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U waive all coverage or are ineligible, you are Read the back of Part 3 - Employee Copy carefully. automatically covered for Basic life insurance as an employee. When Assignees completing this form should read Items 5 and 6 on you first become eligible for FEGLI, you may (1) elect Basic and any the back of Part 3. or all of the options, (2) elect Basic but waive all of the options, or (3) Do not separate the parts. Give this form to your employing waive all life insurance coverage. If you a.
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