Application form opm 2026

1. Click ‘Get Form’ to open the application form opm in the editor.
2. Begin by entering your name in the first field, ensuring you include your last, first, and middle names.
3. Fill in your Social Security Number and Employee Number in the designated fields.
4. Provide details about your position title, pay plan, and grade/pay level in sections 4a, 4b, and 4c respectively.
5. Enter the name of your organization along with your office telephone number.
6. Describe the nature and severity of the medical emergency affecting you or a family member. Include relevant dates for when the emergency began and is expected to end.
7. List the physician's name who will verify your medical emergency and attach any necessary documentation.
8. Indicate your annual and sick leave balances as of the last pay period, along with hours of leave without pay used for this emergency.
9. Provide a description of the medical emergency for distribution purposes, if applicable. Check boxes as needed regarding privacy preferences.
10. Complete sections regarding who is completing the application on behalf of another individual, including their relationship to you.
11. Certify that all statements are true by signing and dating where indicated at the bottom of the form.

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