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pdfApplication to Make Deposit or Redeposit
OMB Approved
No. 3206-0134
Civil Service Retirement System
Civil Service
Retirement System
To avoid a delay in processing your claim:
1. Read the attached information carefully.
2. Type or print in ink.
3. Complete Part A in full and have your employing agency complete Part B. If you are not Federally employed, do not complete Part B.
A. To Be Completed by the Applicant
1.
Name (Last, first, middle)
2.
List all other names you have used
3.
Birthdate (mm/dd/yyyy)
4.
Address (Number and street)
5.
Department or agency in which presently or last employed
6.
Social Security Number
(City, state and ZIP code)
7.
Location of employment (City and state)
List below in chronological order all periods of civilian service for which you would like to pay a deposit or a redeposit.
Department or agency, including bureau,
branch, or division, where
you performed the service
8.
Periods of service
Location
Title of position
(City and state)
Are deductions for civil service retirement now being withheld from your salary?
9.
Yes
No
10. Give the dates of the period of service you want to pay for first.
Beginning date
(mm/dd/yyyy)
Ending date
(mm/dd/yyyy)
If your answer is "No," give the date of separation from your last position under the
Civil Service Retirement Law.
Check below to indicate whether
deductions were not withheld or
were withheld and refunded
Withheld
Not withheld
and refunded
Date of separation (mm/dd/yyyy)
Dates of Period (mm/dd/yyyy - mm/dd/yyyy)
Signature of applicant
Telephone number (including area code) where you can be reached during the day
(
Office of Personnel Management
CSRS/FERS Handbook for Personnel
and Payroll Offices
The February 2001 edition is usable.
All other previous editions are not usable.
Date (mm/dd/yyyy)
)
2803-114
NSN 7540-00-634-4252
Standard Form 2803
Revised July 2006
B. To Be Completed by the Employing Agency
Instructions to the Agency - This application is not to be used as a means for verifying service for leave, retention or other non-retirement purposes.
The procedures for verifying service for establishing creditability of service are contained in Chapter 20 of the CSRS/FERS Handbook. If more space is
needed for information requested in Item 3, please attach a separate sheet. Show the name and Social Security Number of the applicant on the separate
sheet (SF 2801-1 may be used for this purpose).
1.
Is the employee in a position subject to civil service retirement coverage?
No
3.
2.
Yes
Exact date civil service retirement deductions began for the current
appointment (mm/dd/yyyy)
Civilian Service Not Under a Retirement System for Federal Employees
From verified service documented in official personnel records, list any Federal civilian service not subject to a retirement system for Federal (or
D.C. Government) employees. If total basic salary earned for any such period is known, a summary entry may be entered on the right-hand side
below. Otherwise, show each change affecting basic salary during the period of service. Any period of nondeduction service claimed on the front
of this form which cannot be verified from official records should be listed and noted in the "Leave Without Pay" column as "Unverified." NOTE:
This information will also be requested (on the SF 2801-1) in connection with the employee's retirement. The agency should keep a copy of this
schedule to facilitate completion of the SF 2801-1.
If basic salary actually earned is available,
make summary entry below.
Basic
Salary basis
Nature of action
Effective date
Leave
salary rate
(per annum, per
From
To
Total
(Appt., pro., res., etc.)
(mm/dd/yyyy)
without pay
hour, WAE, etc.)
(mm/dd/yyyy)
(mm/dd/yyyy)
Earned
Certification - The information entered above is based on official records of this agency and is correct. There is no official personnel or fiscal record
in this agency of the additional service (if any) alleged by the employee and marked "Unverified" in item 3.
Agency address
Signature
Date (mm/dd/yyyy)
Official title
Email address
Telephone number (including area code)
Fax number (including area
code)
(
)
(
)
Privacy Act and Public Burden Statement
Solicitation of this information is authorized by the Civil Service Retirement law (Chapter 83, title 5, U.S. Code). The information you furnish will be used to determine your
eligibility to make deposits or redeposits to the Civil Service Retirement and Disability Fund, to identify records properly associated with your application, to obtain
additional information if necessary, and to maintain a uniquely identifiable claim file. The information may be shared and is subject to verification, via paper, electronic
media, or through the use of computer matching programs, with national, state, local or other charitable or social security administrative agencies in order to determine
benefits under their programs, to obtain information necessary for determination or continuation of benefits under this program, or to report income for tax purposes. It may
also be shared and verified, as noted above, with law enforcement agencies when they are investigating a violation or potential violation of civil or criminal law. Executive
Order 9397 (November 22, 1943) authorizes the use of the Social Security Number. Failure to furnish the requested information may delay or make it impossible for us to
determine your eligibility to make payments.
We think this form takes an average 30 minutes per response to complete, including the time for reviewing instructions, getting the needed data, and reviewing the completed
form. Send comments regarding our estimate or any other aspect of this form, including suggestions for reducing completion time, to the Office of Personnel Management
(OPM), OPM Forms Officer (3206-0134), Washington, DC 20415-7900. The OMB Number 3206-0134 is currently valid. OPM may not collect this information, and you are
not required to respond, unless this number is displayed.
PRINT
SAVE
CLEAR
Standard Form 2803
Revised July 2006
(Detach this information sheet before filling out the application)
Information Regarding Deposit and Redeposit
Civil Service Retirement System
Read this information carefully before filling out the attached application.
Who Should Use this Application?
You should use this application if you are covered by the Civil Service Retirement System (CSRS) and you want to pay a deposit or a
redeposit for civilian service. You should not use this application if you are covered by the Federal Employees Retirement System (FERS).
What You Should Know About Deposit for Civilian Service Under CSRS
Deposit is a payment to the retirement fund to cover a period of
civilian service during which no retirement deductions were
withheld from your salary (also called "nondeduction" service).
The amount of your deposit will be the percentage of your basic
salary shown below, plus interest.
You do not have to make a deposit if you do not wish to do so.
However, if you do not make the deposit —
•
For nondeduction service performed before October 1,
1982, you will receive credit toward your retirement annuity.
Your annuity will be permanently reduced by 10% of the
amount due as a deposit. For example, if a deposit of $600 is
required and it is not paid, the annuity is permanently reduced
by $60 a year (or $5 a month). On the other hand, if a deposit
of $600 is made, it will increase the annuity by $60 a year.
•
For nondeduction service performed on or after October
1, 1982, you will receive no credit in the computation of your
annuity. The period of service will be creditable for title and
average salary purposes whether or not a deposit is made.
Dates of Service
Deduction
Rate
July 1, 1926, and June 30, 1942 ........................................... 3.50%
July 1, 1942, and June 30, 1948................................................. 5%
July 1, 1948, and October 31, 1956 ........................................... 6%
November 1, 1956, and December 31, 1969 ........................ 6.50%
January 1, 1970, and December 31, 1998 .................................. 7%
January 1, 1999, and December 31, 1999 ............................. 7.25%
January 1, 2000, and December 31, 2000 ............................. 7.40%
January 1, 2001, and December 31, 2002 ............................. 7.50%
After December 31, 2002 .......................................................... 7%
(Certain special categories of employees are subject to higher
percentage deductions as specified in 5 U.S.C. 8334.)
What You Should Know About CSRS Redeposit
Redeposit is a payment to the retirement fund to cover a period of
service for which retirement reductions were withheld from your
salary and later refunded to you.
of service covered by the refund. If you do not pay the
redeposit for this service, your annuity will be permanently,
actuarially reduced because the redeposit is not paid. The
amount of the reduction will be based on factors which will be
divided into the amount of redeposit and interest you owe at
retirement.
You do not have to make a redeposit if you do not wish to do so.
However, if you do not make the redeposit —
•
•
For service which ended on or after October 1, 1990, you
will receive no credit in the computation of your annuity for
the period of service covered by the refund. This usually
results in a reduction in the amount of your annuity, or, in the
event of death, your eligible widow's (or widower's) annuity.
The period of service will be creditable for title and average
salary purposes whether or not a redeposit is made.
For service which ended before October 1, 1990, and your
annuity commences on or after December 2, 1990, you
will receive credit in your annuity computation for the period
•
If you retire on disability, you will not receive credit for
service with unpaid redeposits. This means that should you
retire because of a disability, you could find that you must pay
for the service to receive credit for it and that the accrual of
interest has increased the amount you must pay.
The amount of redeposit will be the sum of the refund plus
interest from the date the refund was paid to the date of redeposit
(or commencing date of annuity, whichever is earlier).
