DD 2652 2014-2024 free printable template
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CATEGORY OF APPROVAL 13. AUTHORIZED FEES 14. DATE OF APPROVAL DD FORM 2652 MAY 2014 PREVIOUS EDITION IS OBSOLETE. 15. OMB No* 0704-0515 OMB approval expires May 31 2017 APPLICATION FOR DEPARTMENT OF DEFENSE CHILD CARE FEES Read Instructions on back before completing form* The public reporting burden for this collection of information is estimated to average 5 minutes per response including the time for reviewing instructions searching existing data sources gathering and maintaining the data...
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How to fill out omb gov 2014-2024 form
How to fill out DD Form 2652:
01
Gather all required information and documents such as your personal identification, medical records, and supporting documents.
02
Download a copy of DD Form 2652 from the official Department of Defense website or obtain a physical copy from your nearest military installation.
03
Read and understand the instructions provided on the form to ensure accurate and complete completion.
04
Begin by filling out the personal information section, including your full name, contact information, and social security number.
05
Provide details regarding your military service, including your branch, rank, and dates of service.
06
Consult with your medical provider to complete the medical information section accurately, providing details of your injuries or illnesses.
07
Attach any supporting documents required, such as medical records or letters from healthcare professionals.
08
Sign and date the form, ensuring that all required sections are filled out correctly.
09
Make copies of the completed form and all supporting documents for your records.
10
Submit the completed DD Form 2652, along with any additional required documents, to the appropriate authority for processing.
Who needs DD Form 2652?
01
Service members who have sustained or aggravated an injury or illness while on active duty and are seeking compensation or benefits.
02
Veterans who have separated from the military and are filing a claim for disability compensation or medical benefits.
03
Survivors of deceased service members who are filing a claim for dependent indemnity compensation or survivor benefits.
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What is dd form 2652?
DD Form 2652 is a Department of Defense form titled "Veterans' Application for Compensation and/or Pension." It is used by military veterans to apply for compensation or pension benefits from the Department of Veterans Affairs (VA). The form collects information about the veteran, their military service, and their eligibility for benefits. It is typically used by veterans who are seeking compensation for service-related disabilities or assistance for non-service-related disabilities.
Who is required to file dd form 2652?
DD Form 2652, which is the Application for DoD Youth Eligibility Letter, is typically filed by military families seeking care for a child with special needs. The form is necessary to determine whether the child is eligible for certain benefits and support services provided by the Department of Defense (DoD) for dependent children with special needs. Therefore, it is primarily the responsibility of military personnel or their dependents who have a child with special needs to file DD Form 2652.
How to fill out dd form 2652?
To fill out DD Form 2652, follow these steps:
1. Start by downloading and printing the DD Form 2652 from the official Department of Defense website, or obtain a physical copy from your military installation.
2. Begin with Section I, titled "Request for Enrollments." Fill in your personal information, including your name, social security number (SSN), and mailing address. Provide your email address and phone number too.
3. In Section II, titled "Elections," you will select the type of coverage you desire. Circle "Active Coverage" if you want to enroll in the Active Duty Dental Program (ADDP) or "Reserve Select Coverage" if you are a member of the Selected Reserve and wish to enroll in the TRICARE Dental Program (TDP). Check the appropriate box to select the coverage type.
4. In this section, you also have to indicate whether you have any dental insurance coverage through other sources. If you have other dental insurance, check the relevant box and provide additional details as required.
5. Section III, titled "Important Information," outlines the rights and responsibilities of military members in accessing dental care. Read this section carefully to understand your obligations and the services available.
6. Sign and date the form at the bottom of Section III.
7. If you are enrolling dependents, proceed to Section IV titled "Family Member Coverage - Enrollments." Provide the required information for each dependent you wish to include in your dental coverage. Include their full names, SSNs, dates of birth, and relationship to you. Remember to sign and date this section as well.
8. Finally, review all the provided information to make sure it is accurate and complete.
9. Make copies of the filled-out DD Form 2652 for your records.
10. Submit the completed form as required, either by mailing it to the appropriate address stated on the form or submitting it electronically through the appropriate channels.
It is recommended to contact your local military personnel office or benefits administrator if you have any questions or need additional assistance in filling out DD Form 2652.
What is the purpose of dd form 2652?
The purpose of DD Form 2652 is to provide a record of prior military service for individuals who have had a break in service or are reentering the military. It is used to gather information about an individual's previous military experience, including dates of service, military branch, rank, and duty stations. This form helps to establish eligibility for certain benefits, such as retirement, promotion, or education benefits, and assists in determining the individual's pay and other entitlements.
What is the penalty for the late filing of dd form 2652?
The penalty for late filing of DD Form 2652 may vary depending on the specific circumstances and the policies of the responsible military organization. It is recommended to consult the relevant regulations or speak with a military finance representative to determine the exact penalty.
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