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Fillable Printable OPM Form 1351-B

Fillable Printable OPM Form 1351-B

OPM Form 1351-B

OPM Form 1351-B

WORK YEARS AND PERSONNEL COSTS REPORT
COST OF EMPLOYEES BENEFITS
FISCAL YEAR
OPM Form 1351-B (Re v. 11/97)
1. Agency Name 2. Agency Code
CODE ITEM
OMB
OBJECT
CLASS
COST (Thousands)
For Agency Edit Check:
COST AS PERCENT OF
BASIC PAYROLL
300 Total Cost of Benefits 12.1
301 Health Insurance 12.1
-Federal Employees Health Benefits Act
-Other
302 Life Insurance Federal Employees Group Life Insurance (FEGLI) 12.1
303 Retirement 12.1
304 -Civil Service Retirement System (CSRS) 12.1
305 -Federal Employees Retirement System (FERS) Basic Benefit 12.1
306 -Federal Employees Thrift Plan (FERS) 12.1
307 -Other Retirement Systems (specify) 12.1
308 Federal Insurance Contributions Act Taxes (OASDHI) 12.1
309
Federal Employees Compensation Act (FECA)
Payments to Department of Labor
12.1
310 Uniform Allowances 12.1
311 Overseas Allowances (including overseas cost of living allowance (COLA)) 12.1
312 Non-Foreign COLA 12.1
313 Retention Allowance 12.1
314 Recruitment Bonus 12.1
315 Relocation Bonus 12.1
316 Other Benefits included in Object Class 12.1 12.1
400 Total Separation Pay (includes severance pay and separation incentive) 13.0
-Severance Pay
-Separation Incentive (i.e., "Buyout Bonus")
Total Benefits Plus Separation Pay (Sum of Codes 300 and 400) 12.1 & 13.0
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