1152 Form PDF Details

The 1152 form, known as the Designation of Beneficiary Unpaid Compensation of Deceased Civilian Employee form, is an essential document for employees within the federal government sector. It enables the civilian federal employees to nominate individuals who will receive any compensation due, which has not been paid out at the time of the employee’s death. The form contains multiple sections, including identification details of the employee, information concerning the beneficiaries with clear examples of possible designations, instructions for designating contingent beneficiaries, and details on how to cancel previous beneficiary designations, ensuring payment allocation follows the order of precedence as required. It also includes a section for witness declarations, wherein the witnesses attest to the authenticity of the designations but are not themselves eligible to be named as beneficiaries. An important aspect to note is that the 1152 form should not be confused with other forms related to beneficiary designations such as Standard Forms 2808, 2823, and 3102, which serve different purposes within the civil service and federal employees' retirement and insurance programs. Additionally, the back of the form offers critical guidance on completing the form accurately, ensuring the employee's wishes are legally documented and can be executed without delay in the event of their passing.

QuestionAnswer
Form Name1152 Form
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namessf1152 pdf, sf 1152, opm designation beneficiary, sf 1152 fillable

Form Preview Example

Designation of Beneficiary

Unpaid Compensation of Deceased Civilian Employee

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A. Identification

Qdph#(Last, first, middle)

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Vrfldo#Vhfxulw|#Qxpehu#

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Ghsduwphqw#ru#djhqf|#Exuhdx#

Glylvlrq#

Orfdwlrq#(City, state and ZIP code)

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B. Information Concerning The Beneficiaries (See Examples of Designations):

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hdfk#ehqhilfldu|#

 

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C.Witnesses (A witness is not eligible to receive payment as a beneficiary):

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Vljqdwxuh#ri#zlwqhvv#

Qxpehu#dqg#vwuhhw#

Flw|/#vwdwh#dqg#]LS#frgh#

Receiving agency certification

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Gdwh#uhfhlyhg#

Vljqdwxuh#

Gdwh#

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Part 1 - Original

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Examples of Designations

1.HOW TO DESIGNATE ONE BENEFICIARY Gr#qrw#zulwh#qdphv#dv#P1H1#Eurzq#ru#dv#Puv1#Mrkq#K1#Eurzq1# Li#|rx#zdqw#wr#ghvljqdwh#|rxu#hvwdwh# dv#ehqhilfldu|/#hqwhu#ᄈP|#hvwdwhᄡ#lq#wkh#ehqhilfldu|#froxpq1#

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Uhodwlrqvkls#

Vkduh#wr#eh#sdlg#wr#

qdph#ri#hdfk#ehqhilfldu|#

hdfk#ehqhilfldu|#

 

hdfk#ehqhilfldu|#

Mary E. Brown

214

Central Avenue ###########

Grphvwlf#Sduwq####################433(#

 

Muncie, IN 47303

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. HOW TO DESIGNATE MORE THAN ONE

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Vkduh#wr#eh#sdlg#wr#

qdph#ri#hdfk#ehqhilfldu|#

 

hdfk#ehqhilfldu|#

 

hdfk#ehqhilfldu|#

 

 

 

 

 

Alice M. Long

509

Canal Street

Aunt

25%

 

Red Bank, NJ 07701

 

 

 

 

 

 

 

Joseph P. Brady

360

Williams Street

Nephew

25%

 

Red Bank, NJ 07701

 

 

 

 

 

 

 

Catherine L. Rowe

792

Broadway

Mother

50%

 

Whiting, IN 46394

 

 

 

 

 

 

 

 

 

 

3. HOW TO DESIGNATE A CONTINGENT BENEFICIARY

 

 

 

 

 

 

 

Iluvw#qdph/#plggoh#lqlwldo/#dqg#odvw#

 

Dgguhvv#+Lqfoxglqj#]LS#frgh,#ri#

Uhodwlrqvkls#

Vkduh#wr#eh#sdlg#wr#

qdph#ri#hdfk#ehqhilfldu|#

 

hdfk#ehqhilfldu|#

 

hdfk#ehqhilfldu|#

 

 

 

 

 

John M. Parrish, if living

810

West 180th Street

Father

100%

 

New York, NY 10033

 

 

 

 

 

 

 

Otherwise to: Susan A. Parrish

810

West 180th Street

Sister

100%

 

New York, NY 10033

 

 

 

 

 

 

 

 

 

 

 

 

4. HOW TO CANCEL A DESIGNATION OF BENEFICIARY AND EFFECT PAYMENT UNDER ORDER OF PRECEDENCE (See back of duplicate)

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qdph#ri#hdfk#ehqhilfldu|#

hdfk#ehqhilfldu|#

 

hdfk#ehqhilfldu|#

Cancel prior designations

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Vwdqgdug#Irup#4485#(Reverse of Part 1)

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Designation of Beneficiary

Unpaid Compensation of Deceased Civilian Employee

Lpsruwdqw=#

Uhdg#doo#lqvwuxfwlrqv#ehiruh#

 

 

iloolqj#lq#wklv#irup#

A. Identification

Qdph#(Last, first, middle)

Gdwh#ri#eluwk#(mm, dd, yyyy)

Vrfldo#Vhfxulw|#Qxpehu#

Ghsduwphqw#ru#djhqf|#lq#zklfk#suhvhqwo|#hpsor|hg#(or former department or agency) =#

Ghsduwphqw#ru#djhqf|#Exuhdx#

Glylvlrq#

Orfdwlrq#(City, state and ZIP code)

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B. Information Concerning The Beneficiaries (See Examples of Designations):

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Dgguhvv#+Lqfoxglqj#]LS#frgh,#ri#

Uhodwlrqvkls#

qdph#ri#hdfk#ehqhilfldu|#

hdfk#ehqhilfldu|#

 

 

 

 

 

 

 

Vkduh#wr#eh#sdlg#wr# hdfk#ehqhilfldu|#

Gdwh#ri#ghvljqdwlrq#(mm, dd, yyyy)

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Wrwdo#@# (#

C.Witnesses (A witness is not eligible to receive payment as a beneficiary):

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Vljqdwxuh#ri#zlwqhvv#

Qxpehu#dqg#vwuhhw#

Flw|/#vwdwh#dqg#]LS#frgh#

Vljqdwxuh#ri#zlwqhvv#

Qxpehu#dqg#vwuhhw#

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Receiving agency certification

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Vljqdwxuh#

Gdwh#

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X1V1#Riilfh#ri#Shuvrqqho#Pdqdjhphqw#

Part 2 - Employee Copy

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8#FIU#4:;#

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#Uhylvhg#Vhswhpehu#5344##

IMPORTANT NOTICE – ORDER OF PRECEDENCE

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INSTRUCTIONS

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This form is not to be confused with Standard Form 2808, Designation of Beneficiary, Civil Service Retirement System,

Standard Form 2823, Designation of Beneficiary, Federal Employees’ Group Life Insurance Program, or

Standard Form 3102, Designation of Beneficiary, Federal Employees Retirement System.

Privacy Act Statement

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Filling out part 4 of sf1152 pdf

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sf1152 pdf completion process detailed (part 5)

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