Form 2828 form-2025

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The document is a Physician Certificate for Child Annuitant, required for the continuation of annuity payments under the Survivor Benefit Plan and Retired Serviceman's Family Protection Plan. It collects information regarding a child's incapacity due to mental or physical conditions, necessitating certification by a licensed physician. The form outlines the process for submitting this information to the Defense Finance and Accounting Service and includes privacy statements and legal disclaimers.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the deceased member's name and Social Security Number (SSN) in the designated fields.
Fill in the annuitant's name, date of birth, and their SSN. Ensure accuracy as this information is crucial for processing.
Provide a brief description of the medical or psychiatric diagnosis affecting the annuitant. This section should be concise yet informative.
Indicate when the condition began by entering the date in YYYYMMDD format.
In the physician's statement section, specify how long you have attended to the patient and provide details of your last examination date.
Select whether the patient is incapable of self-support and/or handling financial affairs by marking the appropriate boxes.
Determine if the incapacity is permanent or temporary, and if temporary, provide an expected recovery date.
Complete your credentials by filling in your name, address, and signing where indicated. Don't forget to include the date of completion.

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