Sf 3106A Form PDF Details

Understanding the nuances of financial and legal processes within the Federal Employees Retirement System (FERS) is crucial for ensuring the rights and obligations of involved parties are observed. Among these procedures is the Sf 3106A form, a document serving as a notification tool for current or former spouses when an individual applies for a refund of retirement deductions. The importance of this form lies in its role in maintaining transparency and complying with federal laws regarding retirement funds. The Sf 3106A not only serves to inform spouses about the potential refund but also addresses the implications such refunds have on entitlements to survivor annuities or portions of annuities that would otherwise be due. Completing the form involves a series of steps where the applicant must provide personal details, and the spouse must acknowledge the application and its repercussions, ensuring their signatures are duly witnessed. This procedure underscores the significance of consent and awareness in financial decisions impacting both parties. Moreover, in instances where a court order is in effect regarding the applicant's retirement deductions, specific instructions are provided to uphold the court's decision, reflecting the interplay between federal retirement operations and legal systems. The form's comprehensive approach to notifications, coupled with stipulations for court orders, illustrates the meticulous considerations federal employees and their spouses must navigate in safeguarding their financial interests and legal rights.

QuestionAnswer
Form NameSf 3106A Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namessf 3106a, sf 3106a form, spouses notification, va form sf3106 a

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Current/Former Spouse's Notification of Application for Refund of Retirement Deductions

Under the Federal Employees Retirement System

If you apply for a refund of retirement deductions, you must notify your current spouse. Also, you must notify any former spouse if the following conditions apply: (1) You have 18 months of creditable civilian service; and (2) You were married to the former spouse for at least 9 months. Refer to the information and instructions given on this form.

Part 1 - To Be Completed By Applicant

Instructions: To notify each current or former spouse of your application for a refund of your retirement deductions, complete Part 1 with your name, date of birth and Social Security Number and have the current or former spouse complete Part 2. The current or former spouse's signature must be witnessed in Part 3. You may not be a witness. After Parts 2 and 3 have been completed, the form must be returned to you for attachment to your refund application. (Use a separate form for current spouse and each former spouse.)

Name (last, first, middle)

Date of birth (mm/dd/yyyy)

Social Security Number

Part 2 - To Be Completed by Current or Former Spouse

Instructions: Complete Part 2 and have two witnesses complete Part 3 and then return the form to the applicant. Payment of the refund of retirement deductions will end any entitlement you may have to a survivor annuity or portion of any annuity to which the applicant would otherwise have been entitled. If a court order expressly relates to the applicant's retirement deductions and you believe that payment of the refund would end a court-ordered entitlement you have to a survivor annuity or to a portion of an annuity to which the above-named person is entitled, see the information provided below regarding such court orders. (Complete Part 2 and have the witnesses complete Part 3 even if you are submitting a court order.)

I have read the paragraph above and I understand that the above-named individual is applying for a refund of retirement deductions under the Federal Employees Retirement System.

Signature (do not print)

Name (type or print legibly)

Date signed (mm/dd/yyyy)

Part 3 - To Be Completed by Witnesses

We, the undersigned, certify that Part 2 of this form was signed by the current or former spouse of the person named in Part 1 in our presence.

Signature

Date signed (mm/dd/yyyy)

Signature

Date signed (mm/dd/yyyy)

 

 

 

 

Name of witness (type or print legibly)

Name of witness (type or print legibly)

Address (number and street)

Address (number and street)

City, state and ZIP code

City, state and ZIP code

Information About Sending Court Orders to the Office of Personnel Management (OPM)

If you are legally separated or divorced from the applicant, you should know that a refund would end your potential entitlement to a survivor annuity and to any portion of any annuity to which the applicant would be entitled. If you have a court order that expressly relates to any portion of the applicant’s retirement deductions, you

should send a copy of the court order to OPM with a cover letter giving:

1.The name, date of birth, and Social Security Number of the person applying for the refund;

2.Your statement that the court order has not been amended, superseded, or set aside.

3.Your name, date of birth, and mailing address; and

4.If the court order states that any payments to you are subject to termination upon your remarriage, a statement that either (1) you have remarried and the date of the remarriage, or (2) that you have not remarried and that you will notify OPM within 15 days of a remarriage should you remarry in the future.

If the court order gives you a survivor annuity after the death of the applicant, also attach a copy of your birth certificate, if available.

The court order can be honored only if it is received before the refund is paid to the applicant. Payment of the refund will end any entitlement you may have to a survivor annuity or a portion of any annuity to which the applicant would otherwise have been entitled. Payment of the refund will also end any eligibility you have to coverage under the Federal Employees Health Benefits Program. Send a copy of the court order and your cover letter to the following address and complete the blocks below:

Office of Personnel Management

Federal Employees Retirement System

Attn: Refund

P.O. Box 45

Boyers, PA 16017-0045

NOTE: A former spouse who remarries before reaching age 55 is not entitled to a survivor annuity. (Termination of the remarriage does not restore a former spouse’s entitlement to a survivor annuity.) Remarriage does not affect a former spouse’s court-ordered right to receive a portion of any annuity during the annuitant’s lifetime, unless the court order provides otherwise. A former spouse may also lose entitlement according to the court order.

I believe I have a court order that meets the criteria described above. I am immediately submitting a copy of the court order and the required cover letter to the address provided above.

Signature (do not print)

Date of court order (mm/dd/yyyy)

Today's Date (mm/dd/yyyy)

U.S. Office of Personnel Management

SF 3106A

CSRS/FERS Handbook for Personnel and Payroll Offices

Revised September 2013

 

Previous editions are not usable.

Notification To Current and Former Spouses of Your Refund Application

The Federal Employees Retirement law provides that your retirement contributions may be refunded to you only if you notify the following persons that you are applying for a refund:

•any current spouse (including any person from whom you are legally separated) and

•any former spouse who is still living.

You are not required to notify a former spouse if you were not married to that person for a total of at least 9 months or you do not have a total of at least 18 months of creditable civilian service.

You should provide a copy of Standard Form 3106A, Current/Former

Spouse’s Notification of Application for Refund of Retirement Deductions (this form, front and back), to (1) your current spouse, if any, and (2) if you have at least 18 months of creditable civilian service, each former spouse that meets the above criteria. The current and/or former spouse(s) must sign the form and have the signature witnessed by two persons. You cannot be one of the witnesses. Additional copies of the SF 3106A should be available from your employing office or you can photocopy both sides of the form

for each spouse/former spouse. SF 3106A is also a part of the SF 3106 forms package which is found on our website at www.opm.gov/retirement-services.

In addition, the law provides that payment of your refund is subject to the terms of any court order (related to a divorce or legal separation) that expressly relates to any portion of your refund, if the payment of the refund would end the entitlement of a spouse or former spouse to a survivor annuity or a portion of your annuity. A court order cannot bar payment of a refund if you do not have a future annuity entitlement under the Federal Employees Retirement System.

Attach all signed and witnessed notification forms to your refund application.

If your current or former spouse refuses to acknowledge the notification or you are otherwise unable to obtain the acknowledgment, you must submit one of the following:

1.Affidavits signed by two individuals who witnessed your attempt to personally notify the current or former spouse. The witnesses must attest that they saw you give or try to give (personally) the notification form to your current or former spouse to whom your purpose should have been clear.

OR 2. The current mailing address of the current or former spouse. (You may use the box at the end of this column to give the address.) The Office of Personnel Management (OPM) will attempt to notify (by certified mail return receipt requested) the current or former spouse at the address you give. OPM will not pay you the refund until we receive the signed return receipt.

If the notice is undeliverable at the address you give, your refund may not be paid unless you subsequently show that the notification requirement should be waived as described below. If you decide you want OPM to make notification, it will cause a 6- to 8-week delay in the payment of your refund.

If you do not know the current whereabouts of a spouse or former spouse, OPM may waive the requirement to notify that person. A waiver may be granted if you submit with your refund application:

1.A determination by a court or administrative agency empowered to make such determinations that the person is missing; OR

2.Notarized statements from yourself and two other persons (one of whom is unrelated to you) stating that the person’s whereabouts are unknown and detailing efforts to locate the person.

I have been unable to notify the following current or former spouse. (Enter name and current mailing address, including ZIP Code, of the current or former spouse.)

Privacy Act Statement

5 U.S.C. 8424 authorizes solicitation of this information. The information you furnish will be used to identify records properly associated with your application for Federal benefits, to obtain additional information if necessary, to determine and allow present or future benefits, and to maintain a uniquely identifiable claim file. The information may be shared and is subject to verification, via paper, electronic media, or through the use of computer matching programs, with national, state, local, or other charitable or social security administrative agencies in order to determine benefits under their programs, to obtain information necessary for determination or continuation of benefits under this program, or to report income for tax purposes. It may also be shared and verified, as noted above, with law enforcement agencies when they are investigating a violation or potential violation of civil or criminal law.

Executive Order 9397 (November 22, 1943) authorizes use of the Social Security Number to distinguish between the applicant and people with similar names. Failure to furnish the requested data may result in our inability to refund the retirement deductions.

Public Burden Statement

We estimate that this form takes an average of 5 minutes to complete, including the time for reviewing instructions, getting the needed data, and reviewing the completed form. Send comments regarding our estimate or any other aspect of this form, including suggestions for reducing completion time, to the Office of Personnel Management, Retirement Services Publications Team (3206-0170), Washington, D.C. 20415-3430. The OMB Number 3206-0170 is currently valid. OPM may not collect this information, and you are not required to respond, unless this number is displayed.

Reverse of SF 3106A

Revised September 2013

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why standard form 3106 completion process shown (part 1)

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Filling out segment 2 of why standard form 3106

You can potentially make a mistake while completing the Todays Date mmddyyyy, therefore be sure you look again before you decide to finalize the form.

3. The following segment is all about whom is unrelated to you stating, I have been unable to notify the, You should provide a copy of, In addition the law provides that, Attach all signed and witnessed, If your current or former spouse, Privacy Act Statement, and USC authorizes solicitation of - complete all of these blank fields.

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