FS Form 5396

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Get your FS Form 5396 in 3 easy steps

  • 01 Fill and edit template
  • 02 Sign it online
  • 03 Export or print immediately

How to Redact and Fill Out FS Form 5396 Online

FS Form 5396, also known as the Report of Medical Examination, is a form used by the U.S. Forest Service (USFS) for pre-employment and fitness-for-duty medical evaluations. Here are the steps for completing and redacting the form online:

  1. Obtain a digital copy of the form in PDF format.
  2. Open the form FS 5396 in a PDFliner editor.
  3. Fill out the form with the required information, such as your name, date of birth, and the results of the medical examination.
  4. Save the completed US treasury FS form 5396 to your computer.
  5. Submit the form electronically or print it out and mail it to the appropriate address.

What Should FS Form 5396 Include

FS Form 5396 Screenshot

FS Form 5396 should include the following information:

  • The agency or organization that is requesting the disposition of the records.
  • The name and contact information of the person submitting the form.
  • The type of records being proposed for disposition (e.g., paper, electronic, audio-visual).
  • The specific location of the records (e.g., office, facility, building).
  • The proposed disposition action (e.g., destruction, transfer, retention).
  • The date or time period when the records were created or received.
  • The legal or regulatory authority that authorizes the proposed disposition.
  • The specific schedule or item number assigned by NARA applies to the records.
  • Any additional information that may be relevant to the disposition of the records.

It is also important to note that the form should be signed and dated by an official with authority to approve the disposition of the records.

When to Request an FS Form 5396

FS Form 5396, or the "Request for Records Disposition Authority," should be used when a federal agency or organization needs to dispose of federal records. This can include destroying, transferring, or retaining records. In general, an FS Form 5396 should be requested when:

  • An agency or organization no longer needs certain records for its operational or administrative use.
  • An agency or organization wants to transfer records to the National Archives and Records Administration (NARA) for permanent preservation.
  • An agency or organization wants to destroy records that are no longer needed and have met the retention period required by NARA.
  • An agency or organization wants to retain records for a specific period of time.

It is important to note that before disposing of any federal records, an agency or organization must first obtain the approval of NARA. The FS Form 5396 is the means to request that approval.

Fillable online FS Form 5396
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(4.7 / 5) 61 votes
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