Benefits Forms for Employees Hired before October 1, 1987 Form # Title   Flexible Spending Account*   Pre-Tax Waiver/Election Form* SF 2817 Life Insurance Election* SF 2819 Notice of Conversion Privilege, Federal Employees Group Life Insurance Program* SF 2820 Certification of Insured Employee's Retired Status* SF 2822 Request for Insurance* SF 2823 Designation of Beneficiary, Federal Employees Group Life Insurance Program* FE 6 Claim for Death Benefits, Federal Employees Group Life Insurance Program* FE 6 DEP Settlement of Claim, Option C: Family Life Insurance* Retirement Computation Form* FE 7 Claim for Accidental Means Dismemberment Benefits* DC 401(a) Retirement Plan Distribution Request for Death Claims** DC 401(a) Retirement Plan Distribution Form** * This document is presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or Learn More About PDFs.     ** Microsoft Word Format: Forms marked with two asterisks (**) are in Microsoft Word. Most information on these forms can be entered from your computer. However, they still must be printed so they can be signed and certain information can be completed. Type your information directly into the fields (gray boxes) then save and print the form. To move from field to field, use the Tab key. Completed forms must be returned by mail or fax to the DC Department of Human Resources.