Section 1, Parts A to C: service history
The employee's identification, the verified service history from official personnel records, and details of any Federal civilian service not subject to a contributory retirement system.
SF2800A
Documentation and Elections in Support of Application for Death Benefits When Deceased was an Employee at the Time of Death - Civil Service Retirement System
- Agency
- GSA
- Revision
- Revised March 2022
- Fillable fields
- 258
- Pages
- 8
- Official source
- GSA form page
- Checked
- October 20, 2026
Standard Form 2800A (SF 2800A): Documentation and Elections for CSRS Death Benefits
Standard Form 2800A (SF 2800A), Documentation and Elections in Support of Application for Death Benefits When Deceased Was an Employee at the Time of Death, is a U.S. Office of Personnel Management (OPM) form for the Civil Service Retirement System (CSRS), Revised March 2022, under 5 CFR 831 with OMB Approval 3206-0156. GSA hosts a copy in its forms library.
The form says it should be completed only if the deceased was a Federal employee under CSRS at the time of death. It holds the forms that the survivor and the deceased person's employing agency need to complete the Application for Death Benefits (SF 2800). Section 1 is the Certified Summary of Federal Service, Section 2 covers post-1956 military service and the survivor's deposit election, and Section 3 is the agency's information and certification.
All applicable forms go to the deceased person's employing agency with SF 2800, and the agency forwards the application to OPM. You can fill it out free in your browser on this page and download the result without an account.
What's on SF 2800A
Section 1, Parts D and E: certifications
An authorized agency personnel official certifies the record. The applicant then certifies that the service is complete or claims additional service with a signed statement of dates, positions and locations.
Section 2: post-1956 military service
Information for the survivor about optional deposits, eligibility for social security survivor benefits, minimum basic annuity, military retired pay and reemployed annuitants.
Survivor's Military Service Election
Part A is completed by the employing agency, Part B is the survivor's election to make or not make the deposit, and Part C is for the survivor of an employee who received military retired pay.
Section 3 A: employing office
The type of death benefit that appears payable, workers' compensation information, health benefits and life insurance information, a checklist of attached documents and the personnel officer's certification.
Section 3 B: payroll office checklist
Earnings for the last 52 weeks for an irregular tour, health benefits status and military deposit annotations on SF 2806, how the SF 2806 was sent, and the payroll officer's certification.
How SF 2800A is completed
- 1
Use it with SF 2800
SF 2800A is used with SF 2800 when the deceased was an employee at the time of death. The survivor and the deceased person's employing agency complete it together.
- 2
Agency fills in Section 1
The personnel office enters the identification and verified service history and certifies it. The form says a certified copy accompanies SF 2800 for a deceased employee if a survivor annuity appears to be payable.
- 3
Review and sign Part E
The applicant confirms the service listed is complete or claims additional service with a signed statement. The form says claimed service cannot be credited for survivor benefit purposes until it has been verified.
- 4
Make the military deposit election
Part B says to read the attached information, make an election, sign and date the form, and return two (2) copies to the address in item 8 of Part A, by the date shown there.
- 5
Attach military survivor benefit proof
If the deceased employee received military retired pay, Part C asks for verification of eligibility or ineligibility for military survivor benefits, and lets the survivor elect to exclude the military service.
- 6
Agency completes Section 3 and forwards it
The personnel and payroll offices complete and certify Section 3. All applicable forms go to the employing agency with SF 2800, and the agency forwards the application to OPM.
Why fill Form SF2800A on indox
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Where it goes and what the form says
Where it goes
The form says all applicable forms in the package should be submitted to the deceased person's employing agency, along with the Application for Death Benefits (SF 2800). The agency forwards the application to OPM.
Deposit amount and payment
The form says the deposit is 7 percent of military basic pay (plus interest, if any), paid in a lump sum to the agency before OPM completes its adjudication of the application for survivor benefits.
Changing the election
An election to pay may be changed at any time before the deposit is actually paid to the agency. The form says an election not to pay is irrevocable after OPM completes processing of the application.
Time to complete
OPM estimates an average of 45 minutes per response. Comments go to the Retirement Services Publications Team (3206-0156), Washington, D.C. 20415-0001, and the form says completed applications should not be sent there.
Privacy
OPM collects the information under 5 U.S.C. Chapter 83, Sections 8341 and 8342. Providing it is voluntary, but the form says OPM may be unable to process the application for death benefits without it.
Related forms
SF2800
Application for Death Benefits - Civil Service Retirement System
204 fields, 7 pages
SF2800-1
Applying for Death Benefits Under the Civil Service Retirement System - Retirement Pamphlet
2 fields, 17 pages
SF2809
Health Benefits Election Form
100 fields, 18 pages
SF2810
Notice of Change in Health Benefits Enrollment
29 fields, 7 pages
SF2806
Individual Retirement Record - Civil Service Retirement System (CSRS)
242 fields, 1 page
SF144
Statement of Prior Federal Service
44 fields, 2 pages
Who completes SF 2800A?
The cover page assigns each section to the applicant or to the deceased person's employing agency.
Official sources and the blank
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Questions about Form SF2800A
Who issues SF 2800A?
The form is printed as an Office of Personnel Management form under 5 CFR 831, Revised March 2022, with OMB Approval 3206-0156. GSA hosts a copy in its forms library.
When is SF 2800A used?
The form says it should be completed only if the deceased was a Federal employee under the Civil Service Retirement System at the time of death. It goes with the survivor's Application for Death Benefits (SF 2800).
Who fills in which section?
Section 1 is completed by the employing agency's personnel office with the applicant's signature, Section 2 by the applicant if appropriate, and Section 3 by the employing agency's personnel and payroll offices.
What is the deposit for post-1956 military service?
The form says the amount of deposit is 7 percent of military basic pay (plus interest, if any). If the deposit is made, the post-1956 military service is credited under both the civil service and the social security systems, if it is otherwise creditable.
Can I change my military deposit election?
The form says an election to make the deposit may be changed at any time before the deposit is actually paid to the agency. If you elect to pay and later decide not to, it says to promptly notify the employing agency and OPM in writing.
What documents go with SF 2800A?
The Part 4 checklist lists SF 2800, SF 2809s, SF 2810s, a DD 214, Sections 1 and 2 of SF 2800A, a death certificate, a marriage certificate, children's birth certificates, medical documentation, adoption and guardianship papers, court appointment documents and Social Security Numbers for all applicants, each where it applies.