Estimated Earnings During Military Service
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Estimated Earnings During Military Service Form. This is a Official Federal Forms form and can be use in Retirement And Insurance US Office Of Personnel Management.
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Tags: Estimated Earnings During Military Service, RI 20-97, Official Federal Forms US Office Of Personnel Management, Retirement And Insurance
United States
Office of Personnel Management
Retirement Operations Center
Boyers, Pennsylvania 16017
Estimated Earnings During Military Service
Instructions: Use a separate RI 20-97 for each branch of service. Attach DD 214 or the equivalent and any available records of pay or
promotions. The pay center cannot provide estimated earnings without verification of service. The requester must complete blocks 1 through
10 and block 19. Visit the Defense Finance and Accounting Service website at http://www.dfas.mil/retiredpay/estimatedearning.html for
addresses and telephone numbers.
1. Name (Last, first, middle)
2. Other names used
3. Social Security Number
4. Date of birth (mm/dd/yyyy)
5. All military service numbers
6. Branch of service
The uniformed services must provide Federal employees' estimated basic pay for military service they performed after December 31, 1956.
This is needed to make a deposit to the Civil Service Retirement and Disability Fund for retirement credit. Please provide the estimated basic
pay earned by the person named above.
7. Signature of requester
9. Date
8. Relationship to person named
Person named is requester
Survivor
Other (specify):
10. Active military service after
December 31, 1956 (Dates
indicated below must be based
on DD 214 or equivalent
certification.)
From
(mm/dd/yyyy)
To
(mm/dd/yyyy)
11. Authorized Official of Retired Pay Center completes blocks 11 through 18.
Estimated Earnings (Base Pay)
Do not provide estimated earnings for any period of service prior to January 1, 1957.
From
(mm/dd/yyyy)
To
(mm/dd/yyyy)
Rate of Basic Pay
12. If period of service began before 13. Lost time
and ended after December 31,
Number of days
None
1956, enter date service actually
From
began. (mm/dd/yyyy)
Inclusive dates
(mm/dd/yyyy)
14. Signature of authorized official furnishing estimate
To
(mm/dd/yyyy)
15. Date
Earnings
From
(mm/dd/yyyy)
To
(mm/dd/yyyy)
16. Telephone number (including area code)
(
17. Typed name of authorized official
Type of Discharge
)
18. Title of authorized official
19. Requester's name and address (Return this completed form to address below)
RI 20-97
Revised April 2008
Previous editions are not usable
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