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Usps light duty request form 2026
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- Click ‘Get Form’ to open it in the editor.
- In Part A, enter your printed name, signature, and date. Provide your Social Security Number, position, office/tour, duty hours/NS days, phone number, HMO number (if applicable), physician's name and specialty, address, and telephone number.
- In Part B, your immediate supervisor will indicate if work is available in your unit by checking the appropriate box and signing with the date.
- Part C requires the Postmaster or Plant Manager to approve or deny light duty. They will fill in the dates for approval if applicable and provide their signature and printed name.
- If light duty is approved for 90 days or more, Part D must be completed by the USPS District Medical Officer with their signature and date.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2000 | 4.8 Satisfied (162 Votes) |
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