Revised Back Pay Forms

Effective immediately, PS Form 8038, Employee State­ment to Recover Back Pay, PS Form 8039, Back Pay Decision/Settlement Worksheet, and PS Form 8041, Pre-Arbitration or Agency Settlement Worksheet, are revised. The April 2009 editions of these forms (see pages 1224) replace all previous editions. All previous editions are obso­lete and must be discarded.

These forms are available on the Postal Service™ Intranet:

n Go to http://blue.usps.gov.

n Under “Essential Links” in the left-hand column, click Forms.

n Browse forms by number, and click 80008999.

n Click the PDF icon for the back pay form needed.

Obtaining Printed Copies

Upon notification of an applicable back pay award, the Labor Relations representative, postal attorney, or other management official responsible for submitting back pay claims to Accounting Services for processing will print for completion hardcopy versions of the required forms from the intranet site above.

ps form 8038, page 1PS Form 8038, Employee Statement To Recover Back Pay, page 1 of 6

ps form 8038, page 2PS Form 8038, Employee Statement To Recover Back Pay, page 2 of 6

ps form 8038, page 3PS Form 8038, Employee Statement To Recover Back Pay, page 3 of 6

ps form 8038, page 4PS Form 8038, Employee Statement To Recover Back Pay, page 4 of 6

ps form 8038, page 5PS Form 8038, Employee Statement To Recover Back Pay, page 5 of 6

ps form 8038, page 6PS Form 8038, Employee Statement To Recover Back Pay, page 6 of 6

ps form 8039, page 1PS Form 8039, Back Pay Decision/Settlement Worksheet, page 1 of 5

ps form 8039, page 2PS Form 8039, Back Pay Decision/Settlement Worksheet, page 2 of 5

ps form 8039, page 3PS Form 8039, Back Pay Decision/Settlement Worksheet, page 3 of 5

ps form 8039, page 4PS Form 8039, Back Pay Decision/Settlement Worksheet, page 4 of 5

ps form 8039, page 5PS Form 8039, Back Pay Decision/Settlement Worksheet, page 5 of 5

ps form 8041, page 1PS Form 8041, Prearbitration or Agency Settlement Worksheet, page 1 of 2

ps form 8041, page 2PS Form 8041, Prearbitration or Agency Settlement Worksheet, page 2 of 2