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CODE.SOFTWARE CODE - FORM TITLE -
REVISION DATE
Award Forms
- AWCASHCL.PDF
- Cash Award for Recruitment of Clerical and Stay-in-School
Clerical Employees - 9/89
- AWMERITG.PDF - Nomination for NIH Merit Award - Group -
None
- AWMERITI.PDF
- Nomination for NIH Merit Award -
Individual - None
- AWSMPUR.PDF
- Nominations for Outstanding Service in Small Purchases - None
- CD -
Commerce Department - Link to forms website.
- CDC75_3.PDF
- CDC-75-3 - Application for Permit to Import or Transport
Agents or Vectors of Human Disease - 9/91
- CDCEA101.PDF
- CDC-EA-101 - Transfer of Select Agent - 7/97
- CKLISTOVER2500.PDF
- Documentation For
Simplified/Commercial Item Acquisitions Actions Greater Than
$2,500 - 1/02 - Entire form, no electronic
fill-in. The following three files contain all 10 pages, and
have electronic fill-in capability:
- CKLISTOVER2500_1.PDF
- Documentation
For Simplified/Commercial Item Acquisitions Actions Greater
Than $2,500 - 1/02 - Pages
1 and 2 only.
- CKLISTOVER2500_2.PDF
- Documentation
For Simplified/Commercial Item Acquisitions Actions Greater
Than $2,500 - 1/02 -
Pages 3 through 6 only.
- CKLISTOVER2500_3.PDF
- Documentation
For Simplified/Commercial Item Acquisitions Actions Greater
Than $2,500 - 1/02 - Pages
7 through 10 only.
- CKLSRVAC.PDF - Checklist for Service
Acquisitions - None
CIT Forms
Ethics Forms
- ETHICS FORMS - For
all ethics forms used at NIH, go to the NIH Ethics Program
website.
FAES Forms
- FAF.PDF
- Request to FAES for Administration for
Fellowship - 8/1/91
- FAFELLOW.PDF
- FAES Fellowship Program - Fellowships -
None
- FAG.PDF
- Request to FAES for Administration for
Fellowship - 8/1/91
- FAMENTOR.PDF
- FAES Fellowship Program - Mentor-Based Fellowships - None
- FASUMGRT.PDF
- Application for FAES Summer Student
Grant - None
- FAX.PDF
- FAX Transmittal Sheet - None
Fogarty Center Forms
- FCJVERC.PDF
- Fogarty Center Request for Extension of J-1 Visa by DOS - 3/21/00
- FCNH590.PDF - Fogarty Center Special
Volunteer and Guest Research Assignment (for use with
Professional Services) - 5/96
- FCNOTINT.PDF - Fogarty
International
Center Notification of International Travel - None
- FCTERM.PDF
- Fogarty Center Program Termination -
12/14/90
- FCVISA.PDF
- Fogarty Center Supporting Documentation
for Non-NIH Visiting Program Participant - 1/13/97
- FCVISA01.PDF
- Fogarty Center Supporting Documentation
for Non-NIH Visiting Program Participant - 2/09/96
FEGLI Forms
- FE6.PDF
- FEGLI - Claim for Death Benefits (Link takes you to OPM's website)
- FE6DEP.PDF
- FEGLI - Settlement of Claim; Option C -- Family Life Insurance
(Link
takes you to OPM's website)
- FE7.PDF
- FEGLI - Claim for Dismemberment Benefits (Link takes you to OPM's
website)
- FILCLNUP.PDF
- Files Cleanup Campaign - None
- FIPAWARD.PDF - FIP Contract Award Data Sheet
- None
- FIPCHKLS.PDF - OIRM FIP Justification
Checklist - None
- GE201.PDF - OGE-201 - Request to Inspect or
Receive Copies of SF 278 Executive Branch Personnel Public
Financial Disclosure Report or Other Covered Record - 7/96
- GE202.PDF - OGE-202 - Notification of Conflict
of Interest Referral - 7/98
- GE203.PDF - OGE-203 - Senior Appointee Pledge -
1/93
- GE450.PDF
- OGE-450 - Office of Government Ethics
Executive Branch Confidential Financial Disclosure Report -
2/96
- GE450A.PDF
- OGE-450A - Confidential
Certificate of No New Interests (Executive Branch) - 4/97
- GFTFNDIN.PDF
- Initiative for the Use of Gift Funds - None
- GRAGREE.PDF
- Guest Researcher Agreement - None
GSA Forms
- GSA - General Services Administration - Link to Web
Site
NICHD Forms
- HDMANCLR.PDF
- NICHD Publication and Abstract Clearance Form - 4/00
- HDFORTRVL.PDF - NICHD Individual Foreign Trip
Travel Request - None
- HDPRFPLN.PDF
- NICHD Performance Plan - None
- HDPROFSV.PDF
- NICHD Professional Services Contract Worksheet - None
- HDRPRNT.PDF
- NICHD Reprint Order - None
- HEALTH
INSURANCE - Link to OPM's Web Site
- HISTOBJART.PDF - DeWitt Stetten, Jr., Museum
of Medical Research Background Information on Artifacts - None
- HISTOBJINS.PDF - DeWitt Stetten, Jr., Museum
of Medical Research Background Information on Instruments - None
HHS Forms
Many links go to the Health and Human
Service's forms websites, http://www.hhs.gov/forms and
http://intranet.hhs.gov/forms.
- HS1.PDF
- HHS-1 - Travel Order - 7/89 - Use ONLY when
the NBS system is down.
- HS16.PDF - HHS-16 -
Request to Use Government Furnished Vehicle for Transportation
Between Domicile and Place of Employment - 6/83
- HS22.PDF - HHS-22 - Request for Property Action
- 4/98
- HS26A.PDF
- HHS-26-A - Printing and Visual Services (NIH Use Only) - 8/12
- HS33.PDF
- HHS-33 - Probationary Employee Certification and
Recommendation - New Appointments - 9/80
- HS33A.PDF
- HHS-33A - Probationary Employee Certification and
Recommendation - Supervisors/Managers - 9/80
- HS68.PDF - Obsolete
- HHS-68 - Request for Staff Manual Materials and Mailing List
Changes - 4/91
- HS99.PDF
- HHS-99 - Authorization to Attend Non-Government Sponsored
Meetings - 9/82
- HS170.PDF
- HHS-171 - DHHS Employee Suggestion Form - 12/87
- HS171.PDF
- HHS-171 - DHHS Recommendation for Cash
Award - 12/87
- HS311.PDF
- HHS-311 - Official Personnel Folder
Transmittal - 1/81
- HS330.PDF - HHS-330 - Intra-Departmental
Delegation of Authority (IDDA) - 8/00
- HS342.PDF - HHS-342 - Report of Survey (Link goes to
HHS's website)
- HS348.PDF
- HHS-348 - Request for Approval for Acceptance of
Payment of Travel Expenses in cash or In Kind (Link goes to
HHS's website)
- HS355.PDF
- HHS-355 - DHHS Employment Agreement for
Transfers to and Within the Continental United States - 3/81
- HS355A.PDF
- HHS-355A - DHHS Employment Agreement
for Transfers and Appointments Overseas - 10/10
- HS355B.PDF
- HHS-355B - DHHS Employment Agreement
for Manpower Shortage Positions in the 50 States and the
District of Columbia - 3/81
- HS357.PDF
- HHS-357 - DHHS Notification of U.S.
Savings Bond Action, Series EE - 3/95
- HS402.PDF - HHS-402 - Requisition for
Equipment and Supplies - None
- HS410.PDF
- HHS-410 - DHHS Supplemental Information
- Expert or Consultant - 12/77
- HS411A.PDF
- HHS-411A - Leave Error Notice (Link goes to HHS's website)
- HS411B.PDF
- HHS-411B - Leave Error Notice (Link goes to
HHS's website)
- HS419.PDF
- HHS-419 - Clearance of Personnel for
Separation or Transfer - 12/10 (Link goes to HHS's website)
- HS420.PDF
- HHS-420 - Timekeeper's Signature Card - 3/81
- HS439.PDF
- HHS-439 - Personal Custody Property Record/Hand Receipt (Link goes to
HHS's website)
- HS441.PDF - Obsolete
- HHS-441 - Assurance of Compliance with the Department of
Health and Human services Regulation Under Title VI fo the Civil
Rights Act of 1964 - 12/82
- HS441A.PDF - Obsolete - HHS-441A - Explanation of HHS Form No. 441,
Assurance of Compliance with the Department of Health and
Human Services Regualtion Under Title VI of the Civil Rights
Act of 1964 - 3/81
- HS474.PDF - Obsolete - HHS-474 - Confidential
Statement of Employment and Financial Interests - 3/77 -
Superseded by OGE
Form 450 - "Confidential Financial Disclosure Report"
- HS476.PDF
- HHS-476 - DHHS Record of Home Address - 1/90
- HS477.PDF -
HHS-477 - Timekeeper Number Change - 3/66
- HS478.PDF
- HHS-478 - Payroll Number Correction - 11/83
- HS481.PDF
- HHS-481 - Employee Claim for
Loss or Damage to Personal Property - 3/81
- HS520.PDF - HHS-520 - Request for Approval of
Outside Activity - Link goes to the NIH Ethics Program
website.
