Page 1 June 2012 

Attachment C - CSA Document Order for Retirement Package Submissions 

(non-disability) 

A. Always check every paper– make sure Name/ DOB/ SSN match 

B. 2-Hole Punch set at 8 1⁄2 

C. Punch holes with 2-hole punch on the RIGHT side of all landscape papers; on the TOP of all 

portrait papers 

D. All forms on the same # above should be mixed together and placed in reverse chronological

order by effective date: most recent date on top, oldest date on bottom 

E. Any partial pieces of paper or small papers should be stapled to a blank full sheet of paper to be 

included in case 

F. If there is a 79-9 or there is a Health Benefits form that is unprocessed or the

effective date is after the retirement date, place at top of retirement package 

G. Do not tear papers off prongs in OPF or other folders. This damages the form and it will need to 

be repaired prior to submission to OPM. Holes need punched at the top (portrait) or right side 

(landscape). If this area is torn, use clear tape on the document to create an area that can be 

punched. 
Page 2 June 2012 

CSA Document Order for retirement package submissions (non-disability) 

Top of Retirement Package 

1. Cover sheet notifying OPM of HB changes at retirement 

2. Documents for HB changes at retirement, unprocessed current open season, 

79-9 & copy of ID cards 

3. Cover sheet for special retirement type (NGT, Law Enforcement, Fire Fighter, ATC, etc.) 

4. 2806, 3100, 2806-1, 3101, computer printout IRR, High 78 – Individual Retirement 

Record (do NOT punch holes through the data, punch right side) 

5. 2806, 3100 -post 56 military deposit IRR(only the military deposit IRR, not worksheets/application) 

6. 2801-1, 3107-1 –Summary of Service 

7. RTR, RTR detail, FAA 3300; certification of service: ATC, LEO/FF, Postal 

Inspector, CBPO 535; ATC retirement SF 50 

8. 2801 Schedule D, 3107 Schedule D – Agency checklist 

9. 2809 & 2810, including Employee Express HB printout, Computer printout, HB memo 

10. 2821, 56, 2820 – Agency Certification of Life Insurance 

11. 2818 – Continuation of LI election 

12. 2817, 2822, 53, 55, RI 76-27, FE2004, 176, 176T, SF 50 in lieu of SF 2817 – LI election 

13. 2819 – Life Insurance conversion privilege 

14. 2823, 54 – FEGLI Designation of Beneficiary 

15. 2808, 3102 – Retirement System Designation of Beneficiary 

16. Any other Designation of Beneficiary 

17. 2801, 3107 – Application for Retirement (always have this form) 

18. RI 38-124, RI 38-122, RI 38-145 – Voluntary Contributions Election, Alternative Annuity Roll 

Over Election, NAF Election

19. 2801, 3107 – Schedule ABC

20. 1515 – Military Service Deposit Election 

21. 2801-2, 3107-2, 1538, notary form – Survivor Election, Former Spouse Survivor Elect. 

22. 1555, 3109, 3110 – FERS Election form; Former Spouse’s Consent to FERS election

23. 1510 – Agency offer of position 

24. DD-214, Military Discharge paperwork 

25. Waiver of Military Pay 

26. SF 50, PS 50, SF 52 – Notification of Personnel Action 

27. 1514, Request for military earnings 

28. 2803, 3108 – Deposit Application or Military Deposit Application/worksheets 

29. 2802, 3106 – Refund Application 

30. 2804 – Voluntary Contributions Application 

31. 2805 – Government Debt 

32. All other forms and papers (retirement estimate, marriage certificate, other papers/forms) 

33. FERCCA information – Erroneous Retirement coverage papers 

34. Court Order (divorce decree, etc.) 

35. W-4 – place State on top of Federal 

36. Direct Deposit form or EFT form (remove carbons) 

Bottom of Retirement Package