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Application form opm 2026
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- Click ‘Get Form’ to open the application form opm in the editor.
- Begin by entering your name in the first field, ensuring you include your last, first, and middle names.
- Fill in your Social Security Number and Employee Number in the designated fields.
- Provide details about your position title, pay plan, and grade/pay level in sections 4a, 4b, and 4c respectively.
- Enter the name of your organization along with your office telephone number.
- 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.
- List the physician's name who will verify your medical emergency and attach any necessary documentation.
- Indicate your annual and sick leave balances as of the last pay period, along with hours of leave without pay used for this emergency.
- Provide a description of the medical emergency for distribution purposes, if applicable. Check boxes as needed regarding privacy preferences.
- Complete sections regarding who is completing the application on behalf of another individual, including their relationship to you.
- Certify that all statements are true by signing and dating where indicated at the bottom of the form.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2001 | 4.8 Satisfied (190 Votes) |
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