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Department of Defense (DD) Forms 2500—2999

Number Title Edition Date

DD2501

Courier Authorization

MAR 1988

DD2502

Uniform Billing for Inpatient Hospital Costs

AUG 1987

DD2503

DoD Medical Examination Review Board (DoDMERB) Applicant Overseas Appointment (Stocked and Used by DoDMERB/SAS)

CANCELLED

DD2504

Abandoned Vehicle Notice

MAY 2000

DD2505

Abandoned Vehicle Removal Authorization

MAY 2000

DD2506

Vehicle Impoundment Report

MAY 2000

DD2507

Notice of Vehicle Impoundment

MAY 2000

DD2508

Report on Government Information Dissemination Products and Services

CANCELLED

DD2509

Military Equal Opportunity Assessment

JAN 2003

DD2510

Prisoner of War (POW) Medal Application/Information

CANCELLED

DD2510-1

Prisoner of War (POW) Medal Application/Information (Philippine Commonwealth Army and Recognized Guerilla Veterans)

CANCELLED

DD2511

Imagery Research Request, NACF

FEB 1988

DD2512

Bulk Fuel Stock Rotation Plan

MAR 1988

DD2513

Retrieval and Protect RIMIT Log (Leased ASC)

CANCELLED

DD2514

Magnetic Disc Inventory

CANCELLED

DD2515

Retrieval and Reprotect Log (GOV'T-Owned ASC's)

CANCELLED

DD2516

Moving Head Disc History Log (Government-Owned ASC's)

FEB 1996

DD2517

Moving Head Disc History Log (Leased ASC's)

CANCELLED

DD2518

Fulfillment of DoD Mandatory Training Requirement

SEP 1988

DD2519

Historically Black Colleges and Universities (HBCU) Program Activities, DoD

CANCELLED

DD2520

CHAMPUS/CHAMPVA Claim Form

DEC 1990

DD2521

Hazardous Chemical Warning Label (8-1/2 X 11)

OCT 2000

DD2522

Hazardous Chemical Warning Label (4 X 6)

OCT 2000

DD2523

DSSW Self Service Supply Center Admittance Card

AUG 1988

DD2524

DSSW Self Service Supply Center Sign-In Log

AUG 1988

DD2525

Certification of Hours Worked in Service Year for Expert or Consultant

SEP 2011

DD2526

Case Abstract for Malpractice Claims

FEB 2000

DD2527

Statement of Personal Injury - Possible Third Party Liability, TRICARE Management Activity

APR 2013

DD2529

Commissary Privilege Card, U.S. Armed Forces

CANCELLED

DD2530

Ozone Depleting Chemicals Annual Report (LRA)

CANCELLED

DD2531

Food Storage Facility Sanitation Compliance Checklist

CANCELLED

DD2532

Request for CHAMPUS Benefits Under the Program for the Handicapped

DEC 1989

DD2533

Request for CHAMPUS Benefits Under the Basic Program

DEC 1989

DD2534

Home Health Care Demonstration Inpatient Costs VS. Home Health Care Costs (Stocked and Issued by OCHAMPUS/DA)

CANCELLED

DD2535

Request for Military Aerial Support

OCT 2010

DD2536

Request for Armed Forces Participation in Public Events (Non- Aviation)

OCT 2010

DD2537

Visual Information Caption Sheet

FEB 1994

DD2538

Voluntary Leave Transfer Program Leave Donor Application

MAY 1989

DD2539

Voluntary Leave Transfer Program Leave Recipient Application

MAY 1989

DD2540

Voluntary Leave Transfer Program Notice of Termination of Medical Emergency

MAY 1989

DD2541

Diagnostic Evaluation, Program for the Handicapped

NOV 1989

DD2542

Certificate of Appreciation for Service in the Armed Forces of the United States

MAY 2001

DD2543

Government Furnished Material (GFM) Status Report

SEP 1999

DD2544

Diving Log

NOV 1989

DD2545

Frozen Desserts Plant Sanitary Compliance Checklist

CANCELLED

DD2546

Meat Processing Plant Sanitary Compliance Checklist

CANCELLED

DD2547

Ice Plant Sanitary Compliance Checklist

CANCELLED

DD2548

Health Insurance Coverage for Military Dependents and Retirees, Survey of

CANCELLED

DD2549

General and Flag Officer Position Data

CANCELLED

DD2550

General and Flag Officer Incumbent Data

CANCELLED

DD2551

Workload Management System for Nursing - General Worksheet

FEB 1992

DD2552

Workload Management System for Nursing - Psychiatric Worksheet

FEB 1992

DD2553

Request for Defense Intelligence Special Career Automated System (DISCAS) Referral List

CANCELLED

DD2554-1

Product Drawings and Associated Lists

DEC 1989

DD2554-2

Conceptual Design Drawings and Associated Lists

DEC 1989

DD2554-3

Developmental Design Drawings and Associated Lists

DEC 1989

DD2554-4

Commercial Drawings and Associated Lists

DEC 1989

DD2554-5

Special Inspection Equipment Drawings and Associated Lists

DEC 1989

DD2554-6

Special Tooling Drawings and Associated Lists

DEC 1989

DD2554-7

Military Specifications

DEC 1989

DD2554-8

Program Peculiar Specifications

DEC 1989

DD2555

Blood Bank Operational Report, Armed Services Blood Program

APR 1993

DD2556

Move-In Housing Allowance Claim Form

MAY 1999

DD2557

Plant Replacement Value (PRV) - FY 19__

FEB 1990

DD2558

Authorization to Start, Stop, or Change an Allotment

SEP 2002

DD2559

Savings Bond Allotment Authorization/Active Duty or Retired Pay

MAR 1990

DD2560

Advance Pay Certification/Authorization

MAR 1990

DD2561

Selected Data Concerning Medical Care Provided At Mixed Military Medical Facilities

CANCELLED

DD2562

Direct Hire Employment, Department of Defense

CANCELLED

DD2563

Right to Financial Privacy Act of 1978 Annual Report for CY___, Department of Defense

CANCELLED

DD2564

Annual Freedom of Information Act Report

JUL 2013

DD2565

Semi-Annual Disciplinary Report

CANCELLED

DD2566

Assistance Award Action Report, DoD

SEP 1998

DD2567

Pearl Harbor Commemorative Medal Application/Information

CANCELLED

DD2568

Defense Instructional Technology Information System (DITIS) Report

CANCELLED

DD2569

Third Party Collection Program/Medical Services Account/Other Health Insurance

JUL 2013

DD2570

Third Party Collection Program - Report on Program Results

JUN 2001

DD2571

Third Party Collection Program - Aging Schedule

FEB 1991

DD2572

Permanent Change of Station (PCS) Package Transfer Actions

CANCELLED

DD2573

Senior Executive Service (SES) Recertification

CANCELLED

DD2574

Armed Forces Exchange Services Identification and Privilege Card

MAR 2000

DD2575

Industrial Base Program Production Capacity Survey, Department of Defense

CANCELLED

DD2575-1

Industrial Base Program Crisis Production Survey, Department of Defense

CANCELLED

DD2575-2

Industrial Base Program Industrial Facility Survey, Department of Defense

CANCELLED

DD2576

Bone Marrow Donor Program Donor Information and Health Screening, DoD

MAY 1991

DD2577

Bone Marrow Donor Program Consent to Donate Bone Marrow - MLC Stage, DoD

MAY 1991

DD2578

Bone Marrow Donor Program Intent to Donate Bone Marrow, DoD

MAY 1991

DD2579

Small Business Coordination Record

DEC 2000

DD2580

Operation Transition Department of Defense Outplacement Referral System/Public and Community Service Individual Application

CANCELLED

DD2580-94ED

Operation Transition -Department of Defense Outplacement and Referral System/Public and Community Service Individual Application

CANCELLED

DD2580C

Operational Transition Department of Defense Outplacement Referral System/Public and Community Service Individual Application (Continuation)

CANCELLED

DD2581

Operation Transition Employer Registration

CANCELLED

DD2581-1

Public and Community Service Organization Validation

CANCELLED

DD2582

Job Opportunity Bank Service Job Referral Worksheet, DoD

CANCELLED

DD2584

Claim for Persian Gulf Conflict Death Gratuity Benefits

CANCELLED

DD2585

Repatriation Processing Center Processing Sheet

DEC 2007

DD2586

Verification of Military Experience and Training

JAN 2010

DD2587

Acquisition Corps - Certificate of Admission, Department of Defense

JUL 1998

DD2588

Acquisition Corps - Waiver Request, Department of Defense

CANCELLED

DD2589

Acquisition Position Restricted to Member of the Armed Forces

JUL 1998

DD2590

Distribution Request for OSD and Joint DoD Components (Stocked & Issued by OSD/WHS/C&D)

CANCELLED

DD2591

Contracting Officer - Waiver Request, Department of Defense

CANCELLED

DD2592

Waiver of Assignment Period in Critical Acquisition Positions, Department of Defense

CANCELLED

DD