Fillable Sf3100 Printing I:\SF\SF3100~1\SF_3100.FRP

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Sf3100 Printing I:\SF\SF3100~1\SF_3100.FRP

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Country of origin: US
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U.S.A. forms for U.S. Office of Personnel Management

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Last Name First Name Middle Name
1.
Date of Birth Soc. Sec. No. Agency Payroll Office Location Payroll Office No.
MM DD YYYY
2.
3.
4.
(RECORD EACH NAME CHANGE-STRIKE OUT PREVIOUS NAME)
Service History Fiscal Record
Effective Date
(1)
Action
(2)
Base Pay
(3)
Remarks
(4)
Year
(5)
Calendar Year
Salary
Deductions
(6)
Accumulated
Salary
Deductions
(7)
Remarks
(8)
Register of Separations Number (SF 3103)
U.S. Office of Personnel Management NSN 7540-01-247-0006
Individual Retirement Record
Standard Form 3100
5 CFR 841 3100-102
(Federal Employees' Retirement System)
Revised January 1987
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Sf3100 Printing I:SFSF31001SF_3100.FRP

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Completed 3 November 2019

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