Request For Insurance - OPM.gov
Request For Insurance . Federal Employees' Group Life Insurance (FEGLI) Program . Read instructions before completing this form. Part A Employing Agency . 1. Employee's name (last, first, middle) 2. Date of birth . mm/dd/yyyy) 3. Social Security number . 4. Employing department/agency (including bureau or division) 5. Work location (city and ...
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