DD 2652 2009 free printable template

DATE OF APPROVAL YYYYMMDD 17. NAME OF CHILD DEVELOPMENT PROGRAM OFFICIAL DD FORM 2652 JUN 2009 PREVIOUS EDITION IS OBSOLETE. Reset Adobe Professional 8. APPLICATION FOR DEPARTMENT OF DEFENSE CHILD CARE FEES PRIVACY ACT STATEMENT AUTHORITY Public Law 101-189 Section 1504 E*O. 9397. PRINCIPAL PURPOSE S To collect total family income data to determine child care fees. ROUTINE USE S None. DISCLOSURE Voluntary however failure to furnish information will result in placement in the highest fee...

How to fill out dd form 2652 2009

How to fill out dd form 2652:

1. Obtain a copy of the dd form 2652 from the appropriate source.
2. Carefully read and understand the instructions provided on the form.
3. Begin by filling out the personal information section, including your name, address, and contact information.
4. Provide the necessary details regarding your military service, such as your rank, branch, and dates of service.
5. Indicate the reason for requesting the form and provide any additional information required in the purpose section.
6. If applicable, fill out the financial information section, including details about your income, expenses, and assets.
7. Review the completed form to ensure all information is accurate and legible.
8. Sign and date the form before submitting it to the designated authority.

Who needs dd form 2652:

1. Members of the military who are planning to retire or separate from service.
2. Veterans who are requesting information or benefits related to their military service.
3. Dependents or next of kin who may be eligible for benefits or entitlements.

Note: The specific requirements for who needs dd form 2652 may vary depending on the purpose of the form and the individual's circumstances. It is always recommended to consult the appropriate military authorities or resources to determine if you need to fill out this form.

For pdfFiller’s FAQs

What is dd form 2652?

DD Form 2652 is a document used in the United States military to apply for physical disability retirement. This form is specifically for members of the Reserve Component who are seeking disability retirement benefits due to a physical condition that occurred or was aggravated during military service. The form includes personal information, details of military service, medical conditions, and other relevant information required for the disability retirement application process.

Who is required to file dd form 2652?

DD Form 2652, also known as the Application for Subsistence Allowance (SA) under the Department of Defense Education Activity (DoDEA), is typically filed by eligible military members who are stationed overseas and have dependents living with them. It is used to request a subsistence allowance to help cover the increased cost of living expenses while stationed abroad.

How to fill out dd form 2652?

To fill out DD Form 2652, which is the Data for Payment of Retired Personnel, you should follow these steps: 1. Obtain a blank copy of the form: You can find the DD Form 2652 on the official website of the Department of Defense or you can request it from your respective military branch or unit. 2. Provide personal information: Fill out Blocks 1 to 10 with your personal information, including your name, address, Social Security Number (SSN), date of birth, and military service data. 3. Indicate your type of retirement: In Block 11, select the appropriate box indicating the type of retirement you are applying for. This could be regular retirement, Temporary Early Retirement Authority (TERA), or Early Retirement. 4. Provide information regarding your beneficiary: In Block 12, provide the required information about your beneficiary, including their full name, address, relationship to you, and their SSN. 5. Fill out Section II: In Section II, provide the details regarding your pay and allowances. Indicate if you received any survivor or retirement benefits, and provide information about any other income you receive that might affect your retirement pay. 6. Sign and date the form: In Block 17, sign and date the form. If you are unable to physically sign the form, you can attach a statement explaining the reason and provide an alternate form of authorization. 7. Attach any required documents: If there are any required documents, such as a marriage certificate or proof of dependency, ensure they are attached before submitting the form. 8. Submit the form: After completing and reviewing the form, submit it to the appropriate personnel office for processing. Follow the instructions provided by your military branch or unit for submission procedures. Note: It is always recommended to consult with your military personnel office or legal assistance office for guidance and clarification when filling out any official forms.

What is the purpose of dd form 2652?

DD Form 2652, "Retired Serviceman's Family Protection Plan (RSFPP) Election Certificate," is a document used by retired members of the military to elect either full, reduced, or no annuity coverage for their eligible survivors after their death. The purpose of this form is to provide retired servicemen the option to participate in the RSFPP and determine the level of financial protection they want to provide for their family in case of their demise. This plan allows retired members to allocate a portion of their retired pay to provide a monthly annuity benefit to their surviving spouse and/or eligible child(ren) upon their death.

What information must be reported on dd form 2652?

DD Form 2652 is called the Medical Evaluation Board (MEB) Worksheet. It is used to gather information about the medical condition of a military service member who may potentially be referred to a Medical Evaluation Board. The following information must be reported on DD Form 2652: 1. Personal information: This includes the service member's name, rank/grade, social security number, service branch, and contact information. 2. Medical condition(s): A detailed description of the service member's medical condition(s) that may potentially result in referral to a MEB. 3. Medical treatment: Information about the medical treatment received by the service member, including the dates of treatment and the healthcare provider involved. 4. Limitations: The impact of the medical condition(s) on the service member's ability to carry out their military duties. This may include physical limitations, cognitive impairments, or psychological factors. 5. Medication: Details about any medications the service member is currently taking or has taken in the past for their medical condition(s). 6. Medical diagnostic tests: Any medical tests or examinations undergone by the service member for diagnosis or evaluation purposes, along with the results of those tests. 7. Medical document review: The names of any medical documents reviewed during the evaluation process and relevant information from those documents. 8. Functional limitation: Specific information on the functional limitation(s) caused by the medical condition(s). It is important that all information provided on the form is accurate and up to date. This form is used to assess the service member's medical condition(s) and determine whether they meet the criteria for referral to a Medical Evaluation Board.

What is the penalty for the late filing of dd form 2652?

According to the Defense Finance and Accounting Service (DFAS), there is no specific penalty mentioned for the late filing of DD Form 2652. However, it is important to adhere to required timelines to ensure timely processing and avoid potential issues with your benefits. It is advisable to contact the appropriate authorities or reach out to DFAS directly for the most accurate and up-to-date information regarding any penalties or consequences associated with late filing.

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