Standard Form 2803
Revised July 2006
How Interest Is Computed on Deposits
How Interest Is Computed on Redeposits
Interest is computed on the deposit from the midpoint of each
period of nondeduction service.
Interest is computed on the redeposit from the date the refund was
paid.
•
•
Interest for nondeduction service performed before October
1, 1982, accrues daily and is charged at the following rates,
compounded annually:
•
4 percent through December 31, 1947; and
•
3 percent from 1948 through the date the deposit is made
or to the commencing date of annuity, whichever is
earlier.
Additional interest does not accrue if payment is made in full
within 30 days after the Office of Personnel Management
(OPM) issues the billing statement.
•
Interest for nondeduction service performed on or after
October 1, 1982, accrues annually, is compounded annually
on December 31 of each year, and is charged at the following
rates:
•
3 percent through December 31, 1984; and
•
At a variable rate determined annually by the
Department of Treasury beginning January 1, 1985. The
variable interest rate for any year equals the overall
average yield to the fund from retirement securities
during the preceding fiscal year.
No interest is charged for a year when payment in full is
received by December 31 of that year.
If the refund was based on an application received by the
employing agency or OPM before October 1, 1982, interest on
the redeposit accrues daily beginning on the date the refund
was paid and is charged at the following rates, compounded
annually:
•
4 percent through December 31, 1947; and
•
3 percent from 1948 through the date the redeposit is
made, or to the commencing date of annuity, whichever
is earlier.
Additional interest does not accrue if full payment is made
within 30 days after the billing statement is issued.
•
If the refund was based on an application received by the
employing agency or OPM after September 30, 1982, interest
is charged beginning on the date the refund was paid, at the
following rates, compounded annually:
•
3 percent through December 31, 1984; and
•
A variable rate determined by the Department of
Treasury beginning January 1, 1985. The variable rate for
any year equals the overall average yield to the fund from
retirement securities during the preceding fiscal year.
For post-September 30, 1982, refunds, interest is not charged
for a year when payment in full is received by December 31
of that year.
Procedures Governing Civil Service Retirement System (CSRS) Deposit And Redeposit
Deposits and redeposits can be made by employees now serving
under the CSRS, by separated employees who are entitled (or
would be entitled after paying for service) to an annuity, or by
eligible widows, widowers, or former spouses of deceased
employees. An applicant for retirement is automatically given an
opportunity to make the deposit for nondeduction service
performed on or after October 1, 1982, and any redeposit when
the application for retirement is processed. An applicant for
retirement must specifically request an opportunity to make a
deposit for nondeduction service performed before October 1,
1982. An employee should not file an application to make
deposit or redeposit if he or she contemplates retirement
within six months.
If you are employed by the Federal or District of Columbia
Government, you must send your completed application to your
department or agency first because they must certify it.
If you are separated from the Federal or District of Columbia
Government, send your completed application directly to the
Office of Personnel Management, Retirement Operations Center,
Deposit Section, P.O. Box 45, Boyers, PA 16017-0045.
Instructions for making payment together with a statement for the
amount due will be sent to you as soon as the processing of your
application is completed.
Installment payments of at least $50 are acceptable. However,
interest accrues on the unpaid balance. You may authorize
direct debit payments. You will receive information about
how to authorize direct debit payments when you receive your
statement.
Specify the period of service you want to pay for first.
Contact your retirement counselor to discuss the advantages of
paying for one period of service over another before you make
your decision. After you have paid in full for the period of
service you select, please notify us if you want us to bill you
for any other service.
You cannot withdraw the payments you make unless you
become eligible for and obtain a refund of all your retirement
deductions.
Additional information and assistance in completing this
application may be obtained from the personnel office of
the Government department or agency in which you are
employed. If this source of information is not available to you,
contact the Office of Personnel Management, Civil Service
Retirement System, Boyers, PA 16017-0045, or call us at
1-888-767-6738 (TDD: 1-800-878-5708) Monday through
Friday from 7:30 AM to 7:45 PM Eastern Time.
Standard Form 2803
Revised July 2006
File Type | application/pdf |
File Title | Printing C:\6SF2803.FRP |
Author | PRPINKNE |
File Modified | 2006-05-23 |
File Created | 2006-05-18 |