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Sf3116 SF 3116 (U.S. Office of Personnel Management)

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Phased Employment/Phased Retirement Status Elections
Part 1: Information about Electing Phased Employment/Phased Retirement Status
Part 1A: Election of Phased Employment/Phased Retirement
Part 2: I
R
nformation about Electing to End Phased Employment/Phased Retirement to Return to
egular Employment Status
Part 2A: Electing to End Phased Employment/Phased Retirement and Return to Regular
Employment Status
Part 3:
P
E
Move to another Agency While in Phased Employment/Phased Retirement: Continuing
hased Employment/Phased Retirement Status as of Move to Another Agency or
nding Phased Employment/Phased Retirement as of Move to Another New Agency
Part 3A: New Agency Consent to Continue Phased Employment/Phased Retirement
Part 3B: Election to End Phased Employment/Phased Retirement Status Upon a Move to
Another Agency
General Instructions for Employee:
Read the information regarding Phased Employment/Phased Retirement elections carefully before completing
any of the election forms in this package.
To Elect Phased Employment/Retirement Status:
Complete the election in Part 1A and obtain the consent of the appropriate agency official. Also complete the Application
for Immediate Retirement (Civil Service Retirement System) or (Federal Employees Retirement System), Standard Form 2801
or Standard Form 3107, as appropriate. Note: Read the special instructions pamphlet for completing the application for
immediate retirement pertaining to Phased Employment/Phased Retirement elections.
Return Part 1A of the election form and the Application for Immediate Retirement to your employing agency's Human Resource
Office or Benefits Office.
Complete deposits for post-1956 military service, if applicable, before the effective date of Phased Employment/Phased
Retirement. See Service Credit: Post-1956 Military Deposit section for more information.
Your employing agency will file a copy of your election in your Official Personnel Folder (OPF or e-OPF), and forward a copy
of the election, along with your application for immediate retirement and appropriate payroll records to the Office of Personnel
Management (OPM). OPM will then calculate and begin paying you your phased retirement annuity.
To Elect to End Phased Employment/Retirement to Return to Regular Employment Status:
Complete the election in Part 2A and obtain the consent of the appropriate agency official.
Return Part 2A of the election form to your employing agency's Human Resource Office or Benefits Office.
Your employing agency will file a copy of your election in your Official Personnel Folder (OPF or e-OPF), and forward a copy
of the election within 15 days of the election to the Office of Personnel Management (OPM). OPM will terminate the phased
retirement annuity.
Note, if you receive any phased retirement annuity payments after the effective date of your election to end Phased
Employment/Phased Retirement, the payments must be immediately returned to OPM.
(See page 11 for the Privacy Act Statement.)
U.S. Office of Personnel Management
3116-001
Standard Form 3116
CSRS/FERS Handbook for Personnel and Payroll Office October 2014
To Elect to Continue Phased Employment/Retirement Upon a Move to Another Agency:
Complete the election in Part 3A and obtain the written consent of the appropriate agency official in the agency where you are
transferring to. Submit the Part 3A of the election form to your current agency's (that is, the agency you are leaving) Human
Resource Office or Benefits Office.
Your current employing agency will file a copy of your election in your Official Personnel Folder (OPF or e-OPF), and forward
a copy of the election to the Office of Personnel Management (OPM).
To Elect to End Phased Employment/Phased Retirement Status Upon a Move to Another Agency:
Complete the election in Part 3B and submit it to your current agency's (that is, the agency you are leaving) Human Resource
Office or Benefits Office.
Your current employing agency will file a copy of your election in your Official Personnel Folder (OPF or e-OPF), and forward
a copy of the election to the Office of Personnel Management (OPM).
General Instructions to Agency:
Submit Part 1A, the Election of Phased Employment/Phased Retirement Status, to OPM with the retirement application,
the Individual Retirement Record, and any other applicable retirement documents upon election of the initial phased
retirement. Keep a copy of the election on the right side of the phased retiree's Official Personnel Folder.
Send a copy of Part 2A, the Election to End Phased Employment/Phased Retirement Status to the Office of
Personnel Management (OPM) within 15 days of the election. Election forms should be emailed to OPM at:
phasedret@opm.gov. Keep the original on the right side of the phased retiree's Official Personnel Folder.
The losing agency should send a copy of Part 3A, the Election to Keep Phased Employment/Phased Retirement Status Upon a
Move to Another Agency or Part 3B, the Election to End Phased Employment/Phased Retirement Status Upon a Move to
Another Agency to the Office of Personnel Management (OPM) at phasedret@opm.gov upon the separation or transfer.
The originals of these elections should be placed in the phased retiree's Official Personnel Folder.
Privacy Act Statement
Solicitation of this information is authorized by title 5, United States Code, Chapter 83 (Section 8336a) and Chapter 84 (Section 8412a). The information you
furnish is needed to document your election of phased retirement status and will be used to determine and allow present or future benefits, to identify records
properly associated with your election, 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 program, with national, state, local or other charitable or Social Security administrative agencies to
determine and issue benefits under their programs. In addition, to the extent this information indicates a possible violation of civil or criminal law, it may be shared
and verified as noted above, with the appropriate Federal, state or local law enforcement agencies. Executive Order 9397 (November 22, 1943) authorizes use of
the Social Security number as an individual identifier to distinguish between people with the same or similar names. Failure to furnish the requested information
may delay or prevent action on your election.
Standard Form 3116
-2-
October 2014
Phased Employment/Phased Retirement Status Highlights
Phased employment/phased retirement is not an
employee right, but rather an option that requires the
consent of both the employee and the employing agency.
To be eligible to elect Phased Employment/Phased
Retirement, an employee must have been working a
full-time work schedule for the 3-year period
immediately before the effective date of a Phased
Employment/Phased Retirement election and must
qualify for a retirement under 5 U.S.C. § 8336(a) or (b),
or 5 U.S.C. § 8412(a) or (b). The age and service
requirements for those retirement provisions are as
follows:
CSRS:
Attained age 55 with at least 30 years of
creditable service, or
Attained age 60 with at least 20 years of
creditable service.
FERS:
Attained MRA (minimum retirement age) with
at least 30 years of creditable service, or
Attained age 60 with at least 20 years of
creditable service.
(MRA ranges between age 55 and 57 depending on
date of birth)
An employee who elects Phased Employment/Phased
Retirement will continue to work on a part-time basis
based on a working percentage, which currently equals
50 percent of a full-time work schedule. The employee
is also considered a phased retiree entitled to a phased
retirement annuity.
The phased retirement annuity equals the amount of the
annuity the employee would have received had the
employee fully retired, without credit for unused sick
leave and without reduction for survivor annuity,
multiplied by the phased retirement percentage. The
phased retirement percentage equals the result of
subtracting the working percentage from 100 percent.
Currently, there is only one possible working
percentage, 50 percent, thus the phased retirement
percentage is 50 percent.
The FERS annuity supplement is not payable with a
phased retirement annuity.
Deposits for military service must be paid in full at the
time the employee enters Phased Employment/Phased
Retirement. Deposits and/or redeposits for civilian
service must be paid in full before the phased retirement
benefit is finalized. Read carefully the information on
service credit provided in Part 1 below.
Federal insurance coverage under the Federal
Employees Health Benefits (FEHB) Program, the
Federal Employees' Group Life Insurance (FEGLI)
Program, the Federal Employees Dental and Vision
Plan (FEDVIP) and the Federal Flexible Spending
Account Program (FSAFEDs) remains with the
employing agency during Phased Employment/Phased
Retirement. The cost of the premiums and the amount
of the FEGLI coverage is based on a full-time work
schedule even though the employee is working on a
part-time basis of 50 percent of full-time.
Leave accrual will be based on the part-time schedule.
An employee in Phased Employment/Phased
Retirement may elect to enter full retirement status at
any time by submitting an Application for Immediate
Retirement (CSRS) or (FERS), SF 2801 or SF 3107, as
appropriate. A phased retiree cannot retire on a
disability retirement.
An employee in Phased Employment/Phased Retirement
may elect to end Phased Employment/Phased Retirement
and return to regular employment status, subject to the
employing agency's consent. Any change to the
employee's working percentage will also end Phased
Employment/Phased Retirement and cause the employee
to return to regular employment status. When Phased
Employment/Phased Retirement ends and the employee
returns to a regular employment status, the phased
retirement annuity terminates and the period of time that
the employee worked under Phased Employment/Phased
Retirement will be treated as part-time service in the
computation of any future annuity benefit. Credit for
that part-time service will be based on the working
percentage. Any service performed in excess of the
working percentage during phased employment will not
be credited in any future annuity benefit.
If an employee in Phased Employment/Phased
Retirement dies before electing full retirement status, the
death benefits will be based on the benefits provided for
survivors of deceased employees. The period of time
that the employee worked under Phased
Employment/Phased Retirement will be treated as
part-time service in the computation of any survivor
annuity benefit. Credit for that part-time service will be
based on the working percentage. Any service in excess
of the working percentage will not be credited in any
survivor annuity benefit.
Standard Form 3116
-3-
October 2014
Part 1 - Information about Electing Phased Employment/Phased Retirement Status
What is Phased Employment/Phased Retirement?
Phased employment/phased retirement status is a human resource management tool under 5 U.S.C. 8336a and 5 U.S.C. 8412a.
The main purpose of this program is to allow for phased employment/phased retirement status as a mechanism to enhance mentoring
and training of the employees who will be filling the positions of more experienced employees who are preparing for full retirement.
It is intended to encourage experienced employees to remain, in a part-time capacity, until the less experienced employees are fully
equipped to fulfill the same duties and responsibilities as those employees who wish to retire. An individual may only elect phased
employment/phased retirement status once in his or her lifetime. If an employee's phased employment/phased retirement status ends
for any reason, including as a result of transitioning to full retirement status, the individual may not re-elect phased employment/
phased retirement status.
Who May Elect Phased Employment/Phased Retirement Status?
Participation is entirely voluntary and requires the mutual consent of both the employee and employing agency. In order to
participate, an individual must have been employed on a full-time basis for not less than a 3-year period preceding the effective date
of phased retirement status. Under CSRS, the individual must be eligible for immediate retirement with at least 30 years of service
and is age 55, or older or with 20 years of service and is age 60 or older. Under FERS, the individual must be eligible for immediate
retirement with at least 30 years of service and is MRA (minimum retirement age 55-57 depending upon year of birth) or older, or
with 20 years of service and is age 60 or older.
Exception: The law provides that employees subject to mandatory separation and retirement (including law enforcement officers,
firefighters, nuclear materials couriers, air traffic controllers, customs and border protection officers, or members of the Capitol
Police or Supreme Court Police) may not participate. However, an individual who was employed as a Customs and Border
Protection Officer before July 6, 2008, and who was exempted from mandatory separation and retirement when special retirement
provisions were provided to Customs and Border Protection Officers, may participate.
How Does Phased Employment/Phased Retirement Status Work?
An employee electing phased employment/phased retirement status continues to work as an employee of the Federal Government but
under a new phased employment part-time work schedule. In addition, the employee (referred to as a "phased retiree") will receive a
phased retirement annuity that is approximately half of the amount of what the full time benefit would be had the employee fully
retired. An explanation of how the phased annuity is computed follows.
The number of hours the phased retiree must work under the phased employment work schedule is based on the working percentage.
A phased retiree may not change the working percentage after the phased retirement election goes into effect without ending phased
employment/phased retirement status. (Currently, there is only one working percentage, 50 percent, but other working percentages
may be permitted by OPM in future regulations.)
The amount of the phased retirement annuity equals a percentage of the annuity the employee would have received had the phased
retiree elected to fully retire rather than elect phased employment/phased retirement status, except credit for unused sick leave is not
included in the phased retirement annuity. The phased retirement annuity cannot form the basis of a survivor annuity and, therefore,
no survivor reduction is applied to the phased retirement annuity. The percentage used to calculate the phased retirement annuity
(i.e., the phased retirement percentage) is determined by subtracting the working percentage from 100 percent. (Currently, there is
only one phased retirement percentage, 50 percent permitted, but this may change if other working percentages are permitted by
OPM in future regulations.)
When the phased retiree receiving a phased retirement annuity decides to fully retire, the full retirement annuity (the "composite
retirement annuity") will equal the sum of the phased retirement annuity, updated by any cost-of-living adjustments that were applied
to the phased retirement annuity, plus the amount of the final phased portion of the full retirement annuity. The final phased portion
of the full retirement annuity equals a percentage of the full annuity the employee would have received had the employee not elected
phased retirement and, instead, continued working full-time until separation for full retirement. The final phased portion includes
credit for unused sick leave. The percentage used to calculate this final phased portion equals the working percentage. The
composite annuity is then subject to a reduction for a survivor annuity election, if applicable.
The FERS Annuity Supplement is not payable with a phased retirement annuity. If applicable, the FERS Annuity Supplement will
be paid after the phased retiree receiving a phased retirement annuity fully retires.
