Phs 6134-2026

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The document provides instructions for completing and submitting Form PHS-6134 (Statement of Service) required by the U.S. Public Health Service Commissioned Corps. It outlines the necessity for certification by an official maintaining military records, details on where to submit the form based on active or inactive duty status, and emphasizes the importance of including accurate service dates for retirement and pay calculations. Additionally, it includes a Privacy Act notice regarding the collection and use of personal information, particularly Social Security numbers.

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Click ‘Get Form’ to open the PHS-6134 in the editor.
Begin by entering your name in the designated fields: Last, First, and Middle Name. Ensure accuracy as this information is crucial for identification.
Input your Social Security Number and Service Number(s) in the appropriate sections. This data is mandatory for processing your service credit.
Fill in the Effective Dates and Nature of Action. For officers, specify whether you are a COMM or WO Component; for enlisted personnel, indicate ENL and Component.
Document your active duty dates by entering 'From' and 'To' dates along with the total number of days served. Include any leave without pay (AWOL) details if applicable.
Complete the Authentication section by providing your signature, name, title, issuing office address, and phone number before submitting.

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