- HS521.PDF - HHS-521 - Annual Report of
Outside Activity - Link goes to the NIH Ethics Program website.
- HS532.PDF
- HHS-532 - DHHS Request for
Approval of Nominees for Public Advisory Committees - 1/82
- HS565.PDF
- HHS-565 -
DHHS Report of Accountable Personal Property - 9/98
- HS581.PDF
- HHS-581 - DHHS Recommendation for
Quality Increase - 3/86
- HS639A.PDF - Obsolete
- HHS-639A - Assurance of Compliance
with Title IX of the Education Amendments of 1972 and the
Regulation Issued by the Department of Health and Human
services Implementation Thereof - 3/77
- HS651.PDF
- HHS-651 - DHHS Initial Interview and
Information EEO Counseling Report - 1/8
- HS652.PDF
- HHS-652 - DHHS Final EEO Counseling
Report - 1/88
- HS653.PDF- HHS-653 - HHS Small Business
Review Form - Please
use the Microsoft
Word version, dated 1/08
- HS690.PDF - HHS-690 - Assurance of
Compliance - 5/97
- HS691.PDF
- HHS-691 - Request for Special Pay for Physicians and Dentists
- 6/98
- HS691_1.PDF
- HHS-691-1 - Employee Agreement to Receive Special Pay for
Physicians and Dentists Under Title 38 - 6/98
- HS697.PDF
- HHS-697 - Foreign Activities Questionnaire - Link goes to
the NIH Ethics Program website.
- HS717_1 - HHS-717-1
- Confidential Report of Financial Interests in
Substantially Affected Organizations for Employees of the NIH - Link goes to
the NIH Ethics Program website.
- HSPROOBL.PDF
- DHHS Procurement Officials
Certification of Continuing Obligation - 8/20/97
- HSRPYAGR.PDF
- DHHS Installment Repayment Agreement
for Transferring Personnel - 8/20/97
- HTLTAX.PDF -
Hotel Occupancy Tax Exemption Certificate - 10/86
- HOTEL
TAX - Travel Management Policy State Tax Exemption
Web Site
- HUSBREV.PDF
- Request for Review of Research Activity Involving Human
Subjects - None
- HUSBSLPR.PDF
- Request for Single Project Assurance Negotiation - None
- IMAPPL.PDF - Impac Purchase Card Application Form -
Replaced by PURCH-NEW.PDF
- IMMSC.PDF
- Level IV MSC Security Statement -
5/12/95
- IMUSER.PDF
- Level IV User Security Statement -
5/12/95
- INS - Link to Web Site for
Immigration and Naturalization Service Forms
- INFECMTRL.PDF
- Registration of Materials (Potentially) Infectious for Humans
- 6/99
- IMMUNREQ.PDF - Travel
Immunization Request Form - None
- INTLLVWAIV.PDF - NIH International Travel Waiver
Form - 5/06
- INVEMREC.PDF
- Inventory of Emergency Operating Records - None
- IRS8233.PDF
- IRS-8233 - Exemption from Withholding on Compensation for
Independent (and Certain Dependent) Personal Services of a
Nonresident Alien Individual - 10/96
IRTA Forms
- IRTAAGRE.PDF
- NIH Intramural Research Training Award
Program IRTA Fellowship Agreement - 3/13/98
- IRTAPROV.PDF
- NIH Intramural Research Training Award
Program Program Provisions - 3/13/98
- IRTASPAG.PDF - Obsolete - NIH Intramural Research Training Award
Program Supplemental IRTA Fellowship Agreement - None
- IRTASTAG.PDF - Obsolete - NIH Student Support IRTA Program Student
Support IRTA Fellowship Agreement - 11/1/94
- I-9.PDF
- I-9 - Employment Eligibility Verification - 11/21/91
- JPM-Dispute.PDF
- JPMorgan SmartPay 2 Dispute Form - not
dated
- LEAVE_REC
2012.PDF - UPDATED
Personal Leave Record for 2012
- MANLOG.PDF - Manual Log
Voluntary Leave Transfer - None
- MVA
- All States - Link to Web Site
- MVA
- Maryland - Link to Web Site
NIH Forms
- NH26_9.PDF
- NIH 26-9 - Handicap Parking Request -3/09
- NH29_2.PDF - NIH 29-2 - Request for Safety
Glasses - 10/06
- NH69.PDF - NIH 69 - Request for Services
- 4/77
- NH75.PDF
- NIH 75 - Request for Translating Service - 10/04
- NH79_3.PDF
- NIH 79-3 - NIH Centralized Animal Order Request - Link goes to Office of Animal
Care and Use (OACU) site
- NH88_1.PDF
- NIH 88-1 - Request for
Purchase and Use of Radioactive Materials - 12/10
- NH88_12.PDF - NIH 88-12 - Monthly
Laboratory Contamination Survey - 12/99
- NH88_16 - NIH-88-16 -
Isotope Receipt, Utilization and Disposal Record - Obsolete
- NH88_22.PDF - NIH 88-22 - Radiation Safety
Branch User Registration Record - Obsolete
- NH88_37.PDF - NIH 88-37 - Radiation Safety
Training Orientation Documentation - Obsolete
- NH145_2.PDF
- NIH 145-2 - Request for Official
Personnel Folder (OPF) - 2/87
- NH230.PDF
- NIH-230 - Inventory Transaction Record - 9/88
- NH254.PDF - NIH-254 - Report of Loss or
Damage of Property - 5/92 - Obsolete and replaced by HHS 342, Report of Survey
- NH356.PDF
- NIH 356 - NIH Visiting Program
Acceptance Notice - 3/03
- NH368.PDF - NIH
368 - Property Pass - Obsolete
and replaced by HHS
439
- NH414_5.PDF - Obsolete - NIH 414-5 - Request
for NIH Manual Issuances - 8/88
- NH414_6.PDF
- NIH 414-6 - NIH
Manual Chapter Review Record - 9/09
- NH414_7.PDF
- NIH 414-7 - NIH Manual Chapter Concurrence and Approval Record
- 7/04
- NH433.PDF - NIH 433 - Request to Change
NIH Directory Information - 7/94
- NH465_1.PDF
- NIH-465-1 - Application for Radionuclide Authorization - 9/05
- Includes Prospective Authorized User
Information page, NIH 465-2.
- NH465_2.PDF - NIH 465-2 -
Prospective Authorized User Information - included
with NH465_1.PDF.
