Form RI 25-14A RI 25-14A Information and Instructions for Completing the Self-Cer

Form Approved:
OMB No. 3206-0032

United States

Office of Personnel Management
Retirement Surveys and Students Branch

Washington, D.C. 20415-3563

Information and Instructions for Completing

the Self-Certification of Full-Time School Attendance

The retirement law provides for payment of a monthly annuity to
unmarried sons and daughters who are: 1) age 18 to 22 and are
full-time students in recognized schools or 2) age 18 or older and
incapable of self-support because of a mental or physical
disability that began before age 18 and is expected to continue for
at least one year.

Not included as recognized educational institutions for purposes

of receiving student benefits are: correspondence schools,

elementary schools, the Government service academies such as

the U.S. Naval Academy, or any training program where the

trainee receives pay primarily as an employee, such as

apprenticeship programs or the Job Corps.

Use the enclosed form to apply for the student benefit. Do not
use this form to apply for a student benefit if the son or daughter
is disabled. Instead, write to the Office of Personnel Management,
Retirement Operations Center, Boyers, PA 16017 to ask about a
disabled child's benefit. We will send you the instructions you
need to document the child's disability. Adult children who qualify
are paid a benefit as long as they are disabled and are not
married.

Benefits (payments) must stop if the student:

1.
dies,

2.
marries,

3.
discontinues full-time schooling,

4.
enters military service on active duty,

5.
enters any of the service academies,

6.
transfers to a non-recognized school, or

7.
attains age 22.

Full-time students must be taking sufficient courses to allow
them to graduate within the minimum time which is considered
normal for a full-time student of the school. For example, usually a
college student must be enrolled for a minimum of 12 credit hours
per semester to be considered a full-time student. If you need

additional information about what is considered full-time
attendance, please call us at (202) 606-0249.

Students who attain age 22 during the school year (between

September 1 and June 30) may receive benefits through the end

of the month preceding the month in which full-time schooling

stops or June 30, whichever occurs first.

A recognized educational institution for the purpose of these
benefits is a school that: 1) has a faculty and requires study or
training at the school; and 2) is accredited as an educational
institution. Such schools are: high schools, trade schools,
technical or vocational schools, colleges, junior colleges, and
universities.

Since you are the payee, you must notify us immediately if
any one of these events occurs. If you are paid benefits after
any of these events, you will be indebted to the retirement
system and we will have to recover the money from you.
If you believe you are eligible to receive survivor benefits for a fulltime student, complete the enclosed form after you read the back
of this notice.

Privacy Act and Public Burden Statements
The Office of Personnel Management (OPM) administers the Civil Service Retirement System (Chapter 83, of title 5, U.S. Code) and the
Federal Employees Retirement System (Chapter 84, title 5, U.S. Code). The information requested on the enclosed form is needed to
document a retirement benefit or claim. 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 from OPM, 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 supply all the requested information may delay or
prevent action on the benefit or claim. Intentionally false statements and/or suspected illegal activities are reportable by us to appropriate
law enforcement agencies.
We estimate the RI 25-14 takes an average 12 minutes per response 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 U.S. Office of Personnel Management, Retirement Services Publications Team
(3206-0032), Washington, D.C. 20415-3430. The OMB Number, 3206-0032, is currently valid. OPM may not collect this information, and
you are not required to respond, unless this number is displayed.

Please Carefully Review The Example On The Reverse Side
Previous editions are usable.

RI 25-14A
Revised June 2011

Instructions for Completing the Enclosed Form
It Is Important That You Follow All Of The Instructions Below.
1.

The enclosed form has been designed to allow your answers to be read using optical scanning equipment. Therefore,
please use a pencil to blacken the ovals. If you make a mistake, erase it completely and blacken the correct oval. (Do not
use a correction fluid on the enclosed form.)

2.

Complete the form as illustrated in the example below:

EXAMPLE
Item 10 of the form is reproduced here to illustrate how you should make your entries on this form. The example below
illustrates how this question would be completed for a student whose school year ends or will end on June 7, 2011.
10. Enter the date this school attendance will end
or ended. If the student plans to attend for
the full school year, you should show the
ending date of the full school year (NOT the
semester). This date must be later than the
date shown in block 9.

Write the month, day, and year in the boxes.
If the month is June, enter JUN.

Day

Month

J

U

N

0

JAN

Blacken the corresponding oval below each
box. For example, if the number is "0,"
blacken the oval with a "0" in it.

Year

1

1

0

0

0

7

FEB

1

1

1

1

MAR

2

2

2

2

APR

3

3

3

3

MAY

4

4

4

JUN

5

5

5

JUL

6

6

6

7

7

AUG

SEP

8

8

8

OCT

9

9

9

NOV

DEC

3.

Please review your entries to avoid delays in your payments due to errors or incomplete data.

4.

DO NOT copy or duplicate the self-certification form. If you need another form, write to the address shown in item 5, call us
on (202) 606-0249, or go to our website at www.opm.gov/forms.
DO NOT staple, damage, or mutilate the form.

5.

The person who is the payee must be sure to sign the form and submit it within 30 days. To reply by mail, use the enclosed
envelope addressed to:
U.S. Office of Personnel Management

Surveys and Students Branch - Attn: Room 2309

1900 E Street, NW

Washington, D.C. 20415-3563

Or, you may fax your completed form to (202) 606-0022.

If you need assistance:
If, after carefully reading the instructions, you need assistance to complete the form on regular work days, you may contact
us from 7:30 a.m. to 5:00 p.m. (Eastern Time) on (202) 606-0249. If you have any other questions regarding student
benefits, please call us at 1-888-767-6738.
Reverse of RI 25-14A
Revised June 2011

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