Office of Personnel Management

Retirement and Insurance Group

1920 1954 1959 1986 

 

Benefits Administration Letter

 Number: 97-701 Date: January 14, 1997 

SUBJECT: Revised Substitute Forms Policy

___________________________________________________________________________

PURPOSE This letter communicates our revised policy to allow the use of

substitute forms for retirement and insurance. The letter also

specifies the approval process and any special requirements for

specific forms.

BACKGROUND The Retirement and Insurance Service (RIS) is aware that

agencies and private sector vendors are working on the

development of PC-based benefits administration processing

systems. These systems include PC-generated forms that are

nearly identical to our "official" forms. The forms--and related

software--have the potential to greatly reduce the benefits

administration and processing workloads in agencies.

The General Services Administration (GSA) has

governmentwide responsibility for standard forms. GSA policy

allows the use of substitute forms and other agencies do accept

computer generated substitute forms. 

POLICY STATEMENT RIS will accept substitute forms that meet the general

requirements established by GSA (41 CFR Part 201-9 (copy

attached) and FIRMR Bulletin B-3, 12g Electronic Generation

of Standard and Optional Forms, as amended) and any specific

requirements specified in this letter. Substitute forms must be

approved by RIS following the procedures in this letter prior to

their use.

Requirements In general, automated forms should be generated with black ink

on white paper that is 8.5" wide and 11" long.
2

Requirements (cont.) The electronic reproduction must be complete, containing all

instructions and questions which appear on the current official

form. The wording and punctuation of all items, instructions,

and identifying information must match exactly. No data

element may be added to or deleted from the form . The

sequence and format for each item on the form must be

reproduced to the highest degree possible. Each item must print

on the page in approximately the same location. The approved

form must include the vendor/agency name and the RIS

approval expiration date at the bottom of each page.

INSTRUCTIONS Agencies using substitute forms must insure that all the

instructional materials included with the forms are provided to

the person completing the form.

Copies Standard forms that have carbons may be photocopied to create

the needed copies. The original form must have an original

signature. Copies may have a photocopy of the signature.

SUBSTITUTE FORM RIS must approve substitute forms. Agencies or vendors 

APPROVAL PROCEDURE who develop forms packages must submit a complete printed

set of the forms and a fully functional copy of the program to us

for approval prior to actual use of the forms. We will issue

approvals for 1-year periods in order to insure that the forms

remain current. We will maintain a list of approvals. If a form

is revised during the year, we will notify the substitute form

developer of the revision and the deadline for revision of the

program.

Requests for approval should be delivered or mailed to:

 Retirement and Insurance Service

 Agency Services Division

 Room 4351

 1900 E. St, NW

 Washington DC 20415

Agencies who have developed, or plan to develop automated

forms that are populated from internal automated systems,

and/or can store input to a data base, should contact RIS for

information on direct data transmission via disk, tape, telephone

or the internet. Agencies may submit their plans to the address
3

shown above or call 202-606-0788.

Information about automated forms and automation initiatives

underway in agencies can be found on the OPM Mainstreet

Bulletin Board System (BBS). The BBS can be accessed by

modem at 202-606-4800. The Agency Automation Initiatives

forum is selection <D> on the forum menu.

LIST OF FORMS The attached tables list the forms and any special

AND SPECIAL requirements. The forms listed may be used in CSRS and

REQUIREMENTS FERS retirement application packages or for any other purpose

for which they were designed. 

Mary M. Sugar, Chief

Agency Services Division

Retirement and Insurance Service

Attachment
4

Table 1. CSRS Applications Special Requirements

__________________________________________________________________________________________________________

SF 2800 Application For Death Benefits (CSRS).

None.

SF 2800A Agency Certification of Death In Service.

None.

SF 2801 Application For Immediate Retirement - CSRS.

If printed 2-sided, must be head-to-foot. May be printed

1-sided.

SF 2801-1 Information and Instructions for completing Application

For Immediate Retirement - CSRS.

If printed 2-sided, must be head-to-foot. May be printed

1-sided.

SF 2801-2 Spouse's Consent to Survivor Election.

Must be printed 1-sided.

SF 2801-3 Election of Former Spouse Survivor Annuitant.

Must be printed 1-sided.

SF 2801, Schedule A,B,C Must be printed 1-sided.

SF 2801, Schedule D If printed 2-sided, must be head-to-foot. May be printed

1-sided.

SF 2802 Application for Refund of Retirement Deductions.

Must be printed on the same sheet as 2802B.

SF 2802B Current/Former Spouse's Notification.

Must be printed on the same sheet as 2802.

SF 2803 Application To Make Deposit Or Redeposit.

None.

SF 2804 Application to Make Voluntary Contributions

None

SF 2805 Request For Recovery Of Debt Due The United States

Government.

None.
5

Table 1 Continued.

 CSRS Applications Special Requirements

__________________________________________________________________________________________________________

SF 2806-1 Notice Of Correction Of Individual Retirement Record.

