| 000 | 01091nam a2200301Ia 4500 | ||
|---|---|---|---|
| 001 | 310628 | ||
| 005 | 20160527190344.0 | ||
| 008 | 110629s2011 dcuk r f000 0 eng d | ||
| 040 | _aPUCPR | ||
| 049 | _acicdf | ||
| 074 | _a0290-J-01 | ||
| 086 | 0 | _aPM 1.53:2809 | |
| 088 | _aOMB no. 3206-0141 | ||
| 088 | _aOPM form 2809 | ||
| 110 | 2 |
_aFederal Employees Health Benefits Program (U.S.) _9222477 _2Local |
|
| 245 | 1 | 0 | _aHealth benefits election form. |
| 250 | _aRev. Apr. 2011. | ||
| 260 |
_a[Washington, D.C.] _bFederal Employees Health Benefits Program _c[2011] |
||
| 300 |
_a[11] p. _bform _c30 cm. |
||
| 500 | _aCaption title. | ||
| 500 | _a"Previous editions are not usable"--P. [1]. | ||
| 500 | _aShipping list no.: 2011-0333-P. | ||
| 500 | _a"Form approved: OMB no. 3206-0141." | ||
| 500 | _a"OPM form 2809"--P. [1]. | ||
| 610 | 2 | 0 |
_aFederal Employees Health Benefits Program (U.S.) _vForms. _9222477 _2Local |
| 610 | 2 | 0 |
_aUnited States _bOffice of Personnel Management. _vForms. _9182913 _2Local |
| 650 | 0 |
_aCivil service _xMedical care _zUnited States _vForms. _973760 _2Local |
|
| 999 |
_c228677 _d228677 |
||