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SF144

- STANDARD FORM 144 (Rev. 10/95) Office of Personnel Management The Guide to Processing Personnel Actions I Statement of Prior Federal Service (PLEASE READ THE FOLLOWING INFORMATION BEFORE COMPLETING THIS FORM) Privacy Act Statement Section 6303 of 5 U.S.C., "Annual Leave Accrual," authorizes col lection of information to determine and record service that may be creditable for accrual of annual leave. Part 351.503, 5 C.F.R., "Length of Service," authorizes collection of data to determine and record service that may be creditable for reduction-in-force reten tion purposes.

Prior Service Questionaire

PRIOR SERVICE QUESTIONNAIRE Please review the questions listed below. If you answer yes to any of these questions, please provide the requested information and fax your completed form to the Benefits Division at 202-502-2877. We will use the information to properly to verify your service, calculate your Retirement Service Computation Date, and populate the HRMIS payroll system. If you know the dates you worked there, please include that information as well. Please note: prior service can include a summer job or employment while you were a student. 1) CIVILIAN SERVICE A.

Ohio Local School Tax

Received a t : 12:20PM, 04/16/2007 4/16/2007 1 1 : 2 0 FAX 202 5 0 2 1 8 1 1 JUDGES C O M P 8 BENEFITS Administrative Office Of The United States Courts Ohio Local School District Withholding Authorization For Convenience Withholding Name; Emplayee ID Number: School District: School Dist. Number Start Deduction Stop Deduction I understand [bar rhe Admini.strativeOffice of the Unittd Stbteg Coum (AOUSC)has no statutory obliyation to wilhhbld lohll school disrricr raxea p r ihe standard withholding agreement bctween the US.Tnwuy and thc Statc orOhio dated July 1.

IT-4

IT 4 Rev. 5/07 Notice to Employee 1. For state purposes, an individual may claim only natural dependency exemptions. This includes the taxpayer, spouse and each dependent. Dependents are the same as defined in the Internal Revenue Code and as claimed in the taxpayer s federal income tax return for the taxable year for which the taxpayer would have been permitted to claim had the taxpayer filed such a return. 2. You may file a new certificate at any time if the number of your exemptions increases.

Employment Eligibility Verification (USCIS Form I-9)

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FMS2231-Direct Deposit

F A S T S T A R T DIRECT DEPOSIT INSTRUCTIONS FOR PROCESSING FEDERAL EMPLOYEE PAYMENTS Use: For processing Federal employee net salary, allotments, and other agency - approved payments associated with Federal employment (i.e. travel reimbursement, uniform allowance, etc). Employee must complete items 1,2,3 and 5. Complete item 4 only if you want to start, cancel or change the amount of a savings or discretionary allotment - see instructions on back of form. 1.

Leave Accrual Chart for 2016

Leave Accrual Chart for 2016 (Full-Time Employees) Leave Period Number From - To 01 Annual Leave Sick Leave Less than 3 Years 3 to 15 Years 15 Years or Over 01/11 - 01/24 4 6 8 4 02 01/25 - 02/07 8 12 16 8 03 02/08 - 02/21 12 18 24 12 04 02/22 - 03/06 16 24 32 16 05 03/07 - 03/20 20 30 40 20 06 03/21 - 04/03 24 36 48 24 07 04/04 - 04/17 28 42 56 28 08 04/18 - 05/01 32 48 64 32 09 05/02 - 05/15 36 54 72 36 10 05/16 - 05/29 40 60 80 40 11 05/30 - 06/12 44 66 88 44 12 06/13 - 06/26 48 72 96 48 13 06/27 - 07/10 52

Benefits Overview Booklet

Benefits Overview 3 Contents 4 Defining Benefit Eligibility 6 Staying Healthy 6 Health Insurance 12 Taking the Long View 19 Helping with Issues Large and Small 12 Federal Judiciary Long-Term Care Insurance Program 19 Employee Assistance Program (EAP) 13 Federal Long-Term Care Insurance Program 7 Dental and Vision Insurance 8 Securing a Sound Retirement 8 Federal Employees Retirement System 9 Thrift Savings Plan 20 Finding Time to Recharge 14 Helping Reduce What You Pay 20 Annual Leave Program 14 Premium Payment Plan

Flexible Benefit Program Booklet

The Federal Judiciary Flexible Benefit Program Eligible Expense Guide for the Flexible Spending and Commuter Reimbursement Accounts 1 EligExp_304.6_May 2015 Welcome to the Eligible Expense Guide This guide will provide a detailed listing of health care, dependent care and commuter expenses covered by a spending account. It lists general expenses allowed by the Internal Revenue Service (IRS). However, it is not an exhaustive list and if you have a question regarding an expense not listed, please call the Judiciary Benefits Center at 1-888-442-FLEX (3539). How to use this guide 1.

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