- NH489_1.PDF
- NIH 489-1 - Nomination for NIH-Sponsored Courses - 11/88
- NH552_2.PDF - NIH 552-2 - Transportation
Section Moving Data Record - 12/64
- NH590.PDF
- Revised- NIH 590 - Special
Volunteer and Guest Researcher Assignment - 8/11
- NH590-1.PDF - Revised-
NIH Guest Researcher Agreement - 11/11
- NH590-2.PDF
- Revised- NIH 590-2 - NIH
Special Volunteer Agreement - 11/11
- NH649.PDF - NIH 649 - Report of Property
Transfer - 7/91
- NH649_1.PDF - NIH 649-1 - Shipping/Transfer
Order and Receipt Document - Contract Property - 8/85
- NH649_2.PDF - NIH 649-2 - Report of Loss,
Damage or Destruction of Property - 5/78
- NH649_3.PDF
- NIH 649-3 - Donation of Contractor-Acquired Property
- 1/92
- NH649_4.PDF - NIH 649-4 - Transfer of
Government Property Title to SBIR Contractor-Awardee - 12/86
- NH649_6.PDF - NIH 649-6 - Report of Lease
Property Returned to Vendor - 12/94
- NH750_2.PDF
- NIH 750-2 - Request for Medical Determination and Report of
Findings - 6/98
- NH750_3.PDF
- NIH 750-3 - Medical Qualification
Determination Questionnaire - None
- NH827.PDF - NIH 827 - Request for
Conference Room - 9/92
- NH827_1.PDF
- NIH-827-1
-
Request
for
Acquisition of Temporary Commercial Conference Space - 4/08
- NH827_2.PDF
- NIH 827-2 - Request for Use of Lister Hill Auditorium - 6/03
- NH829_1.PDF
- Revised - NIH-829-1
- Request for Visiting Program Participant (Parts I & II)
- 8/10
- NH829_1_Part_I.PDF
- NIH 829-1 Part I - (Completed by the Institute/Center)
- NH829_1_Part_II.PDF
- NIH 829-1 Part II - (Completed by the Foreign National
Scientist)
- NH829_2.PDF - Obsolete
- NIH 829-2 - Request for NIH Visiting
Fellowship Award - 3/98
- NH829_5.PDF
- Revised
NIH 829-5 - Notification of Termination of Visiting Program
Participation - 9/11
- NH829_6.PDF
- NIH 829-6 - J-1 Exchange Visitor
Program--Certification of Health Insurance Coverage - 4/04
- NH829_7.PDF - Obsolete
- NIH 829-7 - Request for NIH Supplemental
Visiting Fellowship Award - 5/95
- NH1154_3.PDF
- NIH 1154-3 - Final Certification of
Acceptable Costs - 1/07
- NH1192.PDF
- NIH 1192 - Animal Health and Shipping Certificate - Link goes to Office of Animal
Care and Use (OACU) site
- NH1382_2.PDF
- NIH 1382-2 - Motor Vehicle Trip Ticket - 9/93
- NH1531_1.PDF
- NIH 1531-1 - Request for Special Report
from Taps - 12/81
- NH1533.PDF - Obsolete - NIH 1533 - Nomination for
DCRT Computer Training - 12/90
- NH1590.PDF -
NIH 1590 - Acquisition Worksheet - 9/92
- NH1616_1.PDF - NIH 1616-1 - Request for
Publication and Speech Clearance - 9/96
- NH1616_2.PDF
- NIH 1616-2 - Request for Publication and Speech Clearance -
11/73 (Note - Includes NICHD
version)
- NH1616_3.PDF - NIH 1616-3 - Request for
NIAID Approval of Publication or Presentation - 7/92
- NH1616_4.PDF
- NIH 1616-4 - Request for Approval of Publication or
Presentation - 5/84
- NH1625.PDF
- NIH 1625 - Equipment Temperature Record - 3/70
- NH1688_1.PDF - NIH 1688-1 - Project Objectives -
9/02
- NH1742.PDF
- NIH 1742 - Obsolete-
Agency Agreement and Clearance - 7/99
- NH1757_1.PDF - Obsolete
- Justification for Other than Full and Open Competition (JOFOC)
- Please
see the Office of Acquisition Management and Policy (OAMP) website.
- NH1757_7.PDF - Obsolete
- Justification for Other than Full and Open Competition
(JOFOC) - Please see the Office of Acquisition
Management and Policy (OAMP) website.
- NH1767_1.PDF - NIH 1767-1 - DCRT Account Authorization
- Please
see the CIT
Account Forms website.
- NH1767_2.PDF - Obsolete
- NIH 1767-2 - DCRT Information Change Notice
- NH1767_3.PDF - NIH 1767-3
- DCRT Outside Account Authorization Interagency Agreement - Please
see the CIT
Account Forms website.
- NH1767_4.PDF - NIH 1767-4
- Interagency Agreement for Annual Renewal of DCRT Outside
Account Authorization - Please see the CIT
Account
Forms website.
- NH1767_5.PDF - NIH 1767-5
- Deregistration Official Authorization for DCRT Accounts - Please
see the CIT
Account Forms
website.
- NH1820.PDF - NIH
1820 - Notification of Proposal to Make an Award - 1/96
- NH1861_1.PDF
- NIH-1861-1 - Purchase Request - 3/08
- NH1861_3.PDF - NIH 1861-3 - Requisition
Worksheet - 11/89
- NH1861_9.PDF
- NIH 1861-9 - Requisition Worksheet - 10/92
- NH1872.PDF - Revised - NIH 1872 - Request for Trade-in or Exchange of
Government-Owned Property - 2/13
- NH1884 - Note - This form should not be done in
electronic format. Shipping requests will soon be done via
DelPro and these forms have unique Serial Numbers which are
needed in the shipping unit's tracking system. This system can
not accept duplicate Serial Numbers.
- NH1884_1.PDF - Revised
- NIH 1884-1 - Commercial Invoice - 1/13
- NH1962_1.PDF
- NIH 1962-1 - Request for and Authorization (or Approval) of
Overtime Work - 7/72
- NH1962_2.PDF
- NIH 1962-2 - Overtime Request and Approval Record - 4/86
- NH1962_8.PDF
- NIH 1962-8 - Request for Approval and Authorization of
Overtime
- NH1964_1.PDF
- NIH 1964-1 - Record of Witness of Disposal of Controlled
Substances - 8/92
- NH2010.PDF
- NIH 2010 - Notice of Financial Action
on Fellowship Award - 3/93
- NH2027.PDF - NIH 2027 - Report of Leave as
Shown in Itinerary of Travel Voucher - 12/72
- NH2028.PDF
- NIH 2028 - Request for Permanent Change
of Station Orders--Civilian Personnel and Other Appointed
Persons - 10/02, pamphlet revised 1/03
- NH2028-1.PDF
- NIH 2028 - Request for Permanent Change
of Station Orders--Non-FTE Persons - 10/02
- NH2066.PDF - NIH 2066 - Record of Personal
Appeal Items - 10/81
- NH2138.PDF - Obsolete -
NIH 2138 - Key/Lock Work Request - NOTE
- Requests for locksmith services must be submitted on line
using the Administrative Data Base System.
- NH2144.PDF
- NIH 2144 - Fellowship Termination
Notification - 7/90
- NH2179.PDF - NIH 2179 - Agreement for the
Loan of Property to NIH - 9/91
- NH2245.PDF
- NIH 2245 - Application for Continuing
Education Program Staff Training in Extramural Programs (STEP)
- 9/95
- NH2252_1.PDF
- NIH 2252-1 - Knowledges, Skills, and
Abilities (KSA) Job Analysis - 3/91
- NH2252_2.PDF
- NIH 2252-2 - Knowledges, Skills, and
Abilities (KSA) Crediting Plan - 3/91
- NH2252_3.PDF
- NIH 2252-3 - Knowledges, Skills, and
Abilities (KSA) Supplemental Form - 3/91
- NH2272.PDF
- NIH 2272 - Record of
Congressional Inquiry Received by Telephone - None
- NH2298.PDF
- NIH 2298 - Authorization to Release
Student Information - 5/95
- NH2333.PDF - NIH 2333 - NRSA Special
Action/Change Notice - 3/86
- NH2345.PDF - NIH 2345 - Report of Rental
Equipment and Services Received - 7/81
- NH2369_1.PDF
- NIH-2369-1 - Application for Permit to Introduce Rodents - Link goes to Office of Animal
Care and Use (OACU) site
- NH2369_2.PDF - NIH 2369-2 -
Animal Health Data Request Template - Link goes to Office of Animal Care and Use
(OACU) site
- NH2369_3.PDF
- NIH 2369-3 - Application for
Rodent Products or Rodent Pathogens for Use In Vivo Biological
Assessment - 5/09
- NH2369_4.PDF
- NIH 2369-4 - Rodent
Quarantine Release - 3/09
- NH2386_3.PDF
- NIH 2386-3 - Administrative Time and Leave Record - 1/80
- NH2388.PDF - Revised
- NIH 2388 - Declaration for Exportation of Biologic
Materials - 08/11
- NH2408.PDF
- NIH 2408 - Request for Use of
Gift Funds (for Other than Entertainment Expenses) - 2/04
- NH2408_1.PDF
- NIH 2408-1 - Request for Use of
Appropriated Funds/Gift Funds for Light Refreshments/Meals and
Other Entertainment Expenses - 2/04
- NH2489.PDF - Personal Property Loan Record -
Obsolete
and replaced by NIH 2489-2 and NIH 2489-3 below.
