Ds5004 2026

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The document is an application form for retirement under the Foreign Service Retirement Systems, issued by the U.S. Department of State's Bureau of Human Resources/Office of Retirement. It outlines the necessary personal and retirement information required from applicants, including details about marital status, military service, and any workers' compensation claims. The form emphasizes the importance of accurate completion to avoid delays in processing and includes a privacy statement regarding the use of provided information.

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Click ‘Get Form’ to open the ds5004 in the editor.
Begin by filling out Section A: Personal Information. Enter your name, date of birth, and current address. Ensure all details are accurate to avoid delays.
In Section B: Retirement Information, provide your final separation date and agency details. Select the nature of retirement that applies to you.
Complete Section C: Military Service if applicable. Fill in your branch of service and dates of active duty.
If you have received workers' compensation, complete Section D with the necessary claim information.
Finally, review all sections for accuracy before signing in Section E: Certification of Applicant. This ensures your application is complete and truthful.

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2005	4.8 Satisfied (65 Votes)

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