Office of Personnel




Benefits Forms for Employees Hired on or after October 1, 1987

Form # Title
  Pre-Tax Waiver/Election Form*
SF 1269 Health Benefits Program Registration Form*
SF 1275 Life Insurance Election*
SF 1276 Designation of Beneficiary*
SF 1287 Request for Benefit Payment*


* This document is presented in Portable Document Format (PDF). A PDF reader is required for viewing.
Download a PDF Reader or Learn More About PDFs.