- NH2489_1.PDF - NIH 2489-1 - Record of
Loan-Donation of Personal Property to Foreign Countries - 6/94
- NH2489-2.PDF - NIH 2489-2 - Record of
Personal Property Loan to Non-Federal Government Organizations
or Individuals - 10/99
- NH2489-3.PDF - NIH 2489-3 - Record of
Personal Property Loan to Federal Organizations or Individuals -
10/99
- NH2500.PDF - NIH
2500 - REVISED
Notification of Organization Change - 2/12
- NH2512_2.PDF
- NIH 2512-2 - Request for
Organization Change - 8/90
- NH2513.PDF - NIH 2513 - Record of Expenses
for Travel Reimbursement - 6/82
- NH2539_4.PDF
- NIH 2539-4 - Acknowledgment of
Application and Report of Action Taken - 11/90
- NH2542_1.PDF - NIH 2542-1
- Election of Health Insurance Plan Through FAES - 5/90
(Electronic versions of this form are unacceptable. If your
Administrative Office does not have a copy, contact OFM at
496-5635, 31-B1B06.)
- NH2542_2.PDF - NIH 2542-2 - Election of Health
Insurance Plan Through Private Company - 7/90 (Electronic
versions of this form are unacceptable. If your Administrative
Office does not have a copy, contact OFM at 496-5635, 31-B1B06.)
- NH2544.PDF - NIH 2544 - Professional
Services Acquisitions - 11/85
- NH2555.PDF - NIH 2555 - Order for Supplies
or Services - 12/94
- NH2555_1.PDF - NIH 2555-1 - Purchase Order
Terms and Conditions for Supplies and Services - 11/91
- NH2555_4.PDF
- NIH 2555-4 - Addendum to Terms and Conditions of Purchase
Order - 11/91
- NH2558.PDF
- OMS Medical Evaluation of Functional Activities - 4/04
- NH2560.PDF
- NIH 2560 - Request for Restoration of Annual Leave - 11/84
- NH2562.PDF
- NIH 2562 - Report of Joint Endeavor Between NIH and
Commercial, For-Profit Organizations - 9/88
- NH2570.PDF - NIH 2570 - Checklist for
Microfilming Projects - 11/90
- NH2573.PDF - NIH 2573 - Request for
Mailing and Distribution Services - 7/85
- NH2581.PDF - Obsolete - NIH 2581 - Tentative
Estimate of Foreign Area Allowances and Differentials - 5/86
- NH2582.PDF - NIH 2582 - Contractor's
Release for All Contracts - 6/86
- NH2585.PDF - Obsolete
- NIH 2585 - Individual Performance Plan
- 10/90
- NH2590.PDF
- NIH 2590 - Request for Intramural Research Training Award
(IRTA) - 5/97
- NH2590_1.PDF
- NIH 2590-1 - Verification of U.S.
Citizenship or Permanent Residency Status NIH Intramural
Research Training Award (IRTA) Program - 2/88
- NH2590_2.PDF
- NIH 2590-2 - Request for Supplemental Intramural Research
Training Award (Supplemental IRTA) - 6/97
- NH2590_3.PDF
- NIH 2590-3 - Request for Student
Support Intramural Research Training Award (Student Support
IRTA) - 11/94
- NH2590_4.PDF
- NIH 2590-4 - Request for Technical Intramural Research
Training Award (Technical IRTA) - 7/95
- NH2604.PDF
- NIH 2604 - Delegation of Acquisition Authority - 4/01
- NH2604_1.PDF
- NIH 2604-1 - Request for Ordering Official Authority - 4/01
- NH2619.PDF - NIH 2619 - Request for
Transmission of Telegraphic Message - 3/87
- NH2652.PDF
- NIH 2652 - Code Sheet for the NIH Special Volunteer Program
and Guest Researcher Assignment - 4/88
- NH2657.PDF
- NIH 2657 - Supplemental Information to
Form HHS 520 - Link goes to the NIH Ethics Program website.
- NH2666.PDF
- NIH 2666 - Request for Summer
Intramural Research Training Award (Summer IRTA) - 3/90
- NH2674.PDF - NIH Loan Repayment Programs forms - Please
see the NIH Loan
Repayment Programs website for all forms.
- NH2676_1.PDF
- NIH 2676-1 - DHHS Employee Emergency Payment Request
Promissory Repayment Agreement, and Salary Offset Authorization
- 12/90
- NH2676_2.PDF
- NIH 2676-2 - DHHS Amendment to Employee Emergency Payment
Request Promissory Repayment Agreement, and Salary Offset
Authorization - 12/90
- NH2680_1.PDF
- NIH 2680-1 - Manuscript Transmittal Sheet - 11/91
- NH2683.PDF - NIH 2683 - Certification that
Property is Free from Hazards - 2/00
- NH2684.PDF - NIH 2684 - Approval for Use
of Foreign Flag Carrier - 8/02
- NH2685_1.PDF
- NIH 2685-1 - Notification of Mailing Address for Non-Employee
Workers - 08/90
- NH2690.PDF
- NIH 2690 - Registration Document for Recombinant DNA
Experiments - 8/90
- NH2696.PDF
- NIH 2696 - Evaluation of Employee
Suggestion - 6/91
- NH2705_1.PDF
- NIH 2705-1 - NIH Transhare Program--Application - 3/06
- NH2705_3.PDF
- NIH 2705-3 - NIH Transhare Program--Receipt of Fare Media -
7/03
- NH2705_4.PDF
- NIH 2705-4 - NIH Transhare Program--Program Renewal - 7/03
- NH2705_5.PDF
- NIH 2705-5 - NIH Transhare Program--Termination - 7/03
- NH2705_6.PDF
- NIH 2705-6 - NIH Transhare Program--Vanpool Group Renewal -
7/03
- NH2705_7.PDF - Obsolete - NIH 2705-7 - NIH Transhare
Program--Bi-Monthly Commuting Cost Certification - replaced by NH2831_1.PDF
and NH2831_2.PDF
- NH2709.PDF - NIH 2709 - Ridefinders
Network Application (Carpool--Vanpool) - 6/04
- NH2735.PDF
- NIH-2735 - Hand-Carry Delivery Slip - 3/06
- NH2736_1.PDF
- NIH 2736-1 - Justification for
Temporary Limited Appointment - 6/98
- NH2736_2.PDF
- NIH 2736-2 - Request for Certification
of Eligibles for Temporary Limited Positions - 6/98
- NH2736_3.PDF
- NIH 2736-3 - Employee's Statement of
Understanding Regarding Temporary Appointment - 6/98
- NH2737.PDF - NIH-2737 - Administrative Exit Checklist -
Please use
NIH 2737-2 below.
- NH2737_1.PDF - NIH-2737-1 - Clearance of Personnel for
Separation or Transfer - Please use NIH 2737-2 below.
- NH2737_2.PDF
- Revised
- NIH 2737-2 - Clearance of Personnel for
Separation or Transfer - 11/12
- NH2737_3.PDF
- NEW - NIH-2737-3 - NIDDK
Clearance of Personnel for Separation or Transfer (NIDDK ONLY) - 11/12
- NH2741.PDF - NIH 2741 - Request to
Cannibalize Personal Property - 12/93
- NH2749.PDF - NIH 2749-1 - Application for
the NIDCR Voluntary Leave Transfer Program (NIDCR Only)- 5/09
- NH2760.PDF - NIH 2760 - NIH Excess
(Surplus) Personal Property Screening Record - 3/96
- NH2765_1.PDF
- NIH-2765-1 - Request for Controlled Substances for Nonhuman
Use - 4/08
- NH2765_2.PDF
- NIH-2765-2 - Controlled Substance Record for Nonhuman Use -
4/08
- NH2765_3.PDF
- NIH-2765-3 - Intra-Institute Controlled Substance Transfer
Notification - 4/08
- NH2778.PDF
- NIH 2778 - Senior Executive Service Performance Plan - 11/97
- NH2788_1.PDF
- NIH 2788-1 - Renewal For Parking Permits (for General Permits,
Off-Campus Permits, Red Permits, and Satellite Permits) - 8/06
- NH2788_2.PDF
- NIH 2788-2 - Request for Campus Parking Permit for Contract
Employees - 7/04
- NH2788_3.PDF
- NIH 2788-3 - Mail-in Renewal for Carpool Permits - 5/04
- NH2798.PDF
- NIH 2798 - Request to Establish or Change Property Custodial
Account Data - 10/03
- NH2805.PDF
- NIH 2805 - Inventory of Vital Records -
11/04
- NH2818.PDF
- NIH 2818 - Notification of Receipt of Personal Property -
4/03
- NH2831_1.PDF
- NIH 2831-1 - NIH TRANSHARE Program--Commuting Cost
Declaration (For use in May through October) - 7/03
- NH2831_2.PDF
- NIH 2831-2 - NIH TRANSHARE Program--Commuting Cost
Declaration (For use in November through April) - 7/03
- NH2833.doc
- NIH 2833 - NIH Award Nomination - Link to MS Word file on OHR
Website
- NH2835_1.PDF
- NIH
2835-1 - Telework Application and Agreement - 9/09
- NH2835_2.PDF
- NIH 2835-2 - Telework Equipment Inventory - 10/03
- NH2835_3.PDF
- NIH 2835-3 - Telework Office Evaluation - 10/03
- NH2835_4.PDF
- NIH 2835-4 - Sample Pre-Telework Worksheet - 10/03
- NH2839.PDF
- NIH 2839 - Personal Custody Pass - 3/05
- NH2850.PDF
- NIH 2850 - Non-Compliance Referral for Ethics Violations - Link goes to
the NIH Ethics Program website.
- NH2851_1.PDF
- NIH 2851-1 - Request For Student Loan Repayment Benefit - 8/08
- NH2851_2.PDF
- NIH 2851-2 - Student Loan Repayment Program Service Agreement
- 12/08
- NH2851_3.PDF
- NIH 2851-3 - Outstanding Loan Information - 3/06
- NH2851_4.PDF
- NIH 2851-4 - Waiver of Student Loan Indebtedness - 3/06
- NH2866.PDF
- NIH-2866 - Position Sensitivity
Worksheet - 12/31/08 - Link
takes you to ORS website
- NH2866-Instr.PDF
- Instructions Page for Form
NIH 2866 - 12/31/08 - Link takes you to ORS
website
- NH2897.PDF- REVISED -
NIH 2897 - NIH Child Care Subsidy Program - 09/12
- NH2914.PDF
- NEW
NIH 2914 -Gift Transmittal Form- Appendix 1- 6/11
- NH2914-1.PDF
- NEW NIH 2914-1 -Gift
Transmittal Checklist- Appendix 2- 6/11
- NH2920-1.PDF - NEW NIH 2920-1 - NIH Compensatory Time
for Travel (CTT) Request and Approval Form - 8/11
- NH2923.PDF
- Revised - NIH 2923 -
Authorization for Disclosure of Information - 10/12
- NH2926-1.PDF-
NEW- NIH 2926-1 -
NIH Travel Waiver Request Form for Senior travel Official
Approval - 2/12
- NH2927.PDF-
NEW- NIH 2927 -
Invoice of Fees for Freedom of Information Act (FOIA) Services -
2/12
- NH2936.PDF
- NEW - Application for Special Exception
for Procurement and Use of Mercury - 10/12
- PREMAPP7.PDF -
Request For Premium Class Common Carrier Travel Accommodations
For Employees With Medical Conditions - 8/08
- NH
2934.PDF - Revised
Individual
Trip Authorization (Non-Medical) - Authorization For Use of
Premium-Class Other Than First-Class (PCotFC) Travel
Accommodations - 6/12
- NH2937.PDF
- NEW -
NIH 2937 - NIH Leave Bank Membership and Donation Form - 11/12
- NH2940.PDF -
NEW - NIH 2940 - NIH Leave Bank
Recipient Application Form - 12/12
- NH2941.PDF -
NEW - NIH 2941 - NIH Leave Bank Fax
Cover Sheet - 12/12
- NHFACIL.PDF - Occasional Use of
NIH-Controlled Facilities by the Public - None
- NIH_AWARD_NOM.PDF - NIH Award Nomination - Replaced
by NH2833.PDF.
NINDS Forms
- NSAWCASH.PDF
- NINDS Cash Award Program for Clerical
and Administrative Support Referral Form - None
- NSAWEMMO.PDF
- NINDS Employee of the Month
Nomination Form - None
- NSAWSCHG.PDF
- NINDS Documentation for Change in AWS Day Off - None
- NSBNSEP.PDF
- NINDS Clearance of Personnel for
Separation or Transfer - None
- NSBNPTRN.PDF - NINDS Training Request Authorization Form
- None
- NSDEVPLN.PDF
- NINDS Individual Development Plan - 8/98
- NSIRTANW.PDF
- NINDS New IRTA Package Form - None
- NSMNCNTR.PDF
- NINDS Maintenance Contracts - None
- NSMNHRCH.PDF
- NINDS Man-Hours Chart - None
- NSPRFPLN.PDF
- NINDS Performance Appraisal System -
4/96
- NSPRFSRV.PDF - NINDS Professional Services
Request Form - None
- NSPRGRPT.PDF -
NINDS Annual Progress Report Abstract - None
- NSPSNEVL.PDF
- NINDS Factor Evalaution System Position Evaluation Statement
- None
- NSSERPRT.PDF - NINDS Rental of Serp
Equipment - None
- NSSPVLAG.PDF
- NINDS Special Volunteer Program
Service Agreement - None
- NSTEMPPO.PDF
- NINDS Applicant Supply File Referral Temporary Positions -
None
- NSTRAIN.PDF - NINDS Training
Request/Authorization Form - None
- NSTRNEVL.PDF - NINDS Training Course Evaluation - None
- NSVOLEML.PDF
- NINDS Employer's Special Volunteer
Agreement - None
- NSWOMCLN.PDF
- NINDS Tracking of Women & Minorities in Clinical Studies
- 3/8/96
- OBCCAUTH.PDF - Obsolete - Ober United Travel Agency Charge
Card Authorization -
- OBFSTFAX.PDF - Ober FastRes Fax Form - 6/9/98 - Replaced by WTSFSTFX.PDF
- OBFRQTRV.PDF - Ober United Travel Agency Very
Important Traveler Profile - Replaced by WTSFRQTR.PDF
Optional Forms
- OF5.PDF
- OF-5 - Inquiry as to Availability - 3/82
- OF8.PDF
- OF-8 - Position Description
- OF11.PDF
- OF-11 - Reference Request - Federal Records Centers - 7/87
- OF41.PDF -
OF-41 - Routing and Transmittal Slip - 1/94
- OF41-lg.PDF
- OF-41 - Routing and Transmittal Slip (full page) 1/94
- OF69-HHS.PDF
- OF-69 - HHS Assignment Agreement IPA - no date
- OF108.PDF
- OF-108 - Daily Vehicle Use Record - 10/92
- OF132.PDF - OF-132 - Property Disposal
Authorization and Survey Report - 8/90
- OF306.PDF
- OF-306 - Declaration for Federal Employment - 9/94
- OF310.PDF
- OF-310 - Protection of Human Subjects - Assurance
Identification/Certification/Declaration - 9/92
- OF311.PDF
- OF-311 - Application for Federal Employee Commercial
Garnishment - 3/97
- OF333.PDF - Obsolete
- OF-333 - Procurement Integrity Certification for Procurement
Officials - 10/92
- OF363.PDF
- OF-363 - Memorandum of Call - 7/94
- OF510.PDF
- OF-510 - Privacy and Public Burden
Statements - 9/94
- OF612.PDF - OF-612 -
Optional Application for Federal Employment - Link takes you to OPM's website.
- OF630.PDF - OF-630 -
Leave Recipient Application Under the Voluntary Leave Transfer
Program - Replaced by
OPM 630.
- OF630A.PDF - OF-630A -
Request to Donate Annual Leave to Leave Recipient (Within
Agency) Under the Leave Transfer Program - Replaced
by OPM
630A.
- OF630B.PDF - OF-630B -
Request to Donate Annual Leave to Leave Recipient (Outside
Agency) Under the Leave Transfer Program - Replaced
by OPM
630B.
- OGE450
- OGE 450 - Confidential Financial Disclosure Reports - Link
goes to the NIH Ethics Program website.
- OM0990_31.PDF
- OMB-0090-31 - DHHS Applicant
Background Survey - None
OPM Forms
- OP630.PDF
- OPM 630 - Application to Become a Leave Recipient Under the
Voluntary Leave Transfer Program - Link takes you to OPM's website.
- OP630A.PDF
- OPM 630A - Request to Donate Annual Leave to
Leave Recipient Under the Voluntary Leave Transfer Program
(Within Agency) - Link takes you to
OPM's website.
- OP630B.PDF
- OPM 630B - Request to Donate Annual
Leave to Leave Recipient Under the Voluntary Leave Transfer
Program (Outside Agency) - Link takes you to OPM's website.
- OP913B.PDF -
OPM-913B - Change Form - Recognitions and Agreements - 7/94
- OP117017.PDF - Obsolete -
OPM-1170/17 - Supplemental Qualifications Statement List of
College Courses and Certificate of Scholastic Achievement -
None
- OP117029.PDF - Obsolete -
OPM-1170/29 - Supplemental Qualifications Statement Medical
and Dental Officer - 6/79
- OP1390.PDF
- OPM-1390 - Executive Personnel Transaction - 4/79
- OP1397.PDF
- OPM-1397 - U.S. OPM Worksheet for Special Salary Rate
Requests - 5/98
- OP1482.PDF -
OPM-1482 - FEGLI Agency Certification of Status of Reemployed
Annuitants - 2/93
- OP1510.PDF
- OPM-1510 - Certification of Agency Offer of Position and
Required Documentation (for Discontinued Service Retirement
Under CSRS or FERS) - 10/94
- OP1515.PDF
- OPM-1515 - Military Service Deposit Election - 12/00
- OP1519.PDF
- OPM-1519 - Survivor's Military
Service Election Deceased Employee Covered by CSRS or CSRS
Offset - 1/93
- OP1537.PDF
- OPM-1537 - Current/Former Spouse's
Notification of Application for Refund of Retirement
Deductions - 5/85
- OP1555.PDF
- OPM-1555 - Election of Coverage
Federal Employees Retirement System - 6/87
- OP1635.PDF - OPM-1635 - Welfare to Work
Program - 4/97
- OS544.PDF
- OS-544 - Sign-in/Sign-out Sheet - 12/85
PHS Forms
Many
links
go to the Health and Human Service's websites, http://www.hhs.gov/forms and http://intranet.hhs.gov/forms.
- PH50.PDF -
PHS-50 - Application for Appointment as a Commissioned Officer
in the U.S. Public Health Service Commissioned Corps - 7/97
- PH398BIO.PDF -
PHS-398 - Biographical Sketch (Biography
page ONLY. For intramural use) - 5/95
- PH416_1.PDF
- PHS-416-1 - Individual National Research Service Award
Application (Link to NIH Grants
Website)
- PH416_5.PDF
- PHS-416-5 - Research Fellowship
Activation Notice (Link to NIH
Grants Website)
- PH488.PDF
- PHS-488 - Claim for Temporary Lodging Allowance (TLA) - 5/99
- PH838.PDF
- PHS-838 - Commissioned Officers' Effectiveness Report -
11/01
- PH1345.PDF - PHS-1345 -
Request and Authority for Leave of Absence (Link takes you to
HHS's website)
- PH1485.PDF
- PHS-1485 - DHHS Grant Continuation -
6/83
- PH1558.PDF - PHS-1558 - Request for
Travel Reservations - 8/75
- PH1637_1.PDF
- PHS-1637-1 - Public Health Service Commissioned Officer's
Request for Dependency Determination - 4/92
- PH1637_3.PDF
- PHS-1637-3 - DHHS, PHS Parent's Dependency Affidavit - 09/81
- PH1662.PDF
- Request for Personnel Action - Commissioned Officer - 6/97
- PH1813.PDF
- PHS-1813 - Reference Request for Applicants to the U.S.
Public Health Service Commissioned Corps - 7/97
- PH2977.PDF
- PHS-2977 - Quarters Allowance Certificate PHS Commissioned
Officer Without Dependents - 5/90
- PH2988.PDF
- PHS-2988 - Voucher for Reimbursement for Travel - Dependents
of PHS Commissioned Officers - 9/92
- PH4392.PDF
- PHS-4392 - Billet Description - 11/94
- PH4392_1.PDF
- PHS-4392 - Billet Description - 11/94
- PH4469_1.PDF
- PHS-4469-1 - Junior Commissioned
Officer Student Training and Extern Program (JRCOSTEP)
Evaluation Questionnaire - 6/94
- PH4772.PDF
- PHS-4772 - Junior Commissioned Officer Student Training and
Extern Program (JRCOSTEP) Status Report - 10/93
- PH5141.PDF -
PHS-5141 - Appointment Affidavit - 2/92
PH5141_1.PDF
- PHS-5141-1 - Appointment Affidavit Reserve Corps - 2/00
- PH6040.PDF
- PHS-6040 - Notice of Intramural Research Project - 5/92
- PH6059.PDF
- PHS-6059 - Request for Overseas Station Allowances - 6/99
- PH6106.PDF
- PHS-6106 - Agreement to Receive an Allowance Under the
Federal Physicians Comparability Allowance Program - 9/88
- PH6127.PDF
- PHS-6127 - Commissioned Corps Inactive Reserve Corps
Questionnaire - 11/96
- PH6186.PDF
- PHS-6186 - Request for Advance of Station Housing Allowance
- 11/91
- PH6342_1.PDF
- PHS-6342-1 - PHS Unit Honor Award Nomination Record - 2/97
- PH6342_2.PDF
- PHS-6342-2 - PHS Individual Honor Award Nomination Record -
2/97
- PH6349.PDF
- PH-6349 - Annual Report on Possible Misconduct in Science -
10/91
- PH6353_1.PDF
- PH-6353-1 - Request for Voluntary State Income Tax
Withhholding from Retired Pay - 5/96
- PH6363.PDF - PHS-6363 - DHHS-PHS-Commissioned
Corps Request to Establish/Change Mailing Address - 3/97
- PH6373.PDF
- PHS-6373 - DHHS, PSC, Extramural Training Agreement - 9/96
- PH6374.PDF
- PHS-6374 - DHHS, PSC, Intramural Training Agreement - 9/96
- PH6385.PDF
- PHS-6385 - Status Report on
Commissioned Corps Officers During Probation - 3/93
- PH7017.PDF
- PHS-7017 - Reeemployment Priority List Registration - 7/94
- PH7017-1.PDF
- PHS-7017-1 - Reemployment Priority List Employee Disposition
Record - 7/94
- PH7034.PDF
- PHS-7034 -
Application for Assimilation into the Regular Corps - 2/98
- PH7036.PDF
- PHS-7036 -
Reimbursement Request for Adoption Expenses - 4/98
- POTERMS.PDF - Purchase Order Terms and
Conditions 8/96
- PROPCODE.PDF - Request for Property
Classification/Property Manufacturer Codes - None
- PRSMDHST.PDF
- Personal Medical History - None
Purchase Card Program
- PURCH-NEW - Revised - Request For New Purchase
Cardholder - 3/10
- PURCH-NEWCAO - Revised - Request For New Purchase Card
Approving Official - 3/10
- PURCH-CAOCHG - Revised - CAO Change Request Form -
3/10
- PURCH-CHKS - Revised - Request For Convenience
Checks - 3/10
- PURCH-CANCEL - Revised
- NIH Purchase Card Program
Cancellation Request Form - 1/09
- IMDISPUT.PDF
- I.M.P.A.C. Cardholder Statement of Questioned Item - 9/98
- IMRCPTST.PDF - Impac Statement for
Recipients of Purchase Card Check Issued for a Professional
Service Order - None
- JPM-Dispute.PDF - New - JPMorgan
SmartPay
2
Dispute
Form - None
- PSADDCHG
- Postal Service Change of Address Forms Note - This is a web link only to
the Postal Services web site.
- RADBADGE.PDF - Obsolete - Film Badge Registration
Form, Radiation Safety Branch
- RADDISC.PDF - Radioactive Materials
Package Discrepancy/Problem Reporting Form - None
- RADORNT.PDF
- Authorized User Acknowledgement Form - None
- RETIRANU.PDF
- Retirement Annuity Estimate - None
- RI38_124.PDF
- RI 38-124 - Voluntary Contributions Election - 9/94
(includes Employee Information pages)
- RI38_128.PDF
- RI 38-128 - Direct Deposit
- RI76_10.PDF
- RI 76-10 - FEGLI Assignment of Federal Employees' Group Life
Insurance - 1/95
- RI83_011.PDF
- RI 83-011 - Booklet - Thinking About Retirement
- RSACCHND.PDF
- Reasonable Accommodations for Handicapped Employees During
Inclement Weather - None
- RSTANNLV.PDF
- Request for Restoration of Annual Leave - None
- RWHSLST.PDF
- R&W Rental Listing Form - 7/30/99
- SAVINGS
BONDS - U.S.
