Fillable Dd Form 93 - Record For Emergency Data (Page 4 of 4) in pdf

INSTRUCTIONS FOR PREPARING DD FORM 93

(Continued)

ITEM 11a.

Seek legal advice if naming a minor

NOT

(Continued)

ITEM 13b. Address and telephone number of PADD.

child as a beneficiary. If a member has a spouse but

APPLICABLE to civilians.

designates a person other than the spouse to receive all or a

portion of the death gratuity pay, the Service concerned is

ITEM 14. Continuations/Remarks. Use this item for remarks

required to provide notice of the designation to the spouse.

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

NOT APPLICABLE to civilians.

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

J./son/ 19851220/321 Pecan Drive, Schertz TX 78151. Also

Item 11b. Relationship. NOT APPLICABLE to civilians.

use this item to list name, address, and relationship of other

persons the member desires to be notified. Other

ITEM 11c. Enter beneficiary(ies) full mailing address and

dependents may also be listed. This block offers the

telephone number to include the ZIP Code. NOT

greatest amount of flexibility for the member to record other

APPLICABLE to civilians.

important information not otherwise requested but

considered extremely useful in the casualty notification and

ITEM 11d. Show the percentage to be paid to each person.

assistance process. Besides continuing information from

Enter 10%, 20%, 30%, up to 100% as appropriate. The sum

other blocks on this form, the member may desire to include

shares must equal 100 percent. If no percent is indicated and

additional information such as: NOK language barriers,

more than one person is named, the money is paid in equal

location or existence of a Will, additional private insurance

shares to the persons named. NOT APPLICABLE to

information, other family member contact numbers, etc. If

civilians.

additional space is required, attach a supplemental sheet of

standard bond paper with the information.

ITEM 12a. Beneficiary(ies) for Unpaid Pay/Allowance

(Military only). Enter first name(s), middle initial, last

ITEM 15. Signature of Service Member/Civilian. Check and

name(s) and relationship of person to receive unpaid pay

verify all entries and sign all copies in ink as follows: First

and allowances at the time of death. The member may

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

indicate anyone to receive this payment. If the member

if applicable. May be electronically signed (see DoD

designated two or more beneficiaries, state the percentage

Instruction 1300.18 for guidelines).

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

designate a beneficiary, enter "By Law." The member is

ITEM 16. Signature of Witness. Have a witness

urged to designate a beneficiary for unpaid pay and

(disinterested person) sign all copies in ink as follows: First

allowances as payment will be made to the person in order

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

of precedence by law (10 USC 2771) in the absence of a

as appropriate. A witness signature is not required for

designation. Seek legal advice if naming a minor child as

electronic versions of the DD Form 93 (see DoD Instruction

beneficiary. NOT APPLICABLE to civilians.

1300.18).

ITEM 12b. Enter beneficiary(ies) full mailing address and

ITEM 17. Date the member or civilian signs the form. This

telephone number to include the ZIP Code. NOT

item is an ink entry and must be completed on all copies.

APPLICABLE to civilians.

ITEM 12c. If the member designated two or more

beneficiaries, state the percentage to be paid each in this

section. The sum shares must equal 100 percent. NOT

APPLICABLE to civilians.

ITEM 13a. Enter the name and relationship of the Person

Authorized to Direct Disposition (PADD) of your remains

should you become a casualty. Only the following persons

may be named as a PADD: surviving spouse, blood relative

of legal age, or adoptive relatives of the decedent. If neither

of these three can be found, a person standing in loco

parentis may be named. NOT APPLICABLE to civilians.

DD FORM 93 (INSTRUCTIONS) (BACK), JAN 2008

Dd Form 93 - Record For Emergency Data Page 4

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