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Life Insurance Reference Materials

Agency Certification of Insurance Status

Agencies complete this form when an employee's life insurance stops or is scheduled to stop, except when the employee voluntarily cancels coverage, or the employee is immediately transferring to another position which will provide eligibility for FEGLI insurance coverage.

Electronic Copies:

SF 2821

Paper Copies:


Will receive a copy of the completed form from their servicing Human Resources Office, when applicable.


Use your internal agency procedures for ordering Standard Forms. Paper copies of this form are NOT available from OPM.

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