PART 1653—FORMS

Chapter 16—Office of Personnel Management Federal Employees Health Benefits Acquisition Regulation › Subchapter H—Clauses and Forms

The following forms specified in FAR subparts 53.2 and 53.3 are applicable to FEHBP acquisitions:

Part 53.2	Part 53.3	Form title
53.201-1	53.301-1402	SF 1402-Certificate of Appointment.
53.203	53.301-119	SF 119—Statement of Contingent or Other Fees.
53.204-2(a)	53.301-279	SF 279 FPDS—Individual Contract Action Report (over $10,000).
53.204-2(b)	53.301-281	SF 281 FPDS—Summary of Contract Actions of $10,000 or less.
53.229	53.301-1094	SF 1094—U.S. Tax Exemption Certificate.
53.229	53.301-1094A	SF 1094A—Tax Exemption Certificates Accountability Record.