Form 5521-2026

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The U.S. DOD Form dod-da-5521 is a record used by Non-Appropriated Fund (NAF) employees to provide emergency contact information and designate beneficiaries for unpaid compensation in the event of their death. It includes sections for emergency data, beneficiary designation, and legal requirements under the Privacy Act of 1974, ensuring that compensation is directed to the chosen beneficiaries.

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Click ‘Get Form’ to open it in the editor.
Begin with Part A - Emergency Data. Fill in the 'Employing NAFI Activity' and your full name, including first, middle, and last names.
Enter your date of birth in the format YYYYMMDD. Next, provide the name, address, and email of the person to be notified in case of an emergency.
Include a telephone number for the emergency contact. Then, designate a person to handle your estate in the event of death by providing their name, address, email, and telephone number.
Move to Part B - Designation of Beneficiary. Clearly type or print the names and addresses of your beneficiaries along with their relationship to you and the percentage each should receive.
Sign and date the form at the designated areas. Ensure a witness is present to sign as well.

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Versions	Form popularity	Fillable & printable
2001	4.8 Satisfied (62 Votes)

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