Can I sign OPM Form 71 electronically?

Yes in most cases. Electronic signatures are legally recognized under the ESIGN Act (15 U.S.C. §7001) and UETA where adopted, but confirm your agency’s policy because some federal or agency-specific processes may require wet signatures or notarization.

Do I need a notary or witnesses?

Generally no for a standard designation, but agencies or state-specific rules may require notarization in some workflows. Check your employing agency’s instructions before obtaining notary or witness services to avoid unnecessary fees.

How do I change my beneficiary later?

Complete a new OPM Form 71 with the revised designations, sign and date it, and submit it to your agency’s HR/benefits office. The most recently accepted form typically controls benefit distribution.

What if my named beneficiary has died?

If a beneficiary predeceases you, the agency will follow the contingent beneficiary or default statutory distribution rules. File an updated form to specify new recipients and reduce ambiguity for administrators and survivors.

How long until my agency updates records?

Processing times vary; agencies typically update personnel records within a few weeks. Follow up with HR if you need confirmation for estate planning, and retain proof of submission.

Is my electronically signed copy admissible later?

Yes if the signature meets ESIGN/UETA criteria (intent, consent, attribution, retention). Maintain a verifiable audit trail and secure copy that reproduces the signed record in human-readable form.

OPM Form 71

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

Family and Medical Leave Request Form

Date:

Employee Name:

SSN #:

Job Title:

Supervisor:

Under the Family and Medical Leave Act eligible employees are entitled to up to twelve weeks of unpaid, job-protected leave for certain family and medical reasons. When possible, submit this request form to your supervisor at least 30 days before the leave is to commence. When submission 30 days in advance is impossible due to unavoidable circumstances, submit the request as early as is possible. When permitted under state or federal law, employer may deny or postpone leave for failure to give appropriate notice.

ELIGIBILITY

1. Counting any periods of time that you worked for the company (whether they were consecutive or not) have you worked for the company for a total of 12 months or more?

YES NO

(If "yes," continue to next question. If “no,” stop here.)

2. During the past 12 months, have you worked at least 1,250 hours? (approximately eight months of 40-hour weeks or one year of 25-hour weeks)?

YES NO

(If "yes," continue to next question. If “no,” stop here.)

3. Have you previously received medical or family leave? If yes, provide information below:

Dates of leave: From To

4. Purpose of Leave:

5. Have you taken any intermittent leave?

YES NO

6. Have you taken time off from scheduled hours?

YES NO

If "yes" provide details:

REASONS FOR REQUESTING LEAVE:

I am requesting leave for the following reason (Check one):

Personal serious health condition

Serious health condition of:

Spouse Name:

Child Name:

Parent Name:

Birth of a child

Expected delivery date is:

Adoption or placement of a child for foster care

Child's name:

Scheduled date of adoption or placement:

DATES OF LEAVE REQUESTED:

I request leave from to

I request intermittent leave according to the following schedule:

I request a reduced schedule leave according to the following schedule:

The total number of days of leave requested

EMPLOYEE STATEMENT:

I agree to return to work on . If circumstances change, I agree to inform my supervisor by submitting a NOTICE OF CHANGES IN APPROVED MEDICAL OR FAMILY LEAVE form. I understand that my benefits will continue during my leave and that I will arrange to pay my share of applicable premiums.

Signature:

TO BE COMPLETED BY SUPERVISOR

Date:

Staff member was hired on

He/she started in this department on

Staff member is:

FULL-TIME PART-TIME

Regular hours are hrs on days of the week for a total of hours per week.

Schedule commenced on

Are there 50 or more employees within 75 miles of the facility where employee works?

YES NO

Has the workforce been this large for at least 12 months?

YES NO

How will the staff member's duties and responsibilities in your unit be handled during his/her leave of absence?

