Dd Form 2675, Reimbursement Request For Adoption Page 3
Download a blank fillable Dd Form 2675, Reimbursement Request For Adoption in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Dd Form 2675, Reimbursement Request For Adoption with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3PRIVACY ACT STATEMENT
AUTHORITY: 5 U.S.C. 5701 - 5742, 37 U.S.C. 404-427, P.L. 102 - 190, Section 651, and E.O. 9397.
PRINCIPAL PURPOSE(S): Used for reviewing, approving, accounting and disbursing for adoption reimbursement. The Social
Security Number (SSN) is used to maintain a numerical identification system for individual claims and tax reporting purposes.
ROUTINE USE(S): None.
DISCLOSURE: Voluntary; however, failure to furnish information requested may result in total or partial denial of amount claimed.
APPLICATION PROCESSING INSTRUCTIONS
1. The member's Personnel activity will assist in completing the application for reimbursement. DFAS will provide
any additional guidance needed concerning the program.
2. The member will provide documentation supporting placement by an authorized source, any final court papers
including translations if necessary, all substantiating receipts in U.S. currency amounts with the claim, and in the
case of foreign adoptions, submit proof of U.S. citizenship for the child. Submit certified copies of original court or
agency documents. Documents will not be returned to the member.
3. If necessary, claim requests and certification forms may be mailed to the Personnel activity. Claim forms may be
signed by the member's spouse under a power of attorney, which must be attached.
4. The member must retain copies of all paperwork until the claim is paid or denied.
5. When the reimbursement request with documentation is complete, the member's commanding officer, or
designee, will certify as to the validity of the claim by completing the Adoption Expense Certification.
6. The member's Personnel activity will submit the completed claims package by certified mail to: Defense Finance
and Accounting Service, Cleveland Site (Code PMMCCB), 1240 East Ninth Street, Cleveland, OH 44199-2059.
Phone numbers are as follows: DSN 580-5576 and Commercial (216) 522-5576.
Email: CCL-Adoption-reimbursement@DFAS.mil.
7. If the adoption and expenses are eligible for reimbursement, the Director, DFAS-CL will so certify the payment.
8. DFAS-CL will reimburse by EFT to the member's EFT account. Upon payment, a letter detailing the reimbursed
expenses will be sent to the member.
9. If eligibility for reimbursement cannot be determined from the documents provided or claimed expenses are not
properly supported by receipts, DFAS-CL will retain the claim and request the necessary information or
documentation. The additional documentation must be submitted within 90 days for the claim to be considered.
10. If the claim is denied, a letter stating the denial will be sent to the member's correspondence address. The claim
will not be returned to the member.
11. To obtain detailed requirements, the member should consult the DODFMR, Vol 7C, Chapter 4, "Reimbursement
of Adoption Expenses", found at
DD FORM 2675, SEP 2006
Page 3 of 3 pages
ADVERTISEMENT
0 votes
Related Articles
Related forms
Dd Form 1556-1 - Request, Authorization, Agreement, Certification Of Training And Reimbursement (abbreviated)
Business
Form Dmas-305 - Request For Screening For Individual And Family Developmental Disabilities Support Waiver (dd Waiver)
Legal
Related Categories
Parent category: Business