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Environmental Health and Safety
2408 Wanda Daley Drive
Ames, Iowa 500113602
Phone: (515) 2945359
www.ehs.iastate.eduExchange of Information
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How to fill out dd form 216
01
To fill out DD Form 216, follow these steps:
02
Start by filling out the Personal Information section at the top of the form. This includes providing your name, social security number, rank, and current unit information.
03
Next, complete the Certification section by indicating whether the information provided is true and correct to the best of your knowledge. This section also requires your signature and date.
04
Proceed to the Description of Accident/Incident/Exposure section. Provide a detailed account of the event or exposure, including the date, time, location, and circumstances surrounding it.
05
If there were any witnesses to the incident, include their names, addresses, and contact information in the Witnesses section.
06
In the Injury/Illness section, describe any injuries or illnesses resulting from the incident. Include medical diagnosis, treatment received, and the extent of the injury or illness.
07
If there was any property damage, describe it in the Property Damage section.
08
Finally, complete the Reporting Agency section with the contact information of the agency that will receive the form.
09
Remember to review your completed form for accuracy and legibility before submitting it.
Who needs dd form 216?
01
DD Form 216 is required for military personnel who are involved in an accident, incident, or occupational exposure that results in injury, illness, or property damage. This form is used to document and report such incidents to the appropriate authorities for investigation and follow-up.
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What is dd form 216?
DD Form 216 is a military form used to report the changes in the status of a member's income for the purposes of tax withholding.
Who is required to file dd form 216?
Service members who need to report changes in their income status or tax withholding are required to file DD Form 216.
How to fill out dd form 216?
To fill out DD Form 216, provide personal identification details, indicate the changes in income or withholding status, and ensure all sections are completed accurately before submission.
What is the purpose of dd form 216?
The purpose of DD Form 216 is to assist the military in tracking changes in an individual's income status to ensure proper tax withholding.
What information must be reported on dd form 216?
Information that must be reported includes personal identification, changes in income, current tax withholding status, and any relevant financial details.
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