Forms

wdt_ID Form Number Title MS Word PDF MS Excel Website Link
1 SF 4040-DOP Declaration of Occupational Medicine Provider

MS Word

PDF

Excel

2 SF 4400-PKG Employee Health Plan Benefits Enrollment/Disenrollment Packet

MS Word

PDF

3 SF 4560-G Physician Certificate of Disability (PCII)

PDF

4 SF 2050-P Report of Occupational Injury/Illness

PDF

5 SF 4812-SOH Statement of Health Form (MetLife)

PDF

7 SF 4001-RBR Student Intern Relocation Benefit Request Form

MS Word

PDF

8 SF 6891-APF Affirmative Procurement Form for Federal Procurement

Excel

10 SF 6110-AC Residual Inventory of Material or Equipment Furnished by or Acquired for Sandia

MS Word

PDF

11 SF 6430-RIT Sandia/NTESS Retiree Invoicing Template

MS Word

12 SF 6432-REC Supplier Data Sheet Reporting Supplement

PDF

14 SF 6432-CIP Subcontractor Improvement Plan

MS Word

15 SF 6432-H Payment Bond

PDF

16 SF 6432-I Performance Bond

PDF

17 SF 6432-K Quotation Bond

PDF

19 SF 6432-SCA Supply Chain Assessment

PDF

20 SF-6432-SOT Supply Chain Assessment (Information & Operational Technology)

PDF

21 SF 6432-SVA Supply Chain Assessment (Software)

PDF

22 SF 6432-SDA Supply Chain Assessment (Consultants/Individuals)

PDF

23 DOE 470.5 Authorization and Consent to Release HRP Records in Connection with HRP

PDF

24 DOE 470.4 Acknowledgement and Agreement to Participate in the HRP

PDF

25 SF 312 Classified Information Nondisclosure Agreement

PDF

26 SF 2001-CSS Confined Space Permit Sign-in/Sign-out Sheet for Emergency Response

PDF

27 DOE 5631.34 Data Report on Spouse/Cohabitant
28 SF 2730-LTR DBIDS: Long-Term Request

PDF

29 SF 2730-VPR DBIDS: Short-Term Visitor Request

PDF

30 Electronic Questionnaire for Investigations Processing (e-QIP) Tip Sheet 85

Instructions

31 SF 2730-NCB Name Change Request for Badge Office and Staffing

PDF

32 SA 2712-CVC Non-US Government Computing Equipment and Media Temporary One-Time Exception to SNL Policy

MS Word

PDF

33 SF 2730-LSB Reporting Lost, Stolen, Forgotten or Unrecovered Badge

PDF

34 DOE 5631.18 Security Acknowledgement Form

PDF

35 DOE 5631.29 US DOE Termination Statement and Termination Briefing (SEC225)

PDF

37 SF 4600-LR Staff Augmentation Contract Associate - Authorization to Exceed PerDiem

MS Word

PDF

38 SF 4600-LRA Staff Augmentation Contract Associate - Travel Authorization

MS Word

PDF

39 SF 6432-J Subcontractor's Release Under Subcontract

PDF

43 Electronic Questionnaire for Investigations Processing (e-QIP) Tip Sheet 86

Instructions

65 DOE F 272.2 U.S. Department of Energy Personnel Security Information Reporting Form

PDF

66 Declaration for Federal Employment

PDF

68 SF 6432-CIP Subcontractor Performance Improvement Plan

MS Word

70 SF 9424-EFT Electronic Funds Transfer Agreement

MS Word

PDF

77 SF 4003-REC Sandia Gives/United Way Retiree Pledge Form

PDF

80 SF 4601-C Nonemployees Expense Voucher

MS Excel