Fillable Dd Form 93, Record Of Emergency Data, August 1998 (Page 2 of 2) in pdf

INSTRUCTIONS FOR PREPARING DD FORM 93

(See appropriate Service Directives for supplemental instructions for completion of this form at other than MEPS)

All entries explained below are for electronic or typewriter com-

ITEM 9b. Enter beneficiary(ies) full mailing address to include the

pletion, except those specifically noted. If computer or typewriter is

ZIP Code.

not available, print in black or blue-black ink insuring a legible image

on all copies. Include "Jr.," "Sr.," "III" or similar designation for

ITEM 9c. Show the percentage to be paid to each person if two or

each name, if applicable. When an address is entered, include the

more beneficiaries are designated. The sum shares must equal 100

appropriate ZIP code. If the member cannot provide a current

percent. If no percent is indicated and more than one person is

address, indicate "unknown" in the appropriate item. Addresses

named, the money is paid in equal shares to the persons named.

shown as P.O. Box Numbers or RFD numbers should indicate in Item

13, "Continuations", a street address or general guidance to reach

ITEM 10a. Enter first name(s), middle initial, last name(s) and

the place of residence. In addition, the notation "See Item 13"

should be included in the item pertaining to the particular next of kin.

relationship of person to receive unpaid pay and allowances at the

If the address for the person in the item has been shown in a

time of death. The member may indicate anyone to receive this

preceding item, it is unnecessary to repeat the address; however,

payment. If the member designated two or more beneficiaries, state

the name must be entered. When the space for a particular item is

the percentage to be paid each in item 10c. If the member does not

insufficient, insert "See #13" and continue the information in Item

wish to designate a beneficiary, enter "None." The member is urged

13. Also see preparation instructions for Item 13.

to designate a beneficiary for unpaid pay and allowances as payment

will be made to the person in order of precedence by law (10 USC

ITEM 1. Member's full last name, first name, middle name.

2271) in the absence of a designation.

ITEM 2a. Member's social security number (SSN).

ITEM 10b. Enter beneficiary(ies) full mailing address to include the

ITEM 2b. Member's initials in ink, verifying SSN accuracy.

ZIP Code.

ITEM 3a. Service. Use standard one-letter Service code (A - Army,

ITEM 10c. If the member designated two or more beneficiaries,

F - Air Force, N - Navy, M - Marine Corps).

state the percentage to be paid each in this section. The sum shares

must equal 100 percent.

ITEM 3b. Reporting Unit Code/Duty Station. Army/Air Force/Navy -

see Service Directives. Marine Corps - MEPS enters Monitored

ITEM 11. First name, middle initial, last name, relationship, and

Command Code (MCC) to which the member will be assigned.

address of dependent(s) the member designates to receive an

ITEM 4. First name, middle initial, maiden name (if applicable), and

allotment of pay if missing, captured, or interned. This allotment

address of spouse. If member is single, divorced, or widowed, so

may be initiated by the Service Secretary or his designee in the

state.

event the member enters a missing status. This item may be left

blank. If member designates two or more allottees, state the

ITEM 5. First name, middle initial, last name (only if different from

percentage to be paid to each. The sum shares need not equal 100

member's), relationship to member, and date of birth of all children.

percent, but may not exceed 100 percent. NOTE: Designations

If none, so state. Include illegitimate children if acknowledged by

made in Item 11 are used as a guide by the Service Secretary or

member or paternity/maternity has been judicially decreed. Indicate

designee in establishing, changing, or discontinuing an allotment in

relationship, for example: 03 - son, 04 - daughter, 13 - stepson,

14 - stepdaughter, 33 - adopted daughter, 34 - adopted son.

the interest of the member (37 USC 551-558). The final decision

Sample entries: Mary A./04/19650704; Donald E. Jones/13/

rests with the Service Secretary or designee.

19630102. For children not living with the member's current

spouse, include address and name and relationship of person with

ITEM 12. Insurance information.

whom residing.

a. Serviceman's Group Life Insurance (SGLI). Not applicable for

Marine Corps and Air Force members. NOTE: Completion of this

ITEM 6. First name, middle initial, last name, and address of father.

item does not constitute a SGLI election or designation or

If unknown or deceased, so state. Include civilian title or military

beneficiary(ies). Indicate, by entering an "X" in the appropriate

grade if applicable. If other than natural father is listed, indicate

block, the member's SGLI election (as stated in VA Form 29-8286).

relationship.

For Navy members, on the next line, enter, as appropriate, either:

ITEM 7. First name, middle initial, last name, and address of mother.

"Bene Desig filed (YYYYMMDD)," or "Bene Desig not filed."

If unknown or deceased, so state. Include civilian title or military

b. Insurance companies/policy numbers. Enter full name of all

grade if applicable. If other than natural mother is listed, indicate

commercial life insurance companies to be notified in case of death.

relationship.

Enter policy number if member desires; this expedites settlement of

claims.

ITEM 8. Persons not to be notified due to ill health.

a. List relationship, e.g., "Mother," of person(s) listed in Items 4, 5,

ITEM 13. Continuations/remarks. Use this item for remarks or

6, or 7 who are not to be notified of a casualty due to ill health. If

continuation of other items, if necessary. Prefix entry with the

more than one child, specify, e.g., "daughter Susan."

b. List relationship, e.g., "Father" or name and address of person(s)

number of the item being continued; for example, 5/John J./03/

to be notified in lieu of person(s) listed in item 8a.

19451220/321 Pecan Drive, Schertz TX 78151. Also use this item

to list name, address, and relationship of other persons the member

ITEM 9a. Enter first name(s), middle initial, last name(s) and

desires to be notified. Other dependents may also be listed.

relationship of person to receive the 6 months' gratuity pay if there

is no surviving spouse or child at the time of death. Only parents

ITEM 14. Member's signature. Have the member check and verify

(including a person in loco parentis status) and brothers and sisters

all entries and sign all copies in ink as follows: First name, middle

(including those of half-blood and those through adoption) may be

initial, last name. Include rank, rate, or grade.

designated. Loco Parentis means any person(s) who acted in place

of the member's parent(s) for a period of not less than one year at

any time before the member entered on active duty. If brothers or

ITEM 15. Signature of witness. Have a witness (disinterested

sisters are designated, show date of birth (YYYYMMDD). Enter

person) sign all copies in ink as follows: First name, middle initial,

"None" if the member has no eligible beneficiary. No benefit can be

last name. Include rank, rate, or grade.

paid in that instance (10 USC 1477). Also enter "None" if the

member does not wish to designate a beneficiary. Payment is then

ITEM 16. Date the member signs the form. This item is an ink entry

made in the order of precedence established by law. The member

and must be completed by the member on four copies.

should make specific designations, as it expedites payment.

DD FORM 93 (BACK), AUG 1998

Dd Form 93, Record Of Emergency Data, August 1998 Page 2

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