Web Procedure Manual

Adding a 2810 Record

The Add function allows users to add 2810 records.

To Add a 2810 Record:

1. On the CLER Main Menu, select the Forms tab. The Forms Main page is displayed.

   

2. Select the 2810 option on the Forms tab. The Form 2810 page is displayed.

   

3. Select the Add button on the Form 2810 page to display the Form 2810 Add Part A page.

   

4. Complete the following fields on the Form 2810 Add Part A page:

   Payroll Office ID

   Year

   Quarter

   Personnel Office ID

   Last Name

   First Name

   Initial

   Address Line 1

   Address Line 2

   Address Line 3

   City

   State

   Zip

   Foreign Country

   SSN

   Date of Birth

   Enrollment Code

   Enrollment ID

   Effective Date

   Annuity Claim #

   Survivor Annuity Claim #

   Report #

5. Select the Save Form button. If no errors occur, a popup appears to confirm the record has been added.

   OR

   Select the Clear Data button to clear the form and select the Cancel button to return to the previous page.

   

6. Select the OK button to close the popup.
7. Select Part B thru F on the Form 2810 Add page. The Part B thru F page is displayed.

   

8. Complete the following applicable fields on the Form 2810 Add Part B thru F page:

   Part B - Termination

   Part C - Transfer In

   Part D - Reinstatement

   Part E - Change of Enrollee Information

   Last Name

   First Name

   Initial

   Address Line 1

   Address Line 2

   Address Line 3

   City

   State

   Zip

   Foreign Country

   Date of Birth

   SSN

   Sex

   Part F - Change in Enrollment/Survivor Annuitant

   New Enrollment Code Number

9. Select the Save Form button to save changes.

   OR

   Select the Clear Data button to clear the form.

   OR

   Select the Cancel button to return to the previous page.

   Note: An asterisk (*) indicates a required field. The Plan Name and Enrollment Code fields in Part B are marked with * when Start or Change is selected in the Nature of Action field in Part A. The Last Name, First Name, Date of Birth, Code, SSN, and Sex fields in Part B are marked with * when the third position of the enrollment code entered in the Enrollment Code field in Part B is 2 or 5, indicating family coverage.

10. Select Part G thru H on the Form 2810 Add page. The Part G thru H page is displayed.

    

11. Complete the following applicable fields on the Form 2810 Add Part G thru H page:

    Remarks

    Date of Death

    Agency Name

    Address Line 1

    Address Line 2

    Address Line 3

    City

    State

    Zip

    Foreign Country

    Agency ID

    Personnel Office ID

    Agency Use

    Authorized Official Last Name

    Authorized Official First Name

    Authorized Official Initial

    Authorized Official Date

    Contact (Personnel) Last Name

    Contact (Personnel) First Name

    Contact (Personnel) Initial

    Contact (Personnel) Phone

    Contact (Payroll) Last Name

    Contact (Payroll) First Name

    Contact (Payroll) Initial

    Contact (Payroll) Phone

12. Select the Save Form button. If no errors occur, a popup appears to confirm the record has been added.

    OR

    Select the Clear Data button to clear the form. Select the Cancel button to return to previous form.

    

13. Select the OK button to close the popup.