Gency Report No. 1064-OPM-AR Payroll Office Number Report Number Month reported on Statement of Transactions Date Payroll Paid PAY PERIOD From To Telephone number (including area code) To: OFFICE OF PERSONNEL MANAGEMENT ATTN: FUNDS MANAGEMENT POST OFFICE BOX 582 WASHINGTON, DC 20044-0582 Benefit Category Withholdings I certify that the items listed herein are correct and the amount is available to be credited to the OPM receipt account. Signature of authorized Administrative or Certif.
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How to fill out the OPM SF 2812-A online
The OPM SF 2812-A is a vital document for reporting withholdings and contributions related to health benefits, life insurance, and retirement. This guide will provide detailed instructions on how to fill out this form online, ensuring a smooth experience.
Follow the steps to accurately complete the OPM SF 2812-A form.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by entering your address, including the department, bureau, location, and ZIP code, in the designated field.
- Provide the payroll office number and report number in the appropriate sections to identify your report correctly.
- Indicate the month reported on the statement of transactions and the date payroll was paid, utilizing the respective fields.
- Document the pay period by specifying the 'From' and 'To' dates, indicating the duration covered by the report.
- Enter your telephone number, including area code, in the designated field for contact purposes.
- In the benefit category, complete the sections for withholdings, contributions, and any applicable health benefits and life insurance categories, ensuring all figures are accurate.
- Under retirement, fill in the relevant details for CSRS and FERS categories, including salary offset and military service credits as necessary.
- Verify that all fields are filled out correctly, then affix your signature as the authorized administrative or certifying officer in the signature area.
- Review the form for accuracy, then save changes, and proceed to download, print, or share the completed form as required.
Start completing the OPM SF 2812-A form online today to ensure timely reporting.
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