Savings Bond Forms - Note - This is a web link only to the Treasury
Dept. bonds web site
- SB2253E.PDF
- Authorization for Purchase and Request for Change United
States Inflation-Indexed Savings Bonds - None
- SERPPUR.PDF - Request for Purchase of
Rented Equipment - None
- SESRECRT.PDF
- DHHS, NIH, Senior Executive Service
Recertification Form - None
Standard Forms
- SF8.PDF
- SF-8 - Notice to Federal Employee
About Unemployment Insurance - (Link
takes you to GSA's website)
- SF15.PDF
- SF-15 - Application for 10-Point Veteran Preference - (Link takes you to
OPM's website)
- SF18.PDF - SF-18 - Request for
Quotation - (Link takes you to GSA's website)
- SF26.PDF - SF-26 - Award/Contract - (Link
takes you to GSA's website)
- SF30.PDF - SF-30 - Amendment of
Solicitation/Modification of Contract - (Link takes you to
GSA's website)
- SF39.PDF
- SF-39 - Request for Referral of Eligibles - (Link takes you to
OPM's website)
- SF33.PDF
- SF-33 - Solicitation, Offer and Award - (Link takes you to
GSA's website)
- SF52.PDF
- SF-52 - Request for Personnel Action
(Link takes you to GSA's website)
- SF59.PDF
- SF-59 - Request for Approval of Noncompetitive Action
- (Link takes you to GSA's website)
- SF61.PDF -
SF-61 - Appointment Affidavits - 6/96
- SF62.PDF -
SF-62 - Agency Request to Pass Over a Preference Eligible or
Object to an Eligible - 10/79
- SF71.PDF
- SF-71 - Application for Leave
- 12/98
- SF75.PDF
- SF-75 - Request for Preliminary Employment Data - 8/98
- SF78.PDF
- SF-78 - U.S. Civil Service Commission
Certificate of Medical Examination (Link takes you to
GSA's website)
- SF81.PDF
- SF-81 - Request for Space - 2/89
- SF85P_S.PDF
- SF-85P-S - Supplemental Questionnaire for Selected Positions
- 9/95
- SF88.PDF -
SF-88 - Report of Medical Examination - 3/89
- SF93.PDF - SF-93 - Report of Medical History (Link takes you to
GSA's website)
- SF113A.PDF -
SF-113A - Monthly Report of Federal Civilian Employment - 8/94
- SF115.PDF
- SF-115 - Request for Records Disposition Authority - 3/91
- SF115A.PDF
- SF-115A - Request for Records Disposition Authority -
Continuation - 3/91
- SF120.PDF - SF-120
- Report of Excess Personal Property - 4/57
- SF120A.PDF - SF-120A
- Report of Excess Personal Property Continuation Sheet -
4/57
- SF121.PDF - Annual Report of Utilization and Disposal
of Excess and Surplus Personal Property - 5/96
- SF122.PDF - SF-122 - Transfer Order
Excess Personal Property - 6/74
- SF123A.PDF
- SF-123A - Transfer Order Supplies Personal Property
Continuation Sheet - 5/98
- SF123A.PDF
- SF-123A - Transfer Order Supplies Personal Property
Continuation Sheet - 10/77
- SF126.PDF - SF-126 - Report of Personal
Property for Sale - 7/78
- SF126A.PDF - SF-126-A - Report of
Personal Property for Sale Continuation Sheet - 2/65
- SF135.PDF
- SF-135 - Records Transmittal and Receipt - 7/85
- SF135A.PDF
- F-135A - Records Transmittal and Receipt (Continuation) -
7/85
- SF152.PDF
- SF-152 - Request for Clearance or Cancellation of a Standard
or Optional Form - 2/96
- SF171.PDF -
SF-171 - Application for Federal Employment - 6/88 (Obsolete)
- SF180.PDF -
SF-180 - Request Pertaining to Military Records - (Link takes you to GSA's website)
- SF181.PDF
- SF-181 - Ethnicity and Race Identification
(Link takes you to GSA's website)
- SF256.PDF
- SF-256 - Self-Identification of Disability - 7/10 (Link takes you to
OPM's website)
- SF258.PDF - SF-258
- Request to Transfer, Approval, and Receipt of Records to
National Archives of the United States - 9/95
- SF278.PDF
- SF-278 - Public Financial Disclosure Reports - Link goes to
the Office of Government Ethics. Check with your IC Ethics Office for instructions before using the form.
- SF282.PDF - SF-282 - Mandatory Title
Check - 4/79
- SF293.PDF
- SF-293 - Notice to Separated Employee
Concerning Disposition of Official Personnel Folder/Merged
Records Personnel Folder and Employee Medical Folder - 7/89
- SF298.PDF - SF-298 - Report
Documentation Page - 2/89
- SF308.PDF -
SF-308 - Request for Wage Determination and Response to
Request - (Link takes you to GSA's
website)
- SF326.PDF -
SF-326 - Semiannual Report of Payments
Accepted from a Non-Federal Source (Link takes you to
GSA's website)
- SF326A.PDF -
SF-326A - Semiannual Report of
Payments Accepted from a Non-Federal Source (Continuation
Sheet) - Link goes to the NIH Ethics Program
website.
- SF329.PDF
- SF-329 - Administrative Wage Garnishment Form (Link takes you to
GSA's website)
- SF329E.PDF
- SF-329E - Notice of Termination of Wage Garnishment Order
(Link takes you
to GSA's website)
- SF364.PDF - SF-364 - Report of Discrepancy (Link
takes
you to GSA's website)
- SF424.PDF - SF-424 - Application for Federal
Assistance - Go to http://www.grants.gov for
all forms in the SF 424 series.
- SF510.PDF
- SF 510 - Nursing Notes (Link takes
you to GSA's website)
- SF813.PDF
- SF-813 - Verification of a Military Retiree's Service in
Nonwartime Campaigns or Expeditions
(Link takes you to OPM's website)
- SF1012.PDF
- SF-1012 - Travel Voucher - 10/77
- SF1034.PDF
- SF-1034 - Public Voucher for Purchases and Services other than
Personal (Link takes
you to GSA's website)
- SF1035.PDF
- SF-1035 - Public Voucher for Purchases and Services other
than Personal (Continuation Sheet) - 9/73
- SF1035A.PDF
- SF-1035A - Public Voucher for Purchases and Services other
than Personal - Memorandum - (Continuation Sheet) - 9/73
- SF1038.PDF
- SF-1038 - Advance of Funds Application and Account - 10/77
- SF1081.PDF
- SF-1081 - Voucher and Schedule of Withdrawals and Credits -
9/82
- SF1152.PDF -
SF-1152 - Designation of Beneficiary Unpaid Compensation of
Deceased Civilian Employee - 11/91
- SF1153.PDF -
SF-1153 - Claim for Unpaid Compensation of Deceased Civilian
Employee - 4/82
- SF1154.PDF -
SF-1154 - Public Voucher for Unpaid Compensation Due A
Deceased Civilian Employee - (Link
takes you to GSA's website)
- SF1187.PDF
- SF-1187 - Request for Payroll Deductions for Labor
Organization Dues - 3/89
- SF1190.PDF
- SF-1190 - Foreign Allowances Application, Grant
and Report (Link
takes you to GSA's website)
- SF1199A.PDF
- SF-1199A - Direct Deposit Sign-up Form - 6/87
- SF1303.PDF
- SF-1303 - Request for Federal Cataloging/Supply Support
Action - 4/94
- SF1449.PDF
- SF-1449 - Solicitation/Contract/Order for Commercial Items (Link takes you to GSA's website)
- SF2800.PDF -
SF-2800 - CSRS Application for Death Benefits - 3/92
- SF2801.PDF
- SF-2801 - CSRS Application for Immediate Retirement Under
the Civil Service Retirement System - 1/90
- SF2801_1.PDF
- SF-2801-1 - CSRS Certified Summary of Federal Service - 1/90
- SF2801_2.PDF
- SF-2801-2 - CSRS Spouse's Consent to Survivor Election - (no
date)
- SF2801_3.PDF
- SF-2801-3 - CSRS Election of Former Spouse Survivor annuity
or Combination Current/Former Spouse Annuity - 1/90
- SF2801D.PDF
- SF-2801-Schedule D - CSRS Agency Checklist of Immediate
Retirement Procedures - 1/90
- SF2802.PDF
- SF-2802 - CSRS Application for Refund of Retirement
