Dd Form 2654 - Involuntary Allotment Notice And Processing Page 3
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4SECTION III (Continued)
g. If you fail to respond to me within the time period specified (including any extensions authorized by me), I shall indicate
your failure to respond in Section V of this form, and mail this form and the application package back to the designated DFAS
(or Coast Guard Pay and Personnel Center) official for appropriate action.
8. COMMANDER OR DESIGNEE
a. SIGNATURE
b. SIGNATURE BLOCK
c. DATE SIGNED (YYYYMMDD)
9. MEMBER ACKNOWLEDGMENT
I hereby acknowledge that the commander or his or her designee has counseled me in accordance with Section III of this
form; that I am being given an opportunity to review this form and the application package; I may seek legal assistance prior
to responding; I have received a copy of DD Form 2653 and the entire application package for this involuntary allotment;
and that I must complete Section IV of this form and return the form to my commander.
a. SIGNATURE
b. DATE SIGNED (YYYYMMDD)
SECTION IV - MEMBER RESPONSE
10. MEMBER WILL INITIAL IN THE APPROPRIATE SPACE(S):
a. I acknowledge that this is a valid judgment and consent to the establishment of an involuntary allotment.
b. I contest this Involuntary Allotment Application for the following reasons
(If contesting, you must explain the reason in
item 11, "Remarks," and provide appropriate evidence to support the reason.):
(1) That my rights under the Soldiers' and Sailors' Civil Relief Act were not complied with during the judicial
proceeding upon which this application is based.
(2) That exigencies of military duty caused my absence from appearance in a judicial proceeding forming the
basis for the judgment upon which this application is sought.
(3) That information contained in the application is false or erroneous in material part.
(4) The judgment has been fully satisfied, superseded, or set aside.
(5) The judgment has been materially amended, or partially satisfied.
(Provide evidence of the amount satisfied and
the amount which remains in effect.)
(6) There is a legal impediment to the establishment of the involuntary allotment.
(For example, the judgment debt
has been discharged in bankruptcy, or you have filed for protection from the creditor(s) under the bankruptcy laws of the
United States, or the applicant is not the judgment creditor or a proper successor in interest to the creditor.)
11. REMARKS (Use additional sheets if necessary.)
12. MEMBER
a. SIGNATURE
b. DATE SIGNED (YYYYMMDD)
DD FORM 2654, DEC 1999
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