Federal Benefits Analysis Survey - Federal Employees Retirement & Benefits

1. Person Requesting Federal Benefits Analysis*
First Last
2. Where should we send your Federal Benefits Analysis?*
Street Address City State ZIP Code
3. Your Email*
4. Your Phone*
5. Date of Birth*
Month
Day
Year
6. Service Computation Date (SCD)*
Month
Day
Year
7. Retirement Goal Date*
Month
Day
Year
8. Are you a FERS, FERS Transferee, CSRS, or CSRS Offset employee?
- FERS
- FERS Transferee
- CSRS
- CSRS Offset
9. If you are a FERS Transferee, what is your TRANSFER DATE?
Month
Day
Year
10. What percentage of your income are you putting into the TSP?*
11. About how many hours of unused sick leave do you have?
12. FEGLI Multiplier x Salary (Input 1 if you have basic coverage)
13. TSP Balance*
14. Annual Salary*
15. Are you an Air Traffic Controller, Firefighter, Law Enforcement Officer, Capitol Police, Congressional Staff, or Nuclear Materials Courier?*
- Yes
- No
16. What are your biggest retirement concerns or questions?