Form SF-2812-A Report of Withholdings and Contributions for Health Benefits by Enrollment Code

Form SF-2812-A Report of Withholdings and Contributions for Health Benefits by Enrollment Code

What Is Form SF-2812-A?

This is a legal form that was released by the U.S. Office of Personnel Management on October 1, 2014 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form SF-2812-A?
A: Form SF-2812-A is a report used to document withholdings and contributions for health benefits by enrollment code.

Q: What is the purpose of Form SF-2812-A?
A: The purpose of Form SF-2812-A is to track and report the withholdings and contributions made for health benefits by enrollment code.

Q: Who uses Form SF-2812-A?
A: Form SF-2812-A is used by federal employees who are enrolled in health benefit plans.

Q: What information is required on Form SF-2812-A?
A: Form SF-2812-A requires the employee's enrollment code, the withholding amount, and the contribution amount for each pay period.

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Form Details:

  • Released on October 1, 2014;
  • The latest available edition released by the U.S. Office of Personnel Management;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form SF-2812-A by clicking the link below or browse more documents and templates provided by the U.S. Office of Personnel Management.

Download Form SF-2812-A Report of Withholdings and Contributions for Health Benefits by Enrollment Code

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  • Form SF-2812-A Report of Withholdings and Contributions for Health Benefits by Enrollment Code, Page 1
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