OMB control number

Annuitant/OWCP Health Benefits Election Form

OMB 3206-0239 · OPM.

OMB 3206-0239

Latest Forms, Documents, and Supporting Material

Document Name
Annuitant/OWCP Health Benefits Election Form Form

All Historical Document Collections

200207-3206-002 Approved without change	Extension without change of a currently approved collection	2002-07-03
199901-3206-003 Approved without change	New collection (Request for a new OMB Control Number)	1999-01-29