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USPS Forms and Information Reports

Form No. CA-1 CA-2 CA-2A CA-7 CA-7a CA-17 Form 50 Notice 11 Notice 70 Notice 76 SF 91 SF 94 SF 95 313 1017-A 1017-B 1164 1187 1188 1189 1192 1216 1223-A 1221 1224 1230 1230-A 1230-B 1230-C 1234 1260 1261 1311 1375 1507 1512 1564 1564-A 1564-B 1571 Name of Form and/or Description Employee Notice of Traumatic Injury Employee Notice of Occupational Disease Employee Notice of Recurrence of Disability Claim for Compensation Time Analysis Form, for claiming compensation, including repurchase of leave Duty Status Report Notification of Personnel Action Information for Apartment House Customers Privacy Act Notice Expanded Vehicle Safety Check Operator's Report of Motor Vehicle Accident Statement of Witnesses Tort Claim Requisition for Printed Carrier Case Labels Time Disallowance Record Unauthorized Overtime Record Mileage and Parking Dues Withholding -- Regular Member Revocation of Voluntary Authorization for Dues Withholding Dues Withholding -- Retirees Authorization for Purchase of U.S. Savings Bonds Employee's Current Mailing Address Earnings Statement Advanced Sick Leave Authorization Court Duty Leave Statement Time Card Time Card -- Week 1 Time Card -- Week 2 Other Duty Card Trip Card Non-Transactor Card Non-Transactor Report Carrier Transportation Agreement Employee Identification Card Request to Provide Proper Mail Receptacle Delivery Service Notice Address Change Sheet Carrier Route Book -- Route Instructions Orders to Box Section or Other Special Orders Report of Undelivered Mail, Etc.

1621 1623 1627 1627 1627 1627 1639 1700 1700 1709 1717 1723 1750 1767 1768 1769 1813 1838 1838-A 1838-B 1838-C 1839 1840 1840-A 1840-B 2146 2181 2188 2198 2240 2243 2480 2545 2546 2547 2548-A 2565 2608 2609 2610 2800 2801 2801-A

Carrier Route Report Change in Delivery, Relay and Collection Analysis of Curtailed Mail Analysis of Auxiliary Assistance and Overtime on Route Analysis of Auxiliary Routes Analysis of Late Leaving Carriers Report of Mis-sorted Mail Vehicle Accident Investigation Worksheet Vehicle Accident Worksheet Acceptance of Medical Treatment at USPS Medical Facility Bid for Preferred Assignment Assignment Order Employee Probationary Period Evaluation Report Report of Hazard, Unsafe Condition or Practice Safe Driver Award Committee Decision Accident Report Late Leaving and Returning Report Carrier's Count of Mail (Management Summary) Carrier's Count of Mail -- P.P./Combination Services Worksheet Parcel Post Firm Delivery Worksheet Carrier's Count of Mail -- Letter Carrier Routes Worksheet Payment Record for Carrier Drive-out Agreements Summary of Count and Inspection -- Letter Carrier's Route Summary of Count and Inspection, Mail, P.P. and Combination Carrier Time Card Analysis Employee Claim Forms Authorization and Release of Personal Information Subrogation Receipt Accident Report -- Tort Claim Pay Adjustment Request Payroll Adjustment Driving Record PAR Case Card PAR Correspondence PAR Reports Training Record Formal Regional Appeal of EEO Complaint Grievance Summary Step 1 Grievance Summary Step 2 Grievance Summary Step 3 Application for Death Benefits Application for Retirement Superior Officer's Statement, Application for Disability Retirement

2801-B 2802 2806 2808 2809 2810 2944 3074 3076 3189 3521 3546 3570 3575 3579 3582-A 3582-B 3811 3816 3821 3849-A 3849-B 3867 3868 3883 3921 3922 3923 3968 3971 3972 3973 3981 3982 3996 3997 3997-B 3998 3999 3999-A 3999-B 4003 4003-A

Physician's Statement, Application for Total Disability Retirement Application for Refund of Retirement Deductions Individual Retirement Record Designation of Beneficiary, CSRS Health Benefits Registration Form Notice of Change in Health Benefits Enrollment Receipt for Customs Duty Mail Request for Waiver of Claim for Erroneous Payment of Pay Request to Cancel or Change Salary Allotment Request for Temporary Change of Schedule Carrier's Report on House Numbers and Mail Receptacles Notice to Change Forwarding Order Notice of Attempt to Deliver Mail Change of Address Order Undeliverable 2nd, 3rd, 4th or Controlled Circulation Matter Postage Due Bill Carrier's Due Bill Return Receipt, Regular/Certified/Insured Mail COD Tag and Sender's Receipt COD, Bulk Receipt for Mail and Funds Delivery Notice or Receipt Delivery Reminder or Receipt Registered and Certified Matter Received for Delivery Carrier's Clearance Receipt Delivery Notice or Receipt Daily Volume Recording Worksheet Delivery Volume Unit Recap Daily Delivery Operation Analysis Daily Mail Collection Record Request for Leave Absence Analysis Military Leave Control Roster Sheet Change of Address (Carrier's Case) Carrier Auxiliary Control Unit Daily Summary, Record of Carrier Work Hours, Absences Daily Delivery Analysis Unit Summary of City Delivery Routes Inspection of Letter Carrier Routes Record of Deliveries -- Worksheet Inspection of Collection Route Official Rural Route Description Official Rural Route Description, Continuation Sheet

4027 4098 4239 4240 4241 4241-A 4248 4516 4528 4565 4570 4582 4582-A 4584 4585 4586 7020

Petition for Change in Rural Delivery Employee Identification Card Count of Mail (Rural Route) Rural Carrier Trip Report Rural Delivery Statistics Report Rural Route Evaluation Rural Route Inspection Report Emergency Vehicle Hire Use Vehicle Defect Report Vehicle Repair Tag Vehicle Time Record Operator's Record Summary of Driving Record Observation of Vehicle Operator Postal Driver Accident Information Accident Information Authorized Absence from Workroom Floor Overtime Desired List Router Sheet Record of Discipline Records of Merit Street Supervision Report Vehicle Analyst's Report of Accident Witnesses statements of non-employees, carriers, clerks and supervisors "Carrier Report - Daily" shows clock rings of carriers in the station. (Used when times are needed relative to route, overtime, comparisons.) "Employee Time Certification" - Time used by all employees in a pay location by pay period. (Hours worked, type leave, etc.) History of Clock Rings - Shows individual employee clock rings and leave for pay period P/T Employees Weekly Cumulative Hours - By Pay Locations showing cumulative weekly-to-date- work, leave and OT totals for PTF's Sick Leave and LWOP Usage Report Lists are employees by pay location using sick leave and LWOP Quarterly print-out on sick leave use

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