Transcription of AUTHORIZATION/DESIGNATION FOR EMERGENCY PAY …
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Example: bachelor of science
AUTHORIZATION/DESIGNATION FOR EMERGENCY PAY …
AUTHORIZATION/DESIGNATION FOR EMERGENCY PAY AND ALLOWANCES(Read Privacy Act Statement on back before completing form)1. MEMBER (Last Name, First Name, Middle Initial)2. GRADE, RATE OR RANK3. SOCIAL SECURITY NUMBER4. MEMBER'S STATION OR PRIMARY DEPENDENT'S NAME (or designated representative for minor dependents) (First Name, Middle Initial,Last Name)b. RELATIONSHIP6. DEPENDENTS OTHER THAN PRIMARYa. NAME(Last Name, First Name, Middle Initial)b. DATEOF BIRTH(YYYYMMDD)(1)(2)(3)(4)a. NAME(Last Name, First Name, Middle Initial)(5)(6)(7)(8)a. ADVANCE OF PAY - MAXIMUM AMOUNT $(Not to exceed 2 months basic pay) I hereby authorize an advance of basic pay, as indicated above, to be paid to my above named dependent or representative, in the event of anemergency declared by proper authority.
dd form 1337 (back), nov 2007 instructions to designated dependent or representative for use of dd form 1337 (authorization/designation for emergency pay and allowances)
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