OMB control number
Report of Medical Examination of Person Electing Survivor Benefits Under the Civil Service Retirement System
OMB 3206-0162 · OPM.
OMB 3206-0162
OPM Form 1530 is designed to collect information from both the applicant and the applicant’s physician regarding the applicant’s health. This information is used to determine whether the insurable interest survivor benefits election can be allowed.
The latest form for Report of Medical Examination of Person Electing Survivor Benefits Under the Civil Service Retirement System expires 2026-06-30 and can be found here.
Latest Forms, Documents, and Supporting Material
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Form and Instruction |
Supporting Statement A |
Supplementary Document |
Supplementary Document |
Supplementary Document |
Form OPM 1530 Report of Medical Examination of Person Electing Survivor Benefits Under the Civil Service Retirement System
OPM1530_OMBSupportStmt_2024_04_29.docx
OPM1530_30DayFRNPublished_2024_02_06_Final.pdf
Report of Medical Examination of Person Electing Survivor Benefits Under the Civil Service Retirement System All Historical Document Collections