaires SF-85, SF-85P, and SF-86
SF-144 Statement of Prior Federal Service
SF-256 Self-Identification of Reportable Handicap
SF-1190 Foreign Allowances Application
UB-92 Uniform Health Insurance Claim Form
W-4 Employee's Withholding Allowance Certificate
WH-380 Certification of Health Care Provider

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