Fillable P-00 08a P-00 08a Reg Form.PDF (U.S. Office of Personnel Management)

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P-00 08a P-00 08a Reg Form.PDF (U.S. Office of Personnel Management)

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U.S. Office of Personnel Management
Federal Benefits Conference
Benefits Interchange 2000
To Register for the Benefits Interchange 2000, fax this form to (202) 606-4327 or mail to: U.S. Office of Personnel
Management, Retirement and Insurance Service, Attention: Federal Benefits Conference, 1900 E Street, NW,
Washington, DC 20415-3300
First name: _______________________________ Last name: ______________________________________
Agency: ___________________________________________________________________________________
Address: ___________________________________________________________________________________
Address: ___________________________________________________________________________________
City: __________________________ State: _________ Zip:_______________
Phone: _________________________ FAX: ____________________________________
Email: _______________________________________________________________________
Special Needs (Handicap and Dietary Restrictions): _________________________________________________
Pre-Conference Workshops
Retirement Coverage Issues (June 5, $150) Reemployed Annuitants (June 6, $150)
Insurance 101 (June 5, $150) Advanced Insurance Issues (June 6, $150)
Former Spouse Benefits (June 5, $150) Benefits for Current Spouses (June 6, $150)
Government Pensions & Social Security
(June 6, $150)
Conference Tuition: $545
Total Cost of Workshops:
TOTAL CHARGE:
Payment Method: VISA MasterCard SF 182 or equivalent Check
[If payment is by SF 182 or DD 1556, the completed form MUST be attached.]
Name on Card: ______________________________________________________________________
Card Number: __________________________________________ Expiration Date:_______________
Address of Card Holder: ______________________________________________________________
______________________________________________________________
Telephone Number of Card Holder: ______________________________________
Signature of card holder: _______________________________________________
Ver. Web Acro 4.04
Assisting Survivors Upon the Death of a
Federal Employee (June 5, $150)
Deposits Under CSRS & FERS (June 5-6, $225)
$545
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P-00 08a P-00 08a Reg Form.PDF (U.S. Office of Personnel Management)

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Completed 18 July 2020

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