Employee has previously requested family or medical leave on

Leave taken from to Total time taken

Supervisor:

Title:

Date:

Telephone #:

TO BE COMPLETED BY HUMAN RESOURCES

Prior leave requests confirmed:

Leave is:

APPROVED

DENIED for the following reason(s):

Request approved /denied by:

Date:

What OPM Form 71 Is and when agencies use it

OPM Form 71 is the federal beneficiary designation form used by civil service employees to name one or more recipients for benefits administered or recorded by an employing agency. The form captures identifying information for the employee and each beneficiary, sets shares or contingencies, and provides signature attestation. Agencies use completed forms to determine benefit distribution on death; accuracy and timely filing with the HR/benefits office are critical to avoid processing delays or incorrect payments.

Why completing OPM Form 71 correctly matters

A properly completed OPM Form 71 ensures benefit payments follow the employee’s documented intent, reduces administrative review, and minimizes disputes among claimants. Accurate beneficiary designations preserve rights, limit probate exposure, and speed agency processing of survivor benefits.

Who completes and processes OPM Form 71

Keep your agency’s filing instructions and personnel contact details handy; agencies maintain the official file used to pay benefits and resolve competing claims.

Employees and payees who must designate primary and contingent beneficiaries for federal benefits.
Agency HR or personnel offices that accept, record, and process designations for benefit administration.
Benefits counselors and legal advisers who provide guidance on estate planning and tax consequences.

Core sections you’ll find on the OPM Form 71

A professional OPM Form 71 includes clear employee identifiers, primary and contingent beneficiary blocks, allocation percentages, claimant contact details, and an authenticated signature section. Supplementary instructions and agency routing fields support processing.

Employee details

Full legal name, employing agency, agency address, and a government ID (SSN or payroll ID) to uniquely identify the participant for benefit records.

Primary beneficiaries

Name, relationship, date of birth, social security number, and the share or percentage assigned to each primary beneficiary to control benefit distribution precisely.

Contingent beneficiaries

Secondary recipients designated to receive benefits if primary beneficiaries predecease the employee or otherwise cannot accept the award.

Allocation and contingencies

Clear percentage splits and language specifying per stirpes or per capita distribution to prevent ambiguity during claims adjudication.

Signature and date

Employee signature, printed name, and execution date. Witness or notarization instructions appear only if required by agency or state rules.

Agency routing

Fields for HR acceptance, date received, and internal tracking codes that agencies use to record the designation in personnel systems.

Step-by-step: completing and submitting the form

Follow this sequence to complete OPM Form 71 from start to submission, reducing processing delays and rework.

01

Prepare identity details: Gather your full legal name, SSN, agency name, and contact information.
02

List beneficiaries: Enter primary and contingent beneficiaries with relationship and share percentages.
03

Sign and date: Sign in the required spot and date the signature in MM/DD/YYYY format.
04

File with HR: Submit the form to your employing agency’s HR/benefits office per agency instructions.

How to configure the form for online completion

When converting the form to an online workflow, map common fields and set validation to prevent incomplete submissions.

Field	Validation / Behavior
Full name field	Require non-empty; auto-capitalize names
SSN field	Numeric only; 9 digits; mask display
Percentage field	Validate sum equals 100% across beneficiaries
Signature field	Capture e-signature with timestamp and IP

Where completed OPM Form 71 should be sent

Routing depends on employment status and agency procedures; use the agency personnel office as the primary receiving point unless directed otherwise.

Employing agency HR: Primary recipient for filing and recordkeeping for benefit payment purposes.
Payroll/Benefits office: Records beneficiary data linked to pay and survivor benefit systems.
Agency records system: HR enters the designation into official personnel and benefit databases.
Agency counsel (when needed): Legal review for complex estates, contested designations, or conflicting documents.

Digital submission: formats and platform considerations

Use PDF or DOCX originals when converting OPM Form 71 to a fillable electronic workflow to preserve layout and agency-required fields.

Accepted formats: PDF, Word (DOCX), and exported PDF/A for archival reliability.
Integrations: Common integrations: Salesforce, Microsoft 365, NetSuite, Google Workspace, Box, Procore.
Authentication: Support email/SMS codes, multi-factor, and advanced signer verification when required.

Timing and expected processing windows

Timelines vary by agency; submit early after any life-change and confirm HR receipt to reduce delay.

Effective date entry:

Enter MM/DD/YYYY when signing the form.

