OPM 2809, Health Benefits Election Form

ICR 202304-3206-001

OMB: 3206-0141

Federal Form Document

Forms and Documents

Document Name	Status
Form OPM 2809 Health Benefits Election Form Form and Instruction	Modified
OPM2809_30DayFRNPublished_2023_04_03.doc.pdf Supplementary Document	2023-04-21
OPM2809_60DayFRNPublished_2023_02_06.pdf Supplementary Document	2023-04-21
E8-5659.pdf Supplementary Document	2023-04-21
OPM2809_OMBSupportingStatement_2023_final.docx Supporting Statement A	2023-04-21

IC Document Collections

IC ID	Document Title	Status
33609	Health Benefits Election Form Form and Instruction	Modified