Standard Form 3116
-4-
October 2014
Service Credit: Deposits/Redeposits Owed for Civilian Service
Individuals who owe deposits for Federal civilian service during which no retirement deductions were withheld or redeposits for
periods of service during which deductions were withheld but were later refunded, must complete payment for those deposits
and/or redeposit before the phased retirement annuity is finalized. If full payment is not made by the effective date of the phased
employment/phased retirement status, OPM will send out a deposit/redeposit letter providing 30 days in which to make a lump-sum
payment. It is important to note that if these deposits and redeposits are not paid, there will not be an opportunity to pay them under
the composite retirement annuity. In addition, if a payment for a pre-March 1, 1991, CSRS redeposit is not paid in full, an actuarial
reduction based on the amount of redeposit due divided by a factor for the individual's age at phased retirement will be applied to the
phased retirement annuity and to any subsequent retirement annuity, regardless of type of retirement. (That is, even if the individual
were to end phased retirement to go back to regular employment status and later retire under another retirement provision, he or she
would still be subject to an actuarial reduction). In these subsequent retirements, the actuarial reduction applied will be increased by
any intervening cost-of-living adjustment that took place between the phased retirement and the subsequent retirement.
Service Credit: Post-1956 Military Deposit
Individuals who owe a deposit for active duty military service performed after 1956 must complete payment on the deposit before
their phased retirement annuity commences. Instructions for how CSRS military service is credited are found in the SF 2801.
Instructions for how FERS military service is credited are found in SF 3107. Please note that there will not be an opportunity to
pay this deposit after the phased retirement annuity begins.
Effect of Phased Employment/Phased Retirement Status on Federal Health and Life Insurance Coverage
Phased retirees receiving phased retirement annuity are considered to be working a full-time work schedule for purposes of
determining the phased retiree's share of the Federal Employees Health Benefit plan premium and for purposes of determining the
basic insurance amount for Basic and Additional Optional life insurance under the Federal Employees Group Life Insurance.
Effect of Phased Employment/Phased Retirement Status on Federal Long-Term Care Insurance Program (FLTCIP),
Federal Dental and Vision Program (FEDVIP) and Flexible Spending Account Program (FSAFEDs)
The phased retiree is considered an employee for purposes of the Federal Long-Term Care Insurance Program, the Federal
Dental and Vision Program and the Flexible Spending Account Feds program and can continue these programs during phased
employment/phased retirement. Please note that phased employment/phased retirement is not a Qualifying Life Event (QLE)
allowing changes to benefits.
Court Orders
As in the case of annuity payable in a regular retirement, a phased retirement annuity or a composite retirement annuity is subject to
apportionment by a court decree of divorce, annulment, or legal separation, or the terms of any court order or court-approved
property settlement agreement incident to any court decree of divorce, annulment, or legal separation.
Death of Phased Retiree While in a Phased Employment/Phased Retirement Status
If a phased retiree receiving phased retirement annuity dies before separating for full retirement benefits, the phased retiree will be
deemed to have been a deceased employee for purposes of determining survivor benefits. The time the phased retiree worked while
receiving phased retirement annuity will be credited as part-time service based on the working percentage for annuity calculation
purposes.
Effective Dates
Effective Date of Phased Employment and the Commencing Date of Phased Retirement Annuity
Phased employment is effective the first day of the pay period after phased retirement is approved by the authorized agency
official in the individual's agency or the first day of a later pay period specified by the individual with the concurrence of the
authorized agency official.
The commencing date of a phased retirement annuity is also the first day of the pay period after phased employment/phased
retirement status is approved by the authorized agency official in the individual's agency or the first day of a later pay period
specified by the individual with the concurrence of the authorized agency official.
Effective Date of Full Status Retirement Benefit (i.e. Composite Annuity)
The annuity commencing date of the Composite Retirement Annuity of a phased retiree who enters full retirement status is the
day after separation from Federal service.
-5-
Standard Form 3116
October 2014
Withdrawing an Election for Phased Employment/Phased Retirement Status
A phased retiree may cancel his or her approved election to enter phased employment/phased retirement status and withdraw the
application for phased retirement by submitting a signed written request to the agency before the effective date of the phased
employment/phased retirement status. However, the election cannot be withdrawn if OPM has received a court order affecting the
annuity benefits.
Election to End Phased Employment/Phased Retirement Status and Return to Regular Employment Status
A phased retiree may elect to end phased employment/phased retirement status and return to regular employment status at any time
with the consent of the appropriate agency official. See Part 2 for more information on how to end phased employment/phased
retirement.
Discontinuing Phased Employment/Phased Retirement Status When Transferring to Another Agency
If a phased retiree transfers to another agency and either the agency does not approve the working percentage or the employee does
not wish to continue phased employment/phased retirement status with the new agency, phased employment/phased retirement status
will end effective the day before the date of the transfer to the new agency. See Part 3 for more information on what to do to end
phased employment/phased retirement status upon a move to a new agency.
When a Phased Employment/Phased Retirement Status is Deemed to Have Ended
A phased retiree who does not complete the formal election to end phased employment/phased retirement status but changes his or
her working percentage or returns to a full time schedule is deemed to have ended phased employment/phased retirement status. The
time the phased retiree worked while receiving phased retirement annuity will be credited as part-time service based on the phased
work schedule for annuity calculation purposes. In this situation, the phased employment/phased retirement status ends as of the
day before the effective date of the working percentage change or return to a full time schedule.
Full Retirement Status (Composite Retirement Annuity)
A phased retiree may elect to enter full retirement status at any time by submitting application SF 2801 for CSRS and SF 3107 for
FERS. A phased retiree may be separated for a voluntary or an involuntary retirement but not a disability retirement.
Deemed Election of Full Retirement Status
A phased retiree who is separated from phased employment for more than 3 days enters full retirement status. The fully retired
former phased retiree's composite retirement annuity will begin to accrue on the commencing date of the composite annuity and
payment will be made after the former phased retiree submits an application as prescribed by OPM.
A phased retiree must take care to maintain his or her working percentage. A change in working percentage during phased
employment/phased retirement status will result in the termination of phased employment/phased retirement status just as
if the individual elected to terminate phased employment/phased retirement status, and with the same consequences -- the
time the phased retiree worked while receiving phased retirement annuity will be credited as part-time service based on
the working percentage for annuity calculation purposes. Any payments of phased retirement annuity made after the
change of working percentage is an overpayment and must be repaid to OPM.
Caution:
Standard Form 3116
October 2014
-6-
Phased Retirement Elections
Part 1a - Election of Phased Employment/Phased Retirement Status
See Privacy Act Information on Instruction Sheet
This part should be completed by an employee who wants to elect Phased Retirement. Please complete the
information requested and sign the appropriate signature block. The appropriate agency official must also
complete this Part. The agency must also submit this election form with the retirement package and keep a copy
on the right hand side of the employee's OPF or eOPF.
Section A - Identifying Information (type or print)
1. Employee name (last, first, middle)
2. Date of birth (mm/dd/yyyy) 3. Social security number
4. Position title 5. Series 6. Grade
7. Employing department or agency 8.
Agency location (city, state, zip code)
Section B - Employee Election of Phased Employment/Phased Retirement Status
I have read all of the information provided in Part 1 of this election form. I am eligible to elect phased retirement annuity and I have not
previously elected phased employment/phased retirement status. I elect to change my work schedule from full-time to part-time in
accordance with the working percentage shown below and start receiving phase retirement annuity.
The commencing date of my phased employment/phased retirement status will be ________________________.
Working Percentage: 50 Percent
(mm/dd/yyyy)
I understand that my phased employment/phased retirement status will terminate, and I will return to regular employee status if my
working percentage changes during phased employment.
Signature Date (mm/dd/yyyy)
For Agency Use Only
Date of receipt by agency (mm/dd/yyyy)
Section C - Agency Consent
1.
The agency has determined that this employee meets all the requirements for Phased Employment/Phased Retirement Status and therefore
is eligible for phased employment. This employee is approved for Phased Employment/Phased Retirement Status at a working
percentage schedule of 50 percent.
2. Is the employee entering phased retirement under a time limit agreement, pursuant to 5 CFR 831.1713(d)?
Yes No
Commencing Date (mm/dd/yyyy) of Phased
The commencing date of phased employment/phased retirement will be:
Employment/Phased Retirement Status
(See Effective date of Phased Employment and the Commencing
Date of Phased Retirement Annuity in the instructions)
Authorizing agency officials's signature Date (mm/dd/yyyy) signed
Authorizing agency officials's title
-7-
Standard Form 3116
October 2014
Part 2 - Information about Electing to End Phased Employment/Phased Retirement Status
to Return to Regular Employment Status
Election to End Phased Employment/Phased Retirement Status to Return to Regular Employment Status
A phased retiree may elect to end phased employment/phased retirement status and return to regular employment status with the
consent of the employing agency. The phased retiree is thereafter not subject to any working percentage limitation by reason of
having previously been subject to phased employment/phased retirement status (i.e., they may return to full-time or go to any other
working schedule).
How Service Performed During the Period Phased Employment/Phased Retirement Status Was in Effect Will Be Credited
for Retirement Purposes after Employment Ends
If a phased retiree returns to regular employment status, the period under phased employment/phased retirement status will be
credited as part-time service for annuity calculation purposes. The part-time proration adjustment for the phased employment will be
based upon the phased employment work schedule, with no credit for extra hours worked.
Effective Date of Ending Phased Employment/Phased Retirement Status to Become a Regular Employee
If ending phased employment/phased retirement status is approved by the authorized agency official on any date on or after the first
day of a month through the fifteenth day of a month, the effective date that the phased employment/ phased retirement ends is the day
before the first day of the first full pay period in the month following the date the election to end phased employment/phased
retirement status is approved.
If ending phased employment/phased retirement status is approved by the authorized agency official on any date on or after the
sixteenth day of a month through the last day of a month, the effective date that the phased employment/phased retirement status ends
is the day before the first day of the first full pay period in the second month following the date the election to end phased
employment/phased retirement status is approved.
Discontinuing Phased Employment/Phased Retirement Status When Moving to Another Agency
If a phased retiree transfers to another agency and either the new agency does not approve the working percentage or the employee
does not wish to continue phased employment/phased retirement status with the new agency, phased employment/phased retirement
status will end effective the date of the move to the new agency.
One Opportunity to Elect Phased Employment/Phased Retirement Status
An individual may only elect phased employment/phased retirement status once. If a phased retiree's phased employment/phased
retirement status ends for any reason, including as the result of transitioning to full retirement, the individual may not re-elect phased
employment/phased retirement status.
Deposits Owed for Civilian and Military Service
Phased retirees who elect to end phased employment/phased retirement status and return to regular employment status are allowed to
make a service credit payment for any unpaid civilian or military service that was not made at the start of phased employment/phased
retirement status. PLEASE NOTE that if a pre-March 1, 1991 CSRS redeposit was not paid in full at phased retirement, then the
actuarial reduction that applied to the phased retirement will be applied to any subsequent retirement, regardless of the type of
retirement. This is because the period of service is deemed paid by the actuarial reduction at the time of the phased retirement and
therefore is no longer considered redeposit service. The actuarial reduction will be increased by any intervening cost-of-living
adjustment between the effective date of phased retirement and the effective date of the subsequent retirement.
Deeming a Phased Employment/Phased Retirement Status to End
A phased retiree who does not complete the formal election to end phased employment/phased retirement status but changes his or
her working percentage or returns to a full-time schedule is deemed to have ended phased employment/phased retirement status as of
the day before the change in the work schedule. The period of phased employment/phased retirement status will be credited as
part-time service for annuity calculation purposes. The part-time proration adjustment for the phased employment will be based
upon the phased employment work schedule with no credit for any extra hours worked.
Standard Form 3116
-8-
October 2014
Overpayment
A phased retiree who receives an overpayment of annuity after the phased employment/phased retirement status ends due to a
change in working percentage or return to a full-time schedule must set aside the amount overpaid pending recoupment by OPM.
Unless there are exceptional circumstances, recovery by OPM in these cases is not against equity and good conscience.
(Note: Financial hardship is not an exceptional circumstance.)
Withdrawing an Election to End Phased Retirement
A phased retiree may cancel his or her approved election to end phased employment/phased retirement status by submitting a signed
written request with the agency before the effective date of the return to regular employment status.
Contacting OPM
The employing agency must notify OPM that the phased retiree has ended phased employment/phased retirement status by
submitting to OPM a copy of the completed election form to terminate phased retirement within 15 days of its approval. Agencies
should place the original on the right side of the employee's OPF or eOPF and email a copy of the election form to OPM at
phasedret@opm.gov.
Standard Form 3116
-9-
October 2014
Phased Employment/Phased Retirement Status Elections
Part 2a - Election to End Phased Employment/Phased Retirement Status
and Return to Regular Employment Status
This part should be completed by a phased retiree who wants to end phased employment/phased retirement status
to return to regular employment status. Please complete the information requested and sign in the appropriate
signature block. An authorized agency official must also complete this Part. The agency must also email a copy of
this form to phasedret@opm.gov to notify the Office of Personnel Management (OPM) within 15 days of its approval
of the election to end phased employment/phased retirement status for OPM to stop the annuity payments. The
original should be filed on the right side of the employee's OPF or eOPF.
Section A - Identifying Information (type or print)
1. Phased retiree's name (last, first, middle)
2. Date of birth (mm/dd/yyyy) 3. Social security number
4. Position title 5. Series 6. Grade
7. Employing department or agency 8.
Agency location (city, state, zip code)
Section B - Phased Retiree Election to End Phased Employment/Phased Retirement Status
I am currently receiving a phased retirement annuity and elect to end phased employment/phased retirement status to return to regular
employment status. I understand that the phased employment period will be considered part-time in my final annuity calculation. I further
understand that I will not be eligible to enter phased employment/phased retirement status at a later time.
I understand that prior to the effective date of the end of my phased employment/phased retirement status, I may cancel my approved election
to end phased employment/phased retirement status by submitting a signed written request to the agency and obtaining the approval of the
authorized agency official.
Effective Date of Election: _________________________________
(mm/dd/yyyy)
Overpayment of Phased Retirement Annuity:
I understand that if there is an overpayment of annuity due to ending phased employment/phased retirement status that I need to set aside
the overpayment amount pending OPM recoupment or otherwise, I will be responsible for the repayment of the amount of annuity to
OPM and will not be eligible for waiver of recovery.
Signature Date (mm/dd/yyyy)
For Agency Use Only
Date of receipt by agency (mm/dd/yyyy)
Section C - Agency Consent
The agency agrees to change the phased retiree's work schedule to _________________________________________________. The
agency acknowledges that this change in work schedule will end the phased employment/phased retirement status of the phased retiree and
therefore the status of the phased retiree will revert to a regular employee. The agency will submit this election form to OPM within 15 days
of approval.
If Election is Approved by Employing Office: Effective Date Phased Employment/Phased Retirement
Ends Is:
On or after the first day of the month and on or before the 15th
day of the month
The day before the first day of the first pay period beginning
after the end of the month
On or after the 16th day of the month and on or before the last
day of the month
The day before the first day of the first pay period beginning
after the end of the following month
Effective Date of Election (mm/dd/yyyy):
Authorized agency official's signature Date (mm/dd/yyyy) signed
U.S. Office of Personnel Management
-10-
Standard Form 3116
CSRS/FERS Handbook for Personnel and Payroll Office
October 2014
Part 3 - Move to Another Agency While in Phased Employment/Phased Retirement Status
Part 3A: Move to Another Agency and Retaining Phased Employment/Phased Retirement Status
A phased retiree may move to another agency and retain his or her phased employment/phased retirement status only if the change would
not result in a change in the working percentage. If a phased retiree is moving to another agency during phased employment/phased
retirement and that agency agrees to continue the phased retirement status, the phased retiree must submit to the current (losing) agency
the following election form (Part 3A) with the signed written approval of the authorized agency official in the agency to which the phased
retiree is moving.
Please note that a phased retiree must take care to maintain his or her working percentage. A change in working percentage during
phased employment/phased retirement status will end phased employment/phased retirement status just as if the phased retiree proactively
elected to end phased employment/phased retirement status, and with the same consequences-- the time the phased retiree worked while
in phased employment/phased retirement status will be credited as part-time service based on the phased employment work schedule for
annuity calculation purposes.
Part 3B - Ending Phased Employment/Phased Retirement Status Upon A Move to Another Agency (i.e., Returning to Regular
Employee Status)
A phased retiree's phased employment/phased retirement status will end automatically upon a move to another agency unless Part A is
completed with the signed approval of an authorized official in the new (gaining) agency. Part 3B is not required to effect the
termination of phased employment/phased retirement status; however, an employee must document his or her decision to not continue
phased employment/phased retirement by completing Part 3B. This will facilitate timely processing of the termination of phased
employment/phased retirement status. The phased retiree should submit Part 3B to the current (losing) agency. The phased
employment/phased retirement status ends as of close of business on the day before the move to the new agency.
