6/14/12 Version 1 

Attachment A – CSRS and FERS Development Checklist and Log 

FERS Development Checklist 

Misc: Yes No NA 

FERS Deferred? If 10 or more years of service – refer to LAS

Checked ARPS Service Credit AQS (OWCP) NATS DCCS

Close out U#s, indicate with red ‘C’ on the U #

Discontinued service 1510 and notice

Early out authority number

Agency certification for ATC, LEO, firefighter, nuclear material courier, CBPO 535

ATC: retirement SF50

VA nurse code VN 0610, 0605 and all VA physician: USL expiration date 

Unused Sick Leave

Frozen CSRS Sick Leave

Service: Yes No NA

Complete IRRs for covered service

FICA earnings or pay rates including EO adjustments

FICA earnings when required (all postal 3 months or more)

Intermittent/WAE hours or days worked

Part-time tour or hours worked

5 years congressional service or court ordered award (to DC)

 

HBs & FEGLI: Yes No NA 

Proof of 5 years - HB

HB waiver of 5 years for DSR or Early Out

Correct HB code on label

Print G mat if HB change done

Proof of 5 years - LI

Required signatures on 2821, 2818, desis

2821, 2818, completed accurately

 

Application: Yes No NA 

Required signatures on 3107, 3107-2

Annuitant election and spousal consent agree

Spousal consent signed & notarized on the same date

Former spouse with court awarded benefit

 

Military: Yes No NA 

DD214s noting character of service or military orders

P56 deposit IRR paid in full

MRP clarified

 

Screener Signature: Date:
6/14/12 Version 1 

FERS Development Log for _________________________________ SSN_______________ 

CSA # ___________________ Payroll # _____________________ Date _________

Agency__________________________________________ Submitting Office # __________ 

ISSUES REQUIRING DEVELOPMENT

Use separate line for each matter requiring development

Resolved?

Yes

1.

2.

3.

DEVELOPMENT STEPS TAKEN

Use corresponding block number to document steps taken to develop case

1. Contacted: At: (phone # or email)

Info/documents requested: Date:

 DCCS HOLD CODES

Follow-up date(s):

2. Contacted: At: (phone # or email)

Info/documents requested: Date:

 DCCS HOLD CODES

Follow-up date(s):

3. Contacted: At: (phone # or email)

Info/documents requested: Date:

 DCCS HOLD CODES

Follow-up date(s):
6/14/12 Version 1 

CSRS Development Checklist 

Misc: Yes No NA

Checked ARPS Service Credit AQS (OWCP) NATS DCCS

Close out U#s, indicate with red ‘C’ on the U #

Discontinued service 1510 and notice

Early out authority number

Agency certification for ATC, LEO, firefighter, nuclear material courier, CBPO 535

VA nurse code VN 0610, 0605 and all VA physician: USL expiration date 

Unused Sick Leave

Service: Yes No NA

Complete IRRs for covered service

FICA earnings or pay rates including EO adjustments

FICA earnings when required (all sub rural carrier service, postal service 5 yrs or more)

Intermittent/WAE hours or days worked

Part-time tour or hours worked

5 years congressional service or court ordered award (to DC)

 

Offset cases: Yes No NA 

HBPC breakdown for offset service beginning with cy 2004

2.H entered

Offset amount received for offset cases age 62 or older

HBs & FEGLI: Yes No NA 

Proof of 5 years - HB

HB waiver of 5 years for DSR or Early Out

Correct HB code on label

Print G mat if HB change done

Proof of 5 years - LI

Required signatures on 2821, 2818, desis

2821, 2818, completed accurately

 

Application: Yes No NA

Required signatures on 2801, 2801-2

Annuitant election and spousal consent agree

Spousal consent signed & notarized on the same date

Former spouse with court awarded benefit

 

Military: Yes No NA

DD214s noting character of service or military orders

P56 deposit IRR paid in full

SSA verification if P56 not paid and within 3 months of age 62 or older

MRP clarified

 

Screener Signature: Date:
6/14/12 Version 1 

CSRS Development Log for _________________________________ SSN_______________ 

CSA # ___________________ Payroll # _____________________ Date _________

Agency___________________________________________ Submitting Office # _________

ISSUES REQUIRING DEVELOPMENT

Use separate line for each matter requiring development

Resolved?

Yes

1.

2.

3.

DEVELOPMENT STEPS TAKEN

Use corresponding block number to document steps taken to develop case

1. Contacted: At: (phone # or email)

Info/documents requested: Date:

 DCCS HOLD CODES

Follow-up date(s):

2. Contacted: At: (phone # or email)

Info/documents requested: Date:

 DCCS HOLD CODES

Follow-up date(s):

3. Contacted: At: (phone # or email)

Info/documents requested: Date:

 DCCS HOLD CODES

Follow-up date(s):