None.

SF 2808 Designation of Beneficiary - CSRS.

None.

SF 2809 Health Benefits Registration Form

None.

SF 2810 Notice Of Change In Health Benefits Enrollment.

The instructions to Copy 1 (the Enrollee copy) must be on

the reverse of Copy 1 or attached to it.

SF 2817 Life Insurance Election.

Blue colored paper is preferred but not required. Must

produce separately the front of Part 1 and Part 2 because

they are not identical. The front of Part 3 may be

photocopied. The instructions must be on the reverse of

the part to which they apply, or attached to the part.

SF 2818 Continuation of Life Insurance Coverage.

Blue colored paper is preferred but not required. Must

print all 4 pages.

SF 2819 Notice Of Conversion Privilege.

Blue colored paper is preferred but not required. Must

print the form on the front and back of 1 page.

SF 2821 Agency Certification Of Insurance Status.

Blue colored paper is preferred but not required. The

instructions must be on the reverse of the part to which

they apply, or attached to it.

SF 2823 Designation Of Beneficiary - FEGLI.

Blue colored paper is preferred but not required. The

instructions must be on the reverse of the part to which

they apply, or attached to it.
6

Table 1 Continued.

 CSRS Applications Special Requirements

__________________________________________________________________________________________________________

SF 3112 Documentation In Support of Disability Retirement

Application.

Sections of the form with no printing on the backs must

be printed that way. The instructions must be on the

reverse of the form to which they apply, or attached to it.

SF 3112-1 Information About Disability Retirement.

None, but booklet must accompany SF 3112 used by

CSRS Employees.

OPM Form 1510 Certification of Agency Offer of Position.

None.

OPM Form 1515 Military Service Deposit Election.

None.
7

Table 2. FERS Applications Special Requirements

__________________________________________________________________________________________________________

NOTE: Buff colored paper is preferred, but not required,

for all of the SF 3107 forms and schedules.

SF 2809 )

SF 2810 )

SF 2817 )

SF 2818 }==> Same requirements as stipulated in Table 1.

SF 2819 )

SF 2821 )

SF 2823 )

SF 3107 Application For Immediate Retirement - FERS.

None.

SF 3107-1 Certified Summary of Federal Service (FERS).

None.

SF 3107-2 Spouse's Consent To Survivor Election - FERS.

Must be printed 1-sided.

SF 3107, Schedule A,B,C Must be printed 1-sided.

SF 3112 Documentation In Support of Disability Retirement

Application.

Sections of the form with no printing on the backs must

be printed that way. The instructions must be on the

reverse of the form to which they apply, or attached to it.

SF 3112-2 Information About Disability Retirement.

None, but booklet must accompany SF 3112 used by

FERS Employees.
8

Published in the Federal Register, Thursday, November 2, 1995, pages 55660 and

55661.

GENERAL SERVICES ADMINISTRATION

41 CFR Part 201-9

RIN 309-AF72

Amendment to Revise FIRMR

Provisions Regarding the Standard and

Optional Forms Management Program

AGENCY: Information Technology Service, GSA.

ACTION: Final rule.

SUMMARY: This rule amends the Federal Information Resources Management Regulation

(FIRMR) to simplify and clarify procedures related to the Standard and Optional Forms

Management Program. Current procedures for this Program result in delays in the processing

of forms requests, especially requests for exceptions to the use of Standard forms. This rule

streamlines these processes and allows agencies to deal directly with the responsible parties

regarding the issuance and printing of these forms. The specific changes in this rule include

allowing agencies to obtain approval for an exception to the use of Standard forms directly

from the promulgating agencies; and giving the promulgating agencies fun responsibility for

certifying their proposed forms comply with applicable laws and regulations, announcing the

availability of new or revised Standard forms and providing GSA with an accurate camera

ready copy of the forms.

EFFECTIVE DATE: This rule is effective December 4, 1995.

FOR FURTHER INFORMATION CONTACT:

R. Stewart Randall, GSA,

Office of Information Technology (IT)

Policy and Leadership, Center for IT

Policy and Regulations Management (KAR),

18th and F Streets, NW., Room 3224,

Washington, DC 20405,

telephone FTS/Commercial (202) 501-4469 (v) or

(202) 501-0469 (tdd).

SUPPLEMENTARY INFORMATION: (1) Part 201-9.202 is amended to delegate additional

authority and responsibility to agencies regarding the granting of exceptions to Standard
9

Forms. Currently, the FIRMR requires Federal agencies to submit a request for an exception

to a Standard Form directly to GSA. GSA then reviews the exception request for

conformance to good forms management practices. However, GSA also forwards the

exception request directly to the promulgating agency for the agency's recommendation for

approval or disapproval of the exception request. Since GSA and the promulgating agency

typically agree on the disposition of an exception request, GSA believes it is more efficient to

give promulgating agencies all authority for the exception request process. Accordingly, the

requirement in section 201-9.202-1 paragraph (b)(2) for Federal agencies to obtain approval

from GSA for exceptions to Standard forms is removed for the FIRMR. Instead, agencies

will send their exception requests directly to the agency promulgating the Standard Form.