Deductions - 1/91
- SF2802B.PDF
- SF-2802B - CSRS Current/Former Spouse's Notification of
Application for Refund of Retirement Deductions Under the
Civil Service Retirement System - 1/91
- SF2803.PDF -
SF-2803 - FEGLI Application to Make Deposit or Redeposit -
6/92
- SF2804.PDF
- SF-2804 - Application to Make Voluntary Contributions,
Civil Service Retirement System (Link takes you to
GSA's website)
- SF2805.PDF -
SF-2805 - Request for Recovery of Debt Due the United States -
4/80
- SF2806.PDF -
SF-2806 - CSRS Individual Retirement Record - 2/80
- SF2806_1.PDF
- SF-2806 - CSRS Notice of Correction of Individual Retirement
Record - 2/80
- SF2807.PDF -
SF-2807 - Register of Separations and Transfers Civilian
Service Retirement System - 7/80
- SF2808.PDF
- SF-2808 - Designation of Beneficiary - 1/06
- SF2809.PDF
- SF-2809 - FEHB Health Benefits Registration Form - 7/99 (Link takes you to GSA's website)
- SF2809_1.PDF
- SF-2809-1 - FEHB Health Benefits Election Form - 7/99
- SF2809A.PDF - Obsolete -
SF-2809A - FEHB Information for Federal Civilian Employees
and U.S. Postal Service Employees - 6/90
- SF2810.PDF -
SF-2810 - FEHB Notice of Change in Health Benefits
Enrollment - 6/95
- SF2811.PDF - SF-2811 - Transmittal and Sumary Report
to Carrier - 6/84
- SF2812A.PDF
- SF-2812A - Report of Withholding and Contributions for
Health Benefits by Enrollment Code - 12/21/98
- SF2817.PDF -
SF-2817 - FEGLI Life Insurance Election - 4/99
- SF2818.PDF
- Continuation of Life
Insurance Coverage as an Annuitant or Compensationer - 5/01
- SF2819.PDF -
SF-2819 - FEGLI Notice of Conversion Privilege - 5/95
- SF2820.PDF -
SF-2820 - FEGLI Certification Of Insured Employee's Retired
Status - 8/94
- SF2821.PDF -
SF-2821 - Agency Certification of Insurance Status - 5/95
- SF2822.PDF -
SF-2822 - FEGLI Request for Insurance - 1/93
- SF2823.PDF
- SF-2823 - FEGLI Designation of Beneficiary - (Link takes you to GSA's website)
- SF2824.PDF - Obsolete -
SF-2824 - CSRS Documentation in Support of Disability
Retirement Application - 1/91
- SF2824A.PDF -
SF-2824A - CSRS Applicant's Statement of Disability -
3/31/93
- SF2824B.PDF -
SF-2824B - CSRS Supervisor's Statement - 1/91
- SF2824C.PDF - Obsolete -
SF-2824C - CSRS Physician's Statement - 1/91
- SF2824D.PDF -
SF-2824D - FEGLI Agency Certification of Reassignment and
Accommodation Efforts - 1/91
- SF2824E.PDF -
SF-2824E - FEGLI Disability Retirement Application Checklist
- 1/91
- SF3100A.PDF
- SF-3100-A - FERS Individual Retirement Record - 1/87
- SF3101.PDF - SF-3101 -
FERS Notice of Correction of Individual Retirement Record -
2/87
- SF3102.PDF -
SF-3102 - FERS Designation of Beneficiary - 12/93
- SF3104.PDF -
SF-3104 - FERS Application for Death Benefits - 5/98
- SF3104A.PDF -
SF-3104A - FERS Survivor Supplement - 12/91
- SF3104B.PDF -
SF-3104B - FERS Documentation and Elections in Support of
Application for Death Benefits when Deceased was an Employee
at the Time of Death - 5/98
- SF3105.PDF - Obsolete -
SF-3105 - FERS Documentation in Support of Disability
Retirement Application - 8/87
- SF3105A.PDF -
SF-3105A - FERS Applicant's Statement of Disability - 8/87
- SF3105B.PDF -
SF-3105B - FERS Supervisor's Statement - 8/87
- SF3105C.PDF - Obsolete -
SF-3105C - FERS Physician's Statement - 8/87
- SF3105D.PDF -
SF-3105D - FERS Agency Certification of Reassignment and
Accommodation Efforts - 8/87
- SF3105E.PDF -
SF-3105E - FERS Disability Retirement Application Checklist
- 8/87
- SF3106.PDF
- SF-3106 - Application for Refund of Retirement Deductions
Federal Employees Retirement System - 3/96
- SF3106A.PDF -
SF-3106A - Current/Former Spouse's Notification of
Application for Refund of Retirement Deductions Under the
Federal Employee's Retirement System - 2/97
- SF3107.PDF
- SF-3107 - FERS Application for Immediate Retirement - 4/00
- SF3107_1.PDF
- SF-3107-1 - FERS Certified Summary of Federal Service - 1/97
- SF3107_2.PDF
- SF-3107-2 - FERS Spouse's Consent to Survivor Election -
3/88
- SF3108.PDF -
SF-3108 - Application to Make Service Credit Payment for
Civilian Service - 5/88
- SF3109.PDF
- SF-3109 - FERS Election of Coverage - 7/89
- SF3110.PDF
- SF-3110 - FERS Former Spouse's Consent to FERS Election -
6/90
- SF3111.PDF
- SF-3111 - FERS Request for Waiver, Extension, or Search 6/90
- SF3112.PDF
- SF-3112 - Applicant's Statement of Disability In Connection
With Disability Retirement Under the Civil Service Retirement
System or the Federal Employees Retirement System - 12/95
- SF3112-1.PDF
- SF-3112-1 - Information about Disability Retirement (CSRS) -
3/96
- SF3112-2.PDF
- SF-3112-2 - Information about Disability Retirement (FERS) -
3/96
- SF3112A.PDF
- SF-3112A - CSRS/FERS Applicant's Statement of Disability -
11/96
- SF3112B.PDF
- SF-3112B - CSRS/FERS Supervisor's Statement In Connection
With Disability Retirement Under the Civil Service Retirement
System and the Federal Employees' Retirement System - 11/96
- SF3112C.PDF
- SF-3112C - CSRS/FERS Physician's Statement In Connection
With Disability Retirement Under the Civil Service Retirement
System and the Federal Employees' Retirement Ssytem - 11/96
- SF3112D.PDF
- SF-3112D - CSRS/FERS Agency Certification of Reassignment
and Accommodation Efforts In Connection With Disability
Retirement Under the Civil Service Retirement System and the
Federal Employees' Retirement Ssytem - 11/96
- SF3112E.PDF
- SF-3112E - CSRS/FERS Disability Retirement Application
Checklist - 11/96
- SF3881-NIHonly.PDF
- SF-3881 - ACH Vendor/Miscellaneous Payment Enrollment Form -
2/03 - FOR NIH USE ONLY. The
"Agency Information" section has been completed with NIH
data.
- SF3881.PDF
- SF-3881 - ACH Vendor/Miscellaneous Payment Enrollment Form -
2/03 - For use outside NIH.
- SFLLL.PDF - SF-LLL
- Disclosure of Lobbying Activities - None
- SFLLLA.PDF -
SF-LLL-A - Disclosure of Lobbying Activities Continuation
Sheet - None
Social Security
Administration Forms
TAIMS
Forms
- THRIFT
SAVINGS
PLAN - Go to web site for all TSP forms
- USIMMNT.PDF - US Bank
Cardholder Maintenance - 11/98 (Note - Obtain this form from your Administrative
Officer. Do NOT create this form electronically. US Bank
wishes to control distribution.)
- USIMSET.PDF - US Bank
Cardholder Setup - 11/98 (Note - Obtain this form from your Administrative
Officer. Do NOT create this form electronically. US Bank
wishes to control distribution.)
- VFSUPAGR.PDF
- NIH Supplemental Visiting Fellow Award Program Supplemental
Fellowship Agreement - 7/17/95
- VFSUPPRV.PDF
- NIH Supplemental Visiting Fellow Award Program Statement of
Supplemental Program Provisions - 7/17/95
- VMQWKCHG.PDF
- Voice Mail System Quick Change Request - Revised- 9/10
- VOLAGREE.PDF - NIH
Special Volunteer Agreement - None
- VOTER
REGISTRATION - By Mail - Link to National Web
Site
- Y2KComp.PDF - Biomedical
and Information Technology Equipment Year 2000 Compliance
Certificate
- W9.PDF
- W-9 - Request for Taxpayer Identification Number and
Certification (Link goes to IRS
website)