PO BOX 22122

LEHIGH VALLEY,  PA  18002

(610) 882-3278

fax (610)-865-3781

 

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FORMS & DOWNLOADS 

      

FMLA FORMS   MEMBERSHIP SURVEY FORMS
Dept of Labor Forms  

POS One Training Survey Form 

WH-380-E   Employee's own illness or condition

 

Special Postal Clerk / Higher Level Work Survey Form

WH-380-F   Family member's illness or condition

   
APWU Forms   FLEXIBLE SPENDING ACCOUNT FORMS
APWU-1  Employee's Own illness    [Print]   [Complete & Print]

Withdrawal Request Form 

APWU-2 Family Member's Illness    [Print]   [Complete & Print]        
APWU-3  Exigency for Military Family    [Print]   [Complete & Print     WINDOW CLERK FORMS
APWU-4  Service Member's Caregiver    [Print]   [Complete & Print]  
 (to see a list of completed sample forms - go to our FMLA page)     
    SUPV. / POSTMASTER / CARRIER DOING CLERK WORK
OWCP FORMS  

Daily Witness Statement

CA-2    Notice of Occupational Disease  

Weekly Witness Statement

CA-2a   Notice of Recurrence    
CA-7    Request for Compensation    
CA-7a  Time Analysis Form    
CA-7b  Leave Buy-Back    
CA-17  Duty Status Report    
CA-20  Attending Physicians Report    
CA-915 Claim for Medical Reimbursement    
CA-957 Medical Travel Refund Request    
OTHER USEFUL INFORMATION    
CA-35  Evidence Required in Support of an Occupational Disease    
1199A    Direct Deposit form