OPM will mail a copy of the certified form to the employee's mailing address of record. pay according to the order listed in the first column. Retirement Operations Center An official website of the United States government. While every effort has been made to ensure that Washington, DC, 20585, Office of the Chief Human Capital Officer, Federal Employees' Group Life Insurance (FEGLI), Ethics - Fourteen Principles of Ethical Conduct for Federal Employees, Ethics - Impartiality in Performing Official Duties, Ethics - Restrictions on Former Employees, About Office of the Chief Human Capital Officer. 1320.8(b)(3). Read the instructions on the form carefully since they are different from other beneficiary forms. Instructions (PDF file) Inter vivos Format (PDF file) Testamentary Format (PDF file) Electronic Copies: SF 2823 (PDF file) Paper Copies: Employees: Request a paper copy of this form from your servicing Human Resources Office. Comments are encouraged and will be accepted until November 6, 2020. number; If you are unable to certify compliance with any of Please read the additional instructions below before completing this form. 5th Floor - Mail Stop 1400 Washington, DC 20229: Not an option. Benefits for life insurance, retirement, Thrift Savings Plan, and unpaid compensation are automatically distributed in the following order of precedence: An exception to the order of precedence is for Federal Employees Group Life Insurance (FEGLI). HOW TO DESIGNATE ONE BENEFICIARY First name, middle initial, and last name of each beneficiary Address (Including ZIP code) of each beneficiary Relationship Mary E. Brown 214 Central Avenue Muncie, IN 47303 Niece 100% Important Send it to the Office of Personnel Management, Retirement. PDF SF-2823 Designation of Beneficiary - Federal Employees Group Life Designation of Beneficiary Forms | U.S. Geological Survey - USGS.gov Fourth, if none of the above, to the executor or administrator of your estate. 2020-22153 Filed 10-6-20; 8:45 am]. This page lists all common Entrance on Duty (EOD) forms, MOU's, booklets, and information sheets. PROPERLY COMPLETED DESIGNATIONS ARE NOT VALID UNLESS, THE APPROPRIATE OFFICE LISTED ABOVE RECEIVES THEM, Title 5, U.S. Code, chapter 87, Life Insurance, authorizes solicitation, Office of Federal Employees' Group Life Insurance (OFEGLI) will use the information you, Security Number as an individual identifier to distinguish. Fifth, if none of the above, to your other next of kin as determined under the laws of the State where you lived. Until the ACFR grants it official status, the XML better and aid in comparing the online edition to the print edition. Box 45 Benefits for life insurance, retirement, Thrift Savings Plan, and unpaid compensation are automatically distributed in the following order of precedence: An exception to the order of precedence is for Federal Employees Group Life Insurance (FEGLI). Program_Revised. Mail to: Option B insurance coverage comes in 1, 2, 3, 4, or 5 multiples of your annual basic rate of pay. List the information required in Part B for each beneficiary. and explain the reason in the Supporting Statement. Unfortunately FEGLI Beneficiary designations are not available online and if you are not sure who you designated call OPM or fill out a new SF 2823 Designation of Beneficiary form. hb`````Z8y? endstream endobj 177 0 obj <. endstream endobj startxref Designation of Beneficiary Form (SF 2823) Designation of Beneficiary Section in FEGLI Handbook; OPM Designations of Beneficiary Page; Attachments are also available for designating a trust. You are not required to complete a designation of beneficiary form if you want your benefits distributed according to the order of precedence. If a valid assignment is not on file, but there is a, Management, as appropriate, any designation, I understand that if this Designation is valid, it will. hbbd```b``"VHF9"|Y,LJ`Yy0LZUn[Advd$d`X 256 0 obj <>stream If you want benefits paid to someone else or in a different order, you must designate a beneficiary. Second, to your child or children, with the share of any deceased child distributed among descendants of that child. Where do I send my completed Designation of Beneficiary (SF 2823) for FEGLI Designation of Beneficiary Form | dcrb See examples 5 and 6 on the Back of Part 1. A Notice by the Personnel Management Office on 10/07/2020. First, to the beneficiaries designated by your assignees, if any. edition of the Federal Register. A designation of beneficiary is a legal document outlining how benefits will be paid in the event of your death. If, with your application for a job, license, grant or, is the case, they should provide you with any such uses which are applicable at the time you, subject to verification, via paper, electronic, programs, with national, state, local or other charitable, agencies to determine and issue benefits under their, comments regarding our estimate or any other aspect of this form, including suggestions, We also ask for the Insured's Social Security Number to use it as an individual identifier in the. 230 0 obj <> endobj ATTN: Civilian Benefits Center (FEGLI), Designation of if you want to designate different types of insurance to different. Mail to: to the beneficiary(ies) the Insured validly designated; if none, to the Insured's widow or widower; if none of the above, to the Insured's child or children in equal, if none of the above, to the Insured's parents in equal shares, or, if none of the above, to the court-appointed executor or, if none of the above, to the Insured's other next of kin entitled, Yes. Thrift Savings Plan. Second, to your child or children, with the share of any deceased child distributed among descendants of that child. Mail to: that agencies use to create their documents. Mail to: Access your account to see all saved docs. These markup elements allow the user to see how the document follows the hbbd```b``:"6L*Hw0"YlM0 }` ; The AtHocbutton requires a government computer and a government Common Access Card (CAC) to enter site. Complete an SF 2823, Designation of Beneficiary, FEGLI. Evaluate the accuracy of the agency's estimate of the burden of the proposed collection of information, including the validity of the methodology and assumptions used; 3. A divorce does not invalidate a designation that names your former spouse as beneficiary; you must complete a new designation form. 2817, 2822, 53, 55, RI 76-27, FE2004, 176, 176T, SF-50 in lieu of SF 2817 - LI election. Read instructions on the Back of Part 2 before completing this form. A divorce does not invalidate a designation that names your former spouse as beneficiary; you must complete a new designation form. This feature is not available for this document. This form is not valid unless the Insured/Assignee signs in this box. See example 4 on Back, I understand that if there is a valid assignment on file, only the assignee has the, right to designate a beneficiary. Designation of Beneficiary for Life Insurance. @ f0 these provisions, identify the item by leaving the box unchecked HRSC Southwest "You" and "your" refer to the person completing this form (the Insured or an assignee). the current document as it appeared on Public Inspection on 6300 Miramar Way Back of Part 2 before completing this form. Marine Corps Air Ground Combat Center Twentynine Palms, SF 2823, Designation of Beneficiary, FEGLI, SF 2808, Designation of Beneficiary, CSRS, SF 3102, Designation of Beneficiary, FERS, SF 1152, Designation of Beneficiary, Unpaid Compensation of Deceased Civilian Employee, CA-40 Designation of a Recipient of the Federal Employees' Compensation Act Death Gratuity Payment, Department of Navy Civilian Human Resources, Uniformed Service Employment Reemployment Rights Act, Hosted by Defense Media Activity - WEB.mil, Department of Navy Civilian Benefits Center, Department of Navy Civilian Employee Assistance Program, Department of Navy Employment Information Center, Electronic Official Personnel Folder (eOPF). OPM Retirement Operations Center P.O. publication in the future. Standard Form 2823 is used by any Federal employee or retiree covered by the Federal Employees' Group Life Insurance (FEGLI) Program, or an assignee who owns an insured's coverage, to instruct the Office of Federal Employees' Group Life Insurance how to distribute the proceeds of the FEGLI coverage when the statutory order of precedence does not meet his or her needs. Life Insurance Election (FT/PT Only) SF-2809. you indicate otherwise on your designation of beneficiary, OFEGLI will distribute, that beneficiary's share equally among the surviving beneficiaries, or entirely to the, What if none of the beneficiaries is living when. Update Your FEGLI Designated Beneficiary Form | Federal Employee's Federal Employees' Group Life Insurance (FEGLI) Program, (DO NOT erase or cross-out. These tools are designed to help you understand the official document 3206-0136 Federal EmployeesFederal Employees' Group Life Insurance (FEGLI) Program Important: Group Life Insurance (DO NOT erase or cross-out. ), 12201 Sunrise Valley Drive Reston, VA 20192, Career/Career Conditional Appointment/Reinstatement, Competitive Service Temporary NTE 1 year or less, Excepted Service: Pathway Temporary Intern or Career Intern, Excepted Service Temporary NTE 1 yr or less, Excepted Service - Pathway Recent Graduates, Cooperative Summer Field Training Program or the Partnership Pipeline Program, Memorandum of Understanding for a Term Appt, credentialing center: http://www.fedidcard.gov/centerlocator.aspx, USGS Ethics Office contacts, guides, and other information, Benefits Information for New Hires Webinars, Whistleblower Protection and Prohibited Personnel Practices, Memorandum of Understanding for Seasonal Employment, Memorandum of Understanding for Intermittent Employment, Survey Manual Chapter on Smoking in Federal Buildings, Temporary Hire Pay and Benefits Information, USGS Equal Employment Opportunity & Non-Discrimination Statement, Designation of Beneficiary for Life Insurance, See Factsheets and Other Handouts section below, Some pre-appointment and EOD forms may not be required, please coordinate with your, Memorandum of Understanding for a Temporary Appt, DOI Access Acceptable Forms of Identification, Employee Financial Interests Certification, Honorable Discharge Certification or comparable certificate with entry and separation date of military service, Initial Ethics Orientation for New USGS Employees (March 2010) and Ethics Guide for DOI Employees, Federal Withholding Exemption Certificate, Designation of Beneficiary for Unpaid Compensation. Form SF 2823 Designation of Beneficiary - Fill https://www.federalregister.gov/d/2020-22153, MODS: Government Publishing Office metadata. electronic version on GPOs govinfo.gov. If your beneficiary is a trust, an estate, or anotherorganization, you'll need to know the trustee's, executor's, or business'sinformation. SF 2823, Designation of Beneficiary - Federal Employees' Group Life Insurance Program (FEGLI) SF2823_2020_07_Revised Designation of Beneficiary - Federal Employees' Group Life Insurance Program (FEGLI) OMB: 3206-0136 OMB.report OPM OMB 3206-0136 ICR 202203-3206-008 IC 33600
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