Ps Form 2146 PDF Details

When an employee faces the unfortunate event of personal property loss or damage while on the job, navigating the path to claim reimbursement can be a daunting ordeal. The PS Form 2146, known as the "Employee's Claim for Personal Property," serves as a beacon for such situations, guiding employees through the necessary steps to seek reimbursement. This form demands careful attention to detail and adherence to specific time frames, requiring employees to act within 14 days for bargaining employees, or 90 days for non-bargaining employees, from the incident's occurrence. Completeness and legibility are paramount when filling out the form, further emphasizing the necessity of providing thorough documentation, such as receipts, estimates for repairs, or statements to substantiate the claim. Intrinsically designed to ensure fairness and transparency, the form includes sections for the employee, union steward (for bargaining employees), and the employee's supervisor, each playing a critical role in the claims process. Additionally, it outlines the responsibilities of claimants, including the obligation to notify if the lost or damaged property is later recovered. Importantly, the form also touches on legal aspects, such as the assignment of rights to the United States to the extent of any payment accepted and a declaration certifying no negligence on the part of the claimant. Privacy considerations are not overlooked, with clear stipulations on how the collected information will be used and disclosed, underscoring the form's role not just as a procedural document, but as a safeguard for employees' rights and property.

QuestionAnswer
Form NamePs Form 2146
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesyes employee property online, ps form personal property, ps form employee, ps form claim property

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EMPLOYEE'S CLAIM

FOR PERSONAL PROPERTY

Part One – This Page Completed by Employee

Type or write legibly in ink. Submit in triplicate to your supervisor within 14 days (if you are a bar- gaining employee), or 90 days (if you are a non-bargaining employee) from the date that loss or damage occurred.

Name of Claimant

 

SSN

Job Title of Claimant

 

 

 

 

Claimant's Home Address

 

Claimant's Work Address/Work Phone Number

 

 

 

 

Date Loss/Damage Occurred

 

Total Amount of Claim

 

 

 

$

 

 

 

 

 

 

Article(s) for Which Claim is Made

 

(Include paid receipt or other evidence showing purchase date and original price of lost or damaged article. If repairable, include an estimate for repair. If not repairable include a statement from a tailor, dry cleaner, etc., to substantiate. If claim is for eyeglasses, state exactly what part(s) are broken. Include an itemized receipt for the REPLACEMENT of damaged part(s). Replacement must be of the same quality as the damaged part(s).

Description of Loss or Damage

(Give place, extent of damage, and circumstances of accident involving loss or damage. State salvage value.)

Insurance Coverage/Recovery Attempt

Homeowners

 

 

 

 

 

Name & Address of Insurance Company

Insurance

Yes

No

Collision

#Yes

#No

 

 

 

Comprehensive

#Yes

#No

Other (Specify)#:

 

 

 

 

Has Claim been Filed with Insurance Company?

Yes

#No

 

 

Amount of Deductible

 

If "yes", action taken:

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

If damage/loss result from the negligence of another party, has an attempt

 

 

 

 

 

 

 

 

 

 

 

 

been made#to recover from that party?

 

 

 

 

 

 

Yes

#No

(If "Yes" explain on separate sheet.)

 

 

 

 

I certify that the damage, loss, or destruction was not caused in whole or in

I make the foregoing claim with full knowledge of the penalties involved for

part by any negligence or wrongful act of the claimant, or his agent or employ-

willfully making a false claim. (US Code, Title 18, Section 287, provides for

ee. All articles listed on this sheet (or additional sheets made part of this

a maximum fine of $10,000 or imprisonment for 5 years, or both.)

 

 

 

 

 

 

form) have been privately purchased and are not government property. No

I hereby assign to the United States to the extent of any payment of this

previous claim has been made to the government for the property for which

claim accepted by me all my right, title, and interest in and to any claim that I

this claim is made (except as explained on the attached sheet).

This claim

may have against any insurer or other party, arising out of the damage, loss,

does not duplicate any made under the Workman's Compensation Program.

or destruction to the property described on this form and will, upon request,

 

 

 

 

 

 

If any of the property for which claim is made is later recovered, claimant

furnish such evidence as may be required to enable the United States to en-

agrees to give written notice immediately to the US Postal Service.

 

force such claim.

 

 

PRIVACY ACT: The collection of this information is authorized by 39 USC 1001 & 2008. It will be used to reimburse you for a loss of personal property. As a routine use, this information may be disclosed to an appropriate law enforcement agency for investigative or prosecutorial purposes, to a congressional of- fice at your request, to OMB for review of private and relief legislation, to a labor organization as required by the NLRA, to the Office of EEOC when investi- gating an EEO complaint and where pertinent, in a legal proceeding to which the Postal Service is a party. Completion of this form is voluntary, however, if this information is not provided, it will result in your not receiving reimbursement for a personal loss.

Date of Claim

Claimant's Signature

 

 

PS Form 2146, November 1987

Part 2 – Completed by Union Steward (Bargaining Employees)

Recommendation

Date of Recommendation

Signature

Name of Union

Part 3 – Completed by Employee's Supervisor

(Forward non-bargaining unit claims immediately to: General Manager, Field Division (for Field Units); Regional Director, Human Resources (for Regional Office Units); and General Manager, Headquarters Personnel Division (for Headquarters and Related Units). Forward bargaining unit claims immediately to : Regional Labor Relations Office.

1. Was Claim Submission Timely?

Yes

No

(If "no", explain.)

 

Is Part 1 Complete?

#Yes

No

 

 

Is Part 2 Complete?

Yes

#No

 

 

 

2.

Was possession of lost/damaged property reasonable, proper, and necessary to the performance of the employee's employment?

 

 

#Yes

#No

(If "no", explain.)

 

 

3.

Was there any negligence on the part of the employee which contributed to the loss/damage?

 

 

#Yes

#No

(If "no", explain.)

4. Supervisor's Review (State facts related to claim developed through your investigations, e.g., caused by faulty equipment. Provide basis for recommen- dation of payment or denial.

5. Based on the above, do you recommend payment?

 

 

#Yes

#No

 

 

 

 

Date of Report

Finance No. of Postal Installation

Signature and Title of Supervisor

 

 

 

 

PS Form 2146, November 1987 (Reverse)

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