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Click ‘Get Form’ to open the dd form 2875 in the editor.
Begin with Part I, entering your name, organization, and office symbol. Ensure accuracy as this information is crucial for identification.
Fill in your contact details including phone number and official email address. This facilitates communication regarding your access request.
Complete the citizenship and designation fields. Select whether you are military, civilian, or a contractor.
In Part II, provide justification for access and specify the type of access required by marking the appropriate boxes.
Ensure that your supervisor reviews and signs the form in Part II, confirming the need for access.
Finally, complete Parts III and IV as necessary, ensuring all signatures are obtained before submission.

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Versions	Form popularity	Fillable & printable
2022	4.8 Satisfied (30 Votes)
2018	4.8 Satisfied (35 Votes)
2009	4.4 Satisfied (404 Votes)
2005	4.3 Satisfied (61 Votes)
2004	4.4 Satisfied (37 Votes)

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What is a DD Form 2875 used for?

The DD2875 is required when a system is not in the DLA Account Management and Provisioning System (AMPS) and when access to external DOD systems is required. 1) The latest version of the DD2875 can be found here. 2) The latest version of the Consent to Monitor, Privileged Rules of Behavior can be found here.

Who signs the DD form 2875?

Signature of the Information Owner or functional appointee of the office responsible for approving access to the system being requested. (18b) Date. The date the functional appointee signs the DD Form 2875.

What Army regulation covers DD Form 2875?

The Army designed the single DD Form 2875 initiative to ensure compliance with Army Regulation 25-2, which governs Army information systems and applications management.

How long is a DD Form 2875 good for?

How long is Form DD 2875 valid for? The form is valid until the users access is terminated or until the specified expiration date, whichever comes first. The original form must be maintained on file for one year after termination.

What is dd form 2870 used for?

AUTHORITY: Public Law 104-191; E.O. 9397 (SSAN); DoD 6025.18-R. PRINCIPAL PURPOSE(S): This form is to provide the Military Treatment Facility/Dental Treatment Facility/TRICARE Health Plan with a means to request the use and/or disclosure of an individuals protected health information.

dd form 2875 pdf fillable

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Dd form 2875-2026