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     Congratulations on your employment with the United States District Court, Middle District of Pennsylvania!  As a new employee, you are required to complete various forms prior to your hire date. This site contains all of the forms required to process your appointment. 
     All appointment and payroll forms must be completed and returned to the Human Resources Office via U.S. Mail or other carrier prior to your hire date to ensure timely processing of your appointment.  Also, it is recommended that you be sworn in and fingerprinted prior to your hire date. Please contact the HR Director Deborah T. Skopek to arrange a convenient time. 
     If you have any questions on any of the forms, benefits or policies, please contact Debbie at (570) 207-5670. Thank you.


Federal Judicial Branch Application for Employment (AO 78) - include month/day/year for all date entries.
Voluntary Race/Ethnicity, Gender & Disability Identification (AO 78B)
Employment Eligibility Verification Form (I-9) - proper identification is required (see Page 4 of form)
Emergency Contact Form
FastStart Direct Deposit Form (FMS 2231)
W-4 Federal Withholding Form
Residency Certification Form (complete form for the city where you will be working: Scranton, Harrisburg, Williamsport or Wilkes-Barre)
Please see Policies & Procedures Section for additional forms that also need to be returned.


You have sixty (60) days from your hire date to enroll in any or all of the benefits offered by the Federal Judiciary. Please refer to the Benefits Synopsis for an overview of these benefits. Additional information is included below to assist you in making an informed decision.
Employee Benefits  
Benefits for Life Brochure  
HEALTH INSURANCE:   Enroll by completing election forms below  
Health Insurance Plans Offered HMO Plans / Premiums
Health Insurance Information Fee-For-Service Plans / Premiums
  Health Insurance Comparison Tool
Health Insurance Marketplace (Affordable Care Act) Election Form (SF 2809) - Complete Pages 17 and 18
LIFE INSURANCE:   Enroll by completing election forms below  
Life Insurance Brochure Election Form (SF 2817) - Complete Page 1 only
Premium Calculator Beneficiary Form (SF 2823)
Dental and Vision Summary Dental Rating Area
Dental Plan Information Enroll via BENEFEDS (Employing Agency is Federal Judiciary.)
Dental Rates Dental Comparison Tool
Vision Plan Information Enroll via BENEFEDS (Employing Agency is Federal Judiciary.)
Vision Rates Vision Comparison Tool
Information on the Flexible Benefits Program and the Commuter Benefit Program will be mailed to your home address from the Federal Judiciary's Benefits Center. The Long Term Care Insurance information will be mailed from CNA.
Flexible Benefits Program Enroll via Judiciary Benefits Center/ADP
Health Care Reimbursement  
Dependent Care Reimbursement  
Premium Payment Plan  
Commuter Benefit Enroll via Judiciary Benefits Center/ADP
Long Term Care Insurance Enroll via Long Term Care Partners / John Hancock
Parking Subsidy Program

Parking Subsidy Program Enrollment Agreement and Certification*
*If interested in participating in this parking program, please return the Enrollment Agreement directly to Ruth Davies via email. Ruth can be reached at (570) 207-5666.

Transportation Subsidy Program  
Employee Assistance Program (EAP)  
      The retirement plan for Federal Employees, FERS, includes three components:  (1) Social Security, (2) a Basic Benefit Plan and (3) the Thrift Savings Plan (TSP).  The three components work together.  Most of the cost of social security is paid through payroll taxes, while the FERS Basic Benefit Plan includes a mandatory deduction of 4.4% of your pay, which is an automatic payroll deduction.  You are also automatically enrolled in the TSP at a contribution rate of 3% of your pay.  Additional information on this benefit is included in the welcome letter.
FERS Benefits Overview Summary of TSP
FERS Beneficiary Form (SF 3102) TSP Election Form (TSP-1)
  TSP Beneficiary Form (TSP-3)
  TSP Catch-up Contributions Form  (TSP-1-C)


Unpaid Compensation (SF 1152) - Complete Page 1 only


Acknowledgment Form (review, sign and return)
Code of Conduct for Judicial Employees | Ethics for Chambers Staff
Health and Safety Orientation Manual   (review, sign Page 8 and return)
IT Usage and Security Policy  (review and electronically acknowledge via email on page 8)
Telework Policy | Telework Agreement (review, sign and return)
Telework Duty Station Change form (PER34)


Leave ProgramsLeave Policy
2019 Biweekly Pay Periods and Holidays
2019 CPS Salary Chart - Scranton, Williamsport and Wilkes-Barre
2019 CPS Salary Chart - Harrisburg
2019 Court Reporter Salary Chart (Hired Before 10/11/2009)
2019 JSP Salary Chart - Scranton, Williamsport and Wilkes-Barre
2019 JSP Salary Chart - Harrisburg
        As an employee of the United States District Court, Middle District of Pennsylvania, you are responsible for reviewing the online Personnel Manual and all other related policies and information located on the District Court’s intranet Human Resources Page upon hire.

Welcome to the Court!