Spouse consent part 2026

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The document is a consent form for a spouse of a retiring employee, allowing the employee to elect not to provide a survivor annuity. It outlines the implications of this decision on the spouse's eligibility for Federal Employees Health Benefits (FEHB) coverage after the employee's death, while also detailing the rights of the spouse to enroll in FEHB based on their own employment status. The form requires signatures from both the spouse and a notary public.

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Click ‘Get Form’ to open the Spouse’s Consent to Survivor Election in the editor.
In Part 1, type or print your name in the designated field. This identifies you as the current spouse of the retiring employee.
Next, provide your signature in the specified area. Remember, do not print your name here; a handwritten signature is required.
Enter the date of signing in the format provided. This confirms when you gave your consent.
If applicable, proceed to Part 2 where a Notary Public or authorized person will complete their section. They will need to certify your identification and consent.
Ensure that all fields are filled accurately before saving or exporting your completed form for submission.

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