Report of Medical Examination of Person Electing Survivor Benefits Under the Civil Service Retirement System

OMB 3206-0162

OPM Form 1530 is designed to collect information from both the applicant and the applicant’s physician regarding the applicant’s health. This information is used to determine whether the insurable interest survivor benefits election can be allowed. The form has been revised to bring it up-to-date. Specifically, solicitation of this information is also authorized by the Federal Employees Retirement System (Chapter 84, title 5, United States Code).

The latest form for Report of Medical Examination of Person Electing Survivor Benefits Under the Civil Service Retirement System expires 2021-01-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form OPM 1530 Report of Medical Examination of Person Electing Survivor Benefits Under the Civil Service Retirement System Form and Instruction
OPM1530_OMBSupportStmt_2024_04_29.docx Supporting Statement A
OPM1530_30DayFRNPublished_2024_02_06_Final.pdf Supplementary Document
OPM1530_60DayFRNPublished_2023_05_03.pdf Supplementary Document
E8-5659.pdf Supplementary Document
Report of Medical Examination of Person Electing Survivor Benefits Under the Civil Service Retirement System Form and Instruction

All Historical Document Collections

202404-3206-007 Approved without change	Revision of a currently approved collection	2024-04-30
202402-3206-005 Improperly submitted and continue	Revision of a currently approved collection	2024-02-28
202009-3206-002	Revision of a currently approved collection	2020-09-30
201703-3206-003 Approved without change	Reinstatement with change of a previously approved collection	2017-05-15
201402-3206-006 Approved without change	Extension without change of a currently approved collection	2014-02-25
201011-3206-006 Approved without change	Revision of a currently approved collection	2010-11-30
200712-3206-005 Approved without change	Extension without change of a currently approved collection	2007-12-27
200411-3206-001 Approved without change	Revision of a currently approved collection	2004-11-22
200107-3206-002 Approved without change	Revision of a currently approved collection	2001-07-13
199804-3206-008 Approved without change	Extension without change of a currently approved collection	1998-04-24
199409-3206-001 Approved without change	Revision of a currently approved collection	1994-09-27
199112-3206-004 Approved without change	Revision of a currently approved collection	1991-12-24
198811-3206-003 Approved without change	Revision of a currently approved collection	1988-11-29
198510-3206-003 Approved without change	New collection (Request for a new OMB Control Number)	1985-10-23