(2) Agencies typically request to establish standard forms because of a statutory or

programmatic requirement. In the past, GSA conducted research to verify a requested form

was consistent with the agency's authority and would meet the agency's requirements. GSA

now will accept agencies' certification that their new or revised forms requirements are legally

required and technically adequate. This change eliminates GSA duplicating work already

performed by, the agency. Agencies will also be required to announce the availability of their

new or revised forms in the Federal Register and provide GSA an accurate camera ready copy

of the new or revised form. GSA will no longer verify the accuracy of the camera ready

copy. Agencies are given full authority and responsibility to ensure the accuracy of their

copies; just as they are with other aspects of establishing new or revised forms. These

changes are reflected in § 201-9.202-1 paragraphs (b)(4) and (b)(6). GSA will continue to

publish a list of all Standard and Optional forms in its Inventory of Standard and Optional

Forms and facsimiles of all forms in its Standard and Optional Forms Facsimile Handbook.

(3) Several format and editorial changes are also being made to § 201-9.202-1 to

reflect the new operating environment of the forms program. Also, this amendment reflects a

change in the responsibility for the Standard and Optional Forms Management Program from

the Center for IT Policy and Regulations Management (KAR) to the Forms Management

Branch (CARM) due to the transfer of program responsibility within GSA. FIRMR Bulletin

B-3 has also been revised to reflect the above changes.

(4) GSA has determined that this rule is not a significant rule for the purposes of

Executive Order 12866 of September 30, 1993, because it is not likely to result in any of the

impacts noted in Executive Order 12866, affect the rights of specified individuals, or raise

issues arising from the policies of the Administration. GSA has based all administrative

decisions underlying this rule on adequate information concerning the need for the

consequences of this rule; has determined that the potential benefits to society from this rule

outweigh the potential costs; has maximized the net benefits; and has chosen the alternative

approach involving the least net cost of society.

List of Subjects in 41 CFR Part 201-9
10

Archives and records, Computer technology, Telecommunications, Government procurement,

Property management, Records management, and Federal information processing resources

activities.

For the reasons set forth in the preamble, GSA proposes to amend 41 CFR part 201-9 as

follows:

PART 201-9--CREATING,

MAINTENANCE, AND USE OF RECORDS

1. The authority citation for part 201-9 continues to read as follows:

Authority: 40 U.S.C. 486(c) and 751(f).

2. Section 201-9.202-1 is revised to read as follows:

§ 201-9.202-1 Standard and Optional Forms Management Program.

(a) General. (1) The Standard and Optional Forms Management Program was

established to achieve Governmentwide economies and efficiencies through the development,

maintenance and use of common forms.

(2) FIRMR Bulletin B-3 contains additional guidance on the Standard and

Optional Forms Management Program.

(b) Procedures. Each Federal agency shall--

(1) Designate an agency-level Standard and Optional Forms Liaison

Representative and Alternate, and notify GSA in writing of such designees' names, titles,

mailing addresses, and telephone numbers within 30 days of the designation or redesignation

at the address in paragraph (b)(4) of this section;

(2) Promulgate Governmentwide Standard Forms pursuant to the agency's

statutory or regulatory authority and issue in the Federal Register Governmentwide

procedures on the mandatory use, revision, or cancellation of these forms;

(3) Sponsor Governmentwide Optional Forms when needed in two or more

agencies and announce the Governmentwide availability, revision, or cancellation of these

forms;

(4) Request GSA approval for each new, revised or canceled Standard and

Optional Form, 60 days prior to planned implementation, and certify that the forms comply

with all applicable laws and regulations. Send approval requests to: General Services
11

Administration, Forms Management Branch (CARM), Washington, DC 20405;

(5) Provide GSA with a camera ready copy of the Standard and Optional Forms

the agency promulgates or sponsors prior to implementation, at the address shown in

paragraph (b)(4) of this section;

(6) Obtain promulgator's or sponsor's approval for all exceptions to Standard and

Optional Forms prior to implementation;

(7) Annually review all Standard and Optional Forms which the agency

promulgates or sponsors, including exceptions, for improvement, consolidation, or

cancellation;

(8) When requested by GSA and OMB, submit a summary of the Standard

and Optional Forms used for collection of information covered by 5 CFR part 1320;

(9) Request approval to overprint Standard and Optional Forms by contacting

GSA (CARM); and

(10) Coordinate all matters concerning health care related Standard Forms

through the Interagency Committee on Medical Records (ICMR). For additional

information on the ICMR, contact GSA (CARM).

Dated: October 24, 1995.

Roger W. Johnson,

Administrator of General Services.

[FR Doc. 95-27221 Filed 11-1-95; 8:45 am]