Transcription of OMB No. 0730-0014 DEPENDENCY STATEMENT - PARENT …
{{id}} {{{paragraph}}}
Example: dental hygienist
OMB No. 0730-0014 DEPENDENCY STATEMENT - PARENT …
DEPENDENCY STATEMENT - PARENTPLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ORGANIZATION. RETURN COMPLETED FORM TO YOUR LOCAL SERVING No. 0730-0014 OMB approval expires Nov 30, 2010 CONTROL NUMBERPRIVACY ACT STATEMENTAUTHORITY: 93-64; 37 , Chapter 7, Section 403; 9397 (SSN); and DoDFMR , Vol. 7a, Chapter PURPOSE(S): The information will be used to determine the relationship and DEPENDENCY of the claimed dependentsand determine the member's entitlement to authorized USE(S): In addition to those disclosures generally permitted under 5 552a(b) of the Privacy Act, these records orinformation contained therein may specifically be disclosed outside the DoD as a routine use pursuant to 5 552a(b)(3) asfollows: The DoD "Blanket Routine Uses" published at the beginning of the DoD compilation of systems of records notices : Voluntary.
i. MARITAL STATUS (X one) SINGLE MARRIED SEPARATED DIVORCED WIDOWED 3. PARENT(S) INFORMATION (1) NAME (Last, First, Middle Initial) (2) SSN (3) DATE OF BIRTH (YYYYMMDD) DD FORM 137-3, JAN 2008 PREVIOUS EDITION IS OBSOLETE. Page 1 of 5 Pages Adobe Professional 7.0 ARMY MARINE CORPS NAVY AIR FORCE USIP CARD (4) …
Tags:
Information
Domain:
Source:
Link to this page:
Please notify us if you found a problem with this document: