DD 2642 2007 free printable template
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DD FORM 2642 APR 2007 PREVIOUS EDITION IS OBSOLETE. COPY 1 - PATIENT S COPY Adobe Professional 7. 0 2. If the sponsor and patient are the same enter same. DD FORM 2642 BACK APR 2007 11. By law you must report if the patient is covered by any other health insurance to include health coverage available through other family members. WHERE TO OBTAIN ADDITIONAL FORMS You may obtain additional claim forms from your claims processor the TRICARE Service Center at the nearest military treatment...
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How to fill out dd form 2642
How to fill out DD 2642
01
Obtain a copy of DD Form 2642 from the appropriate military or government website.
02
Start by filling out the top section with your personal information, including your name, rank, and service number.
03
Specify the type of claim you are submitting in the designated section.
04
Complete the details of the expenses you are claiming, ensuring to attach any supporting documents.
05
Review the form for accuracy and completeness before signing.
06
Submit the DD 2642 to the appropriate office as specified in the instructions.
Who needs DD 2642?
01
Active-duty military personnel who are submitting claims for travel or transportation reimbursements.
02
Reservists and National Guard members who have incurred expenses during duty.
03
Veterans seeking to claim certain benefits related to travel or transportation.
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What is DD 2642?
DD Form 2642 is the 'Declaration for Former Spouse Coverage' which is used by military service members to designate their former spouse as a beneficiary for certain benefits.
Who is required to file DD 2642?
Service members who have divorced and wish to provide benefits to their former spouses are required to file DD 2642.
How to fill out DD 2642?
To fill out DD 2642, the service member must complete the form with accurate personal information, including details about the former spouse, as well as sign and date the declaration.
What is the purpose of DD 2642?
The purpose of DD 2642 is to ensure that a former spouse is eligible for specific military benefits, such as medical care or survivor benefits, following a divorce.
What information must be reported on DD 2642?
DD 2642 requires personal information about the service member, details regarding the former spouse, the date of the marriage and divorce, and any benefits being designated.
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