Personnelist: Classifier

CLASSIFIER/DESIGNEE PREPARES CSRS/FERS CHECKLIST

Page 1, Checklist of RECOMMENDATION of FF/LEO coverage:

Complete as appropriate, classifier or authorized official signs at bottom of page 2;

Page 2, Checklist of documentation submitted:

Complete as appropriate, no signature required (this form is not submitted-it’s just for your information)

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Revised 05/03/2002

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