A copy of form 3A and 3B must be emailed by the current (losing) agency to the OPM Point of Contact at phasedret@opm.gov as soon
as possible to alert OPM to the status of the employee. The original form must be maintained on the right side of the employee's OPF or
eOPF until the employee retires. At final retirement, it should be sent to OPM with other retirement documents.
Overpayment
A phased retiree who elects to end phased employment/phased retirement upon a move to another agency and receives an overpayment of
annuity after the phased employment/phased retirement status ends, must set aside the amount overpaid pending recoupment by OPM.
Unless there are exceptional circumstances, recovery by OPM in these cases is not against equity and good conscience. (Note: Financial
hardship is an exceptional circumstance.)
U.S. Office of Personnel Management
Standard Form 3116
CSRS/FERS Handbook for Personnel and Payroll Office
-11-
October 2014
Phased Employment/Phased Retirement Status Elections
Part 3a - New Agency Consent to Continue
Phased Employment/Phased Retirement Status
This Part should be completed when the phased retiree wishes to move to another agency to an appointment that
will not change the working percentage. The election form should be completed by both the phased retiree and an
authorized agency official for the agency to which the phased retiree is moving. The losing agency should (1) Email
a copy of this completed form to OPM at phasedret@opm.gov, and (2) Place the original on the right side of the
phased retiree's OPF or eOPF. The agency handling final separation will submit the forms to OPM with final
retirement documents when the phased retiree fully retires.
Section A - Identifying Information (type or print)
1. Phased retiree's name (last, first, middle)
2. Date of birth (mm/dd/yyyy) 3. Social security number
4. Position title 5. Series 6. Grade
7. Employing department or agency 8.
Agency location (city, state, zip code)
Section B - Phased Retiree Election of Phased Employment/Phased Retirement Status at New Agency
I am currently in phased employment/phased retirement status and I am changing employers without a break in service of more than 3 days.
The new employing agency has consented to continue my prior election of phased employment/phased retirement status based on the
working percentage described below.
Working Percentage: 50 Percent
I understand that my phased employment/phased retirement status will terminate if my working percentage changes during phased
employment/phase retirement status.
Signature Date (mm/dd/yyyy)
Date of receipt by agency (mm/dd/yyyy)
For Agency Use Only
Section C - Agency Certification
1.
The agency has determined that this phased retiree meets all the requirements for continuing phased employment/phased retirement status
and therefore is eligible for phased employment. This phased retiree is approved for phased employment/phased retirement status at a
working percentage schedule of 50 percent.
2. Is the employee entering phased retirement under a time limit agreement, pursuant to 5 CFR 831.1713(d)?
Yes No
The commencing date of the continuance of phased employment will be:
Commencing Date (mm/dd/yyyy)
Authorizing agency official's signature Date (mm/dd/yyyy) signed
Authorizing agency official's title
Standard Form 3116
-12-
October 2014
Phased Retirement Elections
Part 3b - Documentation of Phased Retiree's Decision to End Phased Employment/
Phased Retirement Status Upon a Move to Another Agency
This Part should be completed when the phased retiree has decided to end phased employment/phased retirement
status upon a move to another agency. The election form should be completed by the phased retiree before the
move to the new agency. The phased employment/phased retirement status will end effective close of business the
day before the move to the new agency unless Part 3A is completed, even if this Part 3B is not completed. The
current (losing) agency should (1) email a copy of this completed form to OPM at phasedret@opm.gov (2) place the
original on the right side of the phased retiree's OPF or eOPF and (3) submit the forms to OPM in the final
retirement package.
Section A - Identifying Information (type or print)
1. Phased retiree name (last, first, middle)
2. Date of birth (mm/dd/yyyy) 3. Social security number
4. Position title 5. Series 6. Grade
7. Employing department or agency 8.
Agency location (city, state, zip code)
Section B - Phased Retiree Decision to End Phased Employment/Phased Retirement Status at New Agency
My new employing agency is ______________________________
My move to a new agency will be effective________________
I am currently in phased employment/phased retirement status and I have decided to end phased employment/phased retirement status upon
moving to my new agency. I understand that my phased employment/phased retirement status will end as of close of business the day before
the effective date of my move to my new agency.
I understand that the phased employment period will be considered part-time based on my phased employment work schedule in my final
annuity calculation. I further understand that I will not be eligible to enter phased employment/phased retirement status at a later time.
Signature Date (mm/dd/yyyy)
Standard Form 3116
-13-
October 2014
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