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SF 3112 – Applicant’s Statement of Disability (Fillable PDF)

  1. Language English
  2. Country USA
  3. Department Office of Personnel Management
  4. Sector Standard Forms
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SF 3112 – Applicant’s Statement of Disability (Fillable PDF)

The SF 3112 is the official Applicant’s Statement of Disability used by federal employees who are applying for disability retirement under the Civil Service Retirement System (CSRS) or the Federal Employees Retirement System (FERS). This fillable PDF can be completed directly in your browser with the Formize PDF Filler, eliminating the need for printed copies or third‑party editors.

What Is SF 3112?

SF 3112 collects detailed information about your medical condition, how it affects your ability to perform job duties, and any accommodations you have requested. A completed SF 3112 must be submitted with the supervisor’s statement (SF 3112B) to start the disability retirement process.

How to Complete the SF 3112 Form Online

Follow these simple steps to fill out the form using Formize’s built‑in PDF filler:

  • Click the “Fill out this form” button on this page.
  • Wait a few seconds while the Formize PDF Filler app loads the fillable version of SF 3112.
  • Enter your personal information, describe your disability, and answer all required questions.
  • Use the signature field to sign electronically, then click Save or Download to keep a copy.

Common Mistakes to Avoid

  • Leaving fields blank: Every required field is marked with an asterisk. Incomplete sections can delay processing.
  • Incorrect dates: Use the mm/dd/yyyy format for all dates.
  • Not attaching supporting documents: Attach physician statements and any other evidence before submitting.
  • Using an outdated version: The current revision is May 2011; the linked PDF reflects this version.

Download and Save Your Completed Form

After you finish, you can download the completed PDF, print it for your records, or email it directly to your agency’s HR office. The fillable version ensures that the formatting stays intact, making it easier for reviewers to read.

Need another federal form? Browse Formize’s library for more fillable PDFs.

FAQ
  • What is the purpose of SF 3112?

    SF 3112 is the applicant’s statement required for a disability retirement request under CSRS or FERS. It documents your medical condition and its impact on job performance.

  • Can I fill out SF 3112 on a mobile device?

    Yes. The Formize PDF Filler works on smartphones and tablets, allowing you to complete the form anywhere with an internet connection.

  • Do I need to print the form after filling it online?

    Printing is optional. You can download the completed PDF and email it to your agency, or print a copy for your records if preferred.

  • Is the PDF version on Formize the most recent revision?

    The linked PDF is the May 2011 revision, which is the current official version used by OPM.

  • What should I do if I make a mistake after saving?

    Open the saved PDF again in the Formize filler, correct the error, and re‑save. The fillable fields remain editable until the form is finalized.

  • Do I need a separate supervisor’s statement?

    Yes. SF 3112 must be submitted together with the supervisor’s statement (SF 3112B) for the retirement request to be processed.

HOW TO

How to fill out SF 3112 for free, online in 4 easy steps:

  1. 1
    Click the Fill‑out Button
    Press the “Fill out this form” button on the page to launch the Formize PDF Filler.
  2. 2
    Wait for the Filler to Load
    The fillable version of SF 3112 loads in a few seconds; no download is required.
  3. 3
    Enter Your Information
    Complete each required field, including personal data, disability description, and dates.
  4. 4
    Sign and Save
    Use the electronic signature field, then click Save or Download to store a copy of the completed form.
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ABOUT

Office of Personnel Management (OPM) Forms

SF 3112 is one of the official forms that are used by the United States Office of Personnel Management, which is an independent agency of the federal government responsible for managing the civil service workforce and federal employee benefits. The OPM establishes policies and regulations related to federal employment, administers various personnel programs, and provides services to federal employees, retirees, and job applicants.

Here are some examples of Office of Personnel Management forms:

Standard Form 86 (SF-86): This form is used for the background investigation process for individuals applying for a security clearance. It collects comprehensive personal, employment, education, and financial information, as well as details about foreign contacts and activities.

Standard Form 2809 (SF-2809): This form is used to enroll in the Federal Employees Health Benefits (FEHB) Program, which provides health insurance coverage to federal employees, retirees, and their eligible family members.

Standard Form 2817 (SF-2817): This form is used to apply for continuation of coverage under the Federal Employees Dental and Vision Insurance Program (FEDVIP) after retirement or separation from federal service.

Standard Form 3107 (SF-3107): This form is used to apply for retirement benefits under the Civil Service Retirement System (CSRS).

Standard Form 2801 (SF-2801): This form is used to apply for retirement benefits under the Federal Employees Retirement System (FERS).

Standard Form 15 (SF-15): This form is used to apply for veteran's preference in federal employment. It is submitted by veterans or their eligible family members seeking employment opportunities in the federal government.

These examples represent some common OPM forms used in the context of federal employment and employee benefits. However, the OPM has a range of other forms related to various personnel programs, retirement, insurance, and other aspects of federal employment. The specific forms required may vary depending on the nature of the transaction, program, or benefit being sought. It's advisable to consult the official website of the U.S. Office of Personnel Management (www.opm.gov) or seek guidance from the OPM or relevant human resources personnel to obtain accurate and up-to-date information regarding the specific OPM forms relevant to your federal employment or benefits-related needs.

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