Get the free DA FORM 2217, OCT 59

CHRONOLOGY RECORD (Military Personnel Security Case) For use of this form, see AR 604-10; the proponent agency is DCS PER LAST NAME FIRST NAME — MIDDLE INITIAL SERVICE NO./SSN OR SELECTIVE SERVICE

How to fill out da form 2217 oct

How to fill out DA Form 2217 Oct?

Start by entering your personal information:

1. Write your name in the "Name" field.
2. Provide your Social Security Number (SSN) in the designated space.
3. Fill in your rank and the unit you are associated with.

Next, indicate the purpose of the form:

1. Check the appropriate box to indicate if the form is being used for initial enrollment, change of enrollment, or discontinuation of enrollment.
2. If there is a change in enrollment, make sure to provide the effective date of the change.

Provide your mailing address:

Write your complete mailing address, including street, city, state, and ZIP code.

Indicate your election of coverage:

1. Check the box to specify the plan under which you elect to be insured (Servicemembers' Group Life Insurance (SGLI) or Family Servicemembers' Group Life Insurance (FSGLI)).
2. If selecting FSGLI, also complete the Spouse Coverage section.

Assign beneficiaries:

1. State the percentage of coverage you want to assign to the beneficiaries.
2. Fill in the name, relationship, date of birth, Social Security Number, and address of each beneficiary.
3. If assigning coverage to a trust or an organization, provide details accordingly.

Provide your signature and date:

1. Sign your name in the "Signature" section.
2. Date the form in the designated space.

Who needs DA Form 2217 Oct?

1. Service members on active duty are generally required to complete this form to enroll, update, or discontinue coverage under SGLI or FSGLI.
2. National Guard and Reserve members are also required to fill out this form if they are eligible for SGLI or FSGLI coverage.
3. Family members of the service member, including spouses and dependent children, may be included on this form for FSGLI coverage.

Remember to consult with your unit's administration office or refer to official military regulations for specific guidance on completing DA Form 2217 Oct and to ensure compliance with current policies and procedures.

For pdfFiller’s FAQs

What is da form 2217 oct?

DA Form 2217 OCT is a form used by the Department of the Army for reporting vehicle utilization.

Who is required to file da form 2217 oct?

All Army units and organizations that utilize motor vehicles are required to file DA Form 2217 OCT.

How to fill out da form 2217 oct?

DA Form 2217 OCT should be filled out by entering the required information about vehicle usage, mileage, and other relevant data.

What is the purpose of da form 2217 oct?

The purpose of DA Form 2217 OCT is to track and report vehicle utilization for Army units and organizations.

What information must be reported on da form 2217 oct?

Information such as vehicle number, mileage, purpose of use, driver's information, and other relevant data must be reported on DA Form 2217 OCT.

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