United States
Office of
Personnel Management
The Federal Government's Human Resources Agency
Report a Missing Payment
Please enter the information below and press the Submit button.
Note:
Form fields which are required will be noted with this icon "
" or the message that "This field is required."
Enter identifying information about the retirement benefits record. If this information is not available, please
call us.
Claim Number
(include both the "A" or"F" prefix and the first seven numbers):
Name of the Former Federal Employee
(First, Middle Initial, Last):
Enter information about the payment.
Name of Payee
(First, Middle Initial, Last):
Date of Birth
(MM/DD/YYYY):
Social Security Number
(with dashes):
Date of Missing Check
(MM/DD/YYYY):
Net Amount
(include Dollars and Cents):
$
Pick how payment was sent:
Direct deposit
U.S. Mail
Enter information about yourself.
Name
Street Address
City and State
Zip Code
Telephone Number
(with Area Code):
Call:
AM
PM
Email Address:
Additional Information: