Dd Form 93 - Record For Emergency Data Page 2

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SECTION 2 - BENEFITS RELATED INFORMATION
11a. BENEFICIARY(IES) FOR DEATH GRATUITY
b. RELATIONSHIP
c. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER
d. PERCENTAGE
(Military only)
12a. BENEFICIARY(IES) FOR UNPAID PAY/ALLOWANCES
b. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER
c. PERCENTAGE
NAME AND RELATIONSHIP
(Military only)
13a. PERSON AUTHORIZED TO DIRECT DISPOSITION (PADD)
b. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER
NAME AND RELATIONSHIP
(Military only)
14. CONTINUATION/REMARKS
15. SIGNATURE OF SERVICE MEMBER/CIVILIAN
16. SIGNATURE OF WITNESS
17. DATE SIGNED
(Include rank, rate,
(Include rank, rate, or grade
or grade if applicable)
as appropriate)
(YYYYMMDD)
DD FORM 93 (BACK), JAN 2008
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