Agency receipt:

Confirm receipt with HR immediately upon submission.

Processing time:

Agency update may take 2–8 weeks depending on workload.

Update after life events:

Submit amended form within 30 days of marriage, divorce, birth, or death.

Record confirmation:

Request written confirmation once HR updates benefit records.

Key milestones from completion to record update

Track these sequential milestones to ensure the designation becomes part of the official benefit record.

01

Form completion

Employee completes and signs the form with accurate identifiers.

02

Submission to HR

Employee delivers or uploads the form per agency method.

03

Agency review

HR verifies identity details and beneficiary data for acceptance.

04

Record update

HR enters designation into personnel and benefit systems for future claims.

Essential data elements required on the form

Employee name: Full legal name

Identifier: SSN or payroll ID

Beneficiary name: Full legal name

Relationship: Relationship to employee

Allocation: Percentage share

Signature: Employee signature and date

Risks and consequences of incorrect or missing designations

Misallocated benefits: Delayed or incorrect payments

Agency rejection: Requires amendment and re-filing

Estate exposure: Assets passing through probate

Tax issues: Potential withholding or reporting problems

Family disputes: Increased litigation risk

Invalid signature: Form may be void or require notarization

Common preparation mistakes to avoid

Using nicknames or initials instead of the beneficiary’s full legal name causes identification and payment errors.
Failing to include SSNs or other unique identifiers makes it difficult for agencies to match records accurately.
Allocating percentages that do not total 100% or leaving ambiguous contingency language creates disputes during claims processing.
Not updating the form after marriage, divorce, birth, or death leads to unintended recipients and potential litigation.

Practical tips for accurate and efficient completion

Follow these best practices to reduce rejections and make administration straightforward for your agency and beneficiaries.

Use official names and identifiers

Enter full legal names and the exact SSN or payroll ID shown on your agency records to ensure an unambiguous match and faster processing.

Specify clear allocation

Use whole-number percentages summing to 100% and explicit contingency language to prevent interpretation disputes by benefits administrators and courts.

Keep proof of filing

Retain a stamped copy or written confirmation from HR showing date received and the file number to support future claims or corrections.

Review after life events

Revisit your beneficiary designations after marriage, divorce, birth, or significant estate changes to ensure they reflect current intent.

eSignature platform comparison for executing OPM Form 71

Select an eSignature vendor that supports audit trails, secure storage, and the authentication level your agency accepts. The table compares starting prices and common features.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies by vendor	Varies by vendor	Varies by vendor	Varies by vendor
Bulk Send	Yes	Yes	Yes	Yes	Yes
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No
Envelope Cap	No cap	100 envelopes/user/year	Varies by plan	Varies by plan	Varies by plan

Frequently asked questions about OPM Form 71

Answers to typical questions about electronic signatures, notarization, amendments, and processing of OPM Form 71.

Need help? Contact support

Can I sign OPM Form 71 electronically?
Yes in most cases. Electronic signatures are legally recognized under the ESIGN Act (15 U.S.C. §7001) and UETA where adopted, but confirm your agency’s policy because some federal or agency-specific processes may require wet signatures or notarization.
Do I need a notary or witnesses?
Generally no for a standard designation, but agencies or state-specific rules may require notarization in some workflows. Check your employing agency’s instructions before obtaining notary or witness services to avoid unnecessary fees.
How do I change my beneficiary later?
Complete a new OPM Form 71 with the revised designations, sign and date it, and submit it to your agency’s HR/benefits office. The most recently accepted form typically controls benefit distribution.
What if my named beneficiary has died?
If a beneficiary predeceases you, the agency will follow the contingent beneficiary or default statutory distribution rules. File an updated form to specify new recipients and reduce ambiguity for administrators and survivors.
How long until my agency updates records?
Processing times vary; agencies typically update personnel records within a few weeks. Follow up with HR if you need confirmation for estate planning, and retain proof of submission.
Is my electronically signed copy admissible later?
Yes if the signature meets ESIGN/UETA criteria (intent, consent, attribution, retention). Maintain a verifiable audit trail and secure copy that reproduces the signed record in human-readable form.

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