Form DPRS 2809 DPRS 2809 Request to Change FEHB or to Receive Plan Brochures for

Request to Change FEHB Enrollment or to Receive Plan Brochures for Spouse Equity/Temporary Continuation of Coverage Enrollees/Direct Pay Annuitants

DPRS 2809

Request to Change FEHB Enrollment or to Receive Plan Brochures for Spouse Equity/Temporary Continuation of Coverage Enrollees/Direct Pay Annuitants

OMB: 0505-0024

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