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Expires 02 28 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin with Section 1 - Emergency Contact Information. Fill in your full name, DoD Identification Number or SSN, and reporting unit code/duty station.
- Indicate your service/civilian category by selecting the appropriate option. Then, provide your marital status and spouse's details if applicable.
- List the names and relationships of your children, parents, and any other emergency contacts. Ensure all addresses and phone numbers are accurate.
- Move to Section 2 - Benefits Related Information. Designate beneficiaries for death gratuity and unpaid pay/allowances if you are military personnel.
- Complete the signature section at the end of the form, ensuring all entries are verified before signing.
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