DD1172 2 PDF

Sponsors will usually complete this form for themselves and their dependents, but family members may submit the form with a valid Power of Attorney. Use this form if you are living outside the United States or are applying for a number or card on behalf of a child who is living outside the United States. Health Plans. Compare Plans. Enroll or Purchase a Plan.

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The DD Form March version is up-to-date and in use today: all previous editions are obsolete and should not be used. A fillable version of the application can be acquired through the chain of command, downloaded from the DoD documentation website or down below. The DD Form is divided into six sections. These sections provide information about the employee or sponsor, sponsoring agency and benefits eligibility.

All the information being input must be valid and accurate. Section I is filled by the applicant and contains personal identifying information including the name, social security number, gender, pay grade, status, and detailed contact information of the individual. Section II requires additional information regarding the current assignment and the benefits the individual is eligible for and is completed by the applicant or their department or agency.

The third section contains all details and lists contact information regarding the applicant's sponsoring group or agency. This part provides details about the applicant's position and assignment and further information about the sponsoring official: their name, pay grade and title. The section is then signed by a qualified official for authorization. All personal and contact information about any dependents is listed in the fourth section of the DD The standard form allows listing of two individuals.

A copy of the DD Form must be kept on hand for further reference or to use when filing amended DD Forms in the future. Download the document to your desktop, tablet or smartphone to be able to print it out in full. Table of Contents. What Is DD Form ? DD Form Instructions. Rate 4. Show Pagination. I certify the information provided in connection with the eligibility requirements of this form is true and accurate to the best of my knowledge. I certify the individual identified above, based on personal knowledge and available documentation, is in a status eligible for and requires an.

The public reporting burden for this collection of information is estimated to average 3 minutes per response, including the time for reviewing. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for.

Respondents should be aware that. Chapter 53, Miscellaneous Rights and Benefits; 10 U. Chapter 54, Commissary and Exchange Benefits; 50 U. These benefits and privileges include, but are not limited to, medical coverage, DoD Identification Cards, access to DoD.

To the. For a complete list of. Applicant information is subject to computer matching within the Department of Defense or with other Federal or non-Federal agencies. Matching programs are conducted to assure that an individual eligible under a Federal program is not improperly receiving duplicate benefits.

A beneficiary or former beneficiary who has applied for privileges of a Federal Benefit Program and has received. The instructions for completing the DD Form should be closely followed to ensure accurate data collection and to preclude over. DD Forms U. Featured Tags Bill of Sale U. Please read before printing. Url of this page:.

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