Forms
Forms for New Employees
Appointment Affidavits (SF-61)
Purpose: This form is used on your first day of work when you take the Oath of Office. This form is NOT to be completed until you are sworn in.
Instructions: Print one copy. Bring this blank form with you on your first day. DO NOT COMPLETE. After you are sworn in, you will sign and date the affidavits.
Employment Eligibility Verification (I-9)
Purpose: To verify your citizenship and eligibility to work in the United States. Complete Section 1. Print one copy and sign and date the form.
Instructions: On your first day of work, you will be required to provide sufficient proof of citizenship. Refer to the back of this form for a list of acceptable documentation
NOTE: As of July 1, 2010, certified Puerto Rico birth certificates issued prior to July 1, 2010 will be invalid and unacceptable for Form I-9 purposes.
Declaration For Federal Employment (OF-306)
Purpose: This form is used to determine your acceptability for Federal employment.
Instructions: This form was requested at the time of your tentative offer. You must bring this form with your original signature in the applicant's signature block 17a on your first day of work. You will be required to sign as the appointee in block 17b on your fist day of work.
NOTE: A false statement on any part of this form may be grounds for not hiring you or for firing you after you begin work. You may also be punished by a fine or imprisonment.
Purpose: This form is used to designate your official mailing/residence address so you can receive important mailings.
Instructions: Read and complete ONLY sections 1-7. Print one copy and sign the form.
Employee's Withholding Allowance Certificate (W-4 Form)
Purpose: Determine the correct amount of Federal income tax to be withheld from your biweekly earnings based on the number of exemptions you claim. Required by the Internal Revenue Service (IRS).
Instructions: Use the Personal Allowances Worksheet to help you determine the number of withholding allowances that you are entitled to claim. Then, complete the W-4 Form, print a copy, and sign and date the form.
NOTE: If you are a resident of Colorado, Montana, Nebraska, New Mexico, North Dakota, or Utah, you must also submit a Pre-2020 W-4 in order to comply with the National Finance Center's acceptable state tax exemption data (Single/Married, Number of Exemptions). Please label the top of the Pre-2020 W-4 "State Tax" for State tax withholding purposes.
Purpose: To determine the correct amount of State income tax to be withheld from your biweekly earnings based on the number of exemptions you claim.
Instructions: Locate the appropriate form for your state/district of residence. Complete, print, sign and date one copy.
Not required for residents of Alaska, Florida, Nevada, South Dakota, Texas, Washington, and Wyoming. If you are a resident of Colorado, Montana, Nebraska, New Mexico, North Dakota, or Utah, see the note under the W-4 Form above.
NOTE: If you work in the District of Columbia and are not a resident of D.C., you must also complete the DC Non-Resident Form.
Direct Deposit Sign-Up Form (SF-1199A)
Purpose: Identify the financial institution where your biweekly earnings will be deposited through electronic funds transfer.
Instructions: Read and complete the form in type, print one copy, and sign the form. You must fill out this form by typing the information. In addition, please submit a copy of a voided check with the completed form.
Ethnicity and Race Identification (SF-181)
Purpose: To collect statistical information on the composition of the tdo workforce. Completion of this form is optional.
Instructions: Complete the form and print one copy.
Self-Identification of Disability (SF-256)
Purpose: To collect statistical information on the composition of the tdo workforce.
Instructions: Complete the requested information at the top of the form, using the appropriate code. Print one copy.
Purpose: This form is used to maintain an accurate record of your current military status.
Instructions: Print one copy, read and sign the form.
Purpose: This form summarizes the restrictions that apply to many Executive Branch employees after they leave Government employment.
Instructions: Print one copy and sign the form.
Previous Federal Employees
Verification of a Military Retiree's Service in Non-War Time Campaigns or Expeditions (SF-813)
Who Submits: All military retirees.
Purpose: This form is used to request verification of a retiree's military service performed in a non-war time campaign or expedition for which badge/medal was authorized, in order to credit such service for leave accrual rate and reduction-in-force purposes.
Instructions: Complete address block and items 1 through 9. Print one copy. Bring this completed form with you on your first day.
Non-Resident Employees Working in Washington D.C.
Certificate of Non-residence in the District of Columbia (D-4A)
Purpose: To certify non-resident status in the District of Columbia for tax purposes.
Instructions: Print one copy, complete, sign and date.
Benefit Forms
Health Benefits Election Form – Federal Employees Health Benefits Program (SF 2809)
Instructions: Complete and submit a SF2809 to the Benefits Service Center within the 60 days of the effective date found on your hire/confirmation letter (not necessarily your first day at work) if you wish to enroll in FEHB as a new employee.
Email: Benefits@fiscal.treasury.gov
Fax: (304) 480 - 8019
Mail:
Human Resources Operations Division
Benefits Avery 4-K, P.O. Box 1328
Parkersburg, WV 26106-1328
Life Insurance Election – Federal Employees' Group Life Insurance Program (SF 2817)
Instructions: Complete and submit a SF2817 to the Benefits Service Center within the 60 days of the effective date found on your hire/confirmation letter (not necessarily your first day at work) if you wish to elect additional FEGLI coverage.
Email: Benefits@fiscal.treasury.gov
Fax: (304) 480 - 8019
Mail:
Human Resources Operations Division
Benefits Avery 4-K, P.O. Box 1328
Parkersburg, WV 26106-1328
Thrift Savings Plan Election Form (TSP-1)
Instructions: New employees who want to change (increase or decrease) their Traditional TSP contribution amount or change to the Roth TSP or a combination of both Traditional TSP and Roth TSP may submit a TSP-1 directly to the Benefits staff during the first pay period after your hire date. Once you receive access to your Employee Personal Page account, you will be required to use the self-service feature for any future contribution changes.
Email: Benefits@fiscal.treasury.gov
Fax: (304) 480 - 8019
Mail:
Human Resources Operations Division
Benefits Avery 4-K, P.O. Box 1328
Parkersburg, WV 26106-1328
Note: New employees who do not wish to participate in the TSP are required to submit a TSP-1 during the first pay period to stop the automatic contribution.
Designation of Beneficiary – Unpaid Compensation of Deceased Civilian Employee (SF 1152)
Instructions: Complete and submit a SF 1152 if you would like funds payable upon your death to be paid in a different order than the order of precedence.
Email: Benefits@fiscal.treasury.gov
Mail original form to:
Human Resources Operations Division
Benefits Avery 4-K, P.O. Box 1328
Parkersburg, WV 26106-1328
Designation of Beneficiary – Federal Employees' Group Life Insurance (FEGLI) Program (SF 2823)
Instructions: Complete and submit a SF 2823 if you would like funds payable upon your death to be paid in a different order than the order of precedence.
Email: Benefits@fiscal.treasury.gov
Mail original form to:
Human Resources Operations Division
Benefits Avery 4-K, P.O. Box 1328
Parkersburg, WV 26106-1328
Designation of Beneficiary – Federal Employees Retirement System (SF 3102)
Instructions:: Complete and submit a SF 3102 if you would like funds payable upon your death to be paid in a different order than the order of precedence.
Email: Benefits@fiscal.treasury.gov
Mail original form to:
Human Resources Operations Division
Benefits Avery 4-K, P.O. Box 1328
Parkersburg, WV 26106-1328
Designation of Beneficiary – Civil Service Retirement System (SF 2808)
Instructions: Complete and submit a SF 2808 if you would like funds payable upon your death to be paid in a different order than the order of precedence.
Email: Benefits@fiscal.treasury.gov
Mail original form to:
U.S. Office of Personnel Management
Retirement Operations Center, P.O. Box 45
Boyers, PA 16017-0045
Contact Us
If you have any questions about these forms, contact FS/ARC at:
(304) 480 - 8000 Option 4