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Certification of Insured Employee's Retired Status

Certification of Insured Employee's Retired Status

Agencies use this form for employees who have (1) retired under any Federal system OTHER THAN the Civil Service Retirement System (CSRS) or Federal Employees' Retirement System (FERS), and who (2) submit a completed SF 2821, Agency Certification of Insurance Status.

Electronic Copies:

SF 2820

Paper Copies:


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

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