CFR > Title 5 - Administrative Personnel > CHAPTER I—OFFICE OF PERSONNEL MANAGEMENT > SUBCHAPTER B—CIVIL SERVICE REGULATIONS (parts 110 to 990) > PART 839—CORRECTION OF RETIREMENT COVERAGE ERRORS UNDER THE FEDERAL ERRONEOUS RETIREMENT COVERAGE CORRECTIONS ACT > SUBPART L—Discretionary Actions by OPM (§839.1201 to §839.1206) > 839.1206—How do I submit a claim under this subpart?

839.1206—How do I submit a claim under this subpart?

(a) No specific form is required. Your request must be in writing and contain the following information:
(1) It must describe the basis for the claim and state the dollar amount you seek to receive;
(2) It must include your name, address, and telephone number;
(3) It must include the name, address, and telephone number of your current or last employer;
(4) It must be signed by you; and
(5) It must include any information you believe OPM should consider, such as cancelled checks or other evidence of amounts you paid.
(b) Send your claim to: Office of Personnel Management, Retirement and Insurance Service, ATTN: FC Section, Washington, DC 20415-3200