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Standard form 2817 2000-2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling in your identifying information in Section 2, including your name, employing department, Social Security Number, and contact details.
  3. In Section 3, indicate whether you want Basic life insurance by signing and dating the appropriate box. Remember, if you do not sign for Basic, you cannot elect any optional insurance.
  4. If you wish to select optional insurance (Options A, B, or C), proceed to Section 4. Mark the boxes for the options you want and specify the multiples where applicable.
  5. If you choose not to have any life insurance coverage at all, sign and date Section 5 to waive all coverage.
  6. Finally, review your completed form carefully for accuracy before submitting it through our platform to your employing office.

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standard form 2817

Life Insurance Election

NSN 7540-01-231-4280. 2817-105. Standard Form 2817. Rev. June 2000. The employees copy of this form, when completed by the employing office, together with theRead more

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