OMB control number

Health Benefits Election Form, Annuitants

OMB 3206-0102 · OPM.

OMB 3206-0102

Latest Forms, Documents, and Supporting Material

Document Name
HEALTH BENEFITS ELECTION FORM, ANNUITANTS Form

All Historical Document Collections

198107-3206-014 Approved with change	No material or nonsubstantive change to a currently approved collection	1981-07-17
197911-3206-002 Approved without change	New collection (Request for a new OMB Control Number)	1979-11-29