Transcription of APPLICATION FOR IDENTIFICATION CARD/DEERS …
{{id}} {{{paragraph}}}
Example: bachelor of science
APPLICATION FOR IDENTIFICATION CARD/DEERS …
PREVIOUS EDITION IS form is valid for issue of DoD ID Card for 90 days from date of form 1172 -2, APRIL 2020 APPLICATION FOR IDENTIFICATION CARD/DEERS ENROLLMENT Please read Agency Disclosure Notice, Privacy Act Statement, and Instructions prior to completing this form . OMB No. 0704-0415 OMB approval expires 20230430 SECTION I - SPONSOR/EMPLOYEE INFORMATION1. NAME (Last, First, Middle)2. GENDER3. SSN OR DoD ID STATUS5. ORGANIZATION6. PAY GRADE7. GEN. CAT8. CITIZENSHIP9. DATE OF BIRTH (YYYYMMDD)10. PLACE OF BIRTH11. CURRENT HOME ADDRESS12. CITY13. STATE14. ZIP CODE15. COUNTRY16. PRIMARY EMAIL ADDRESS Permission to use for benefits notifications17. TELEPHONE NUMBER (Include Area Code/DSN)18. CITY OF DUTY LOCATION19. STATE OF DUTY LOCATION20.
The DD Form 1172-2 currently covers the RUs that would include retirees and dependents. To the Department of Health and Human Services, the Department of Veterans Affairs, the Social Security Administration, and to other Federal, state, and local government agencies to identify individuals having benefit eligibility in another plan or
Tags:
Information
Domain:
Source:
Link to this page:
Please notify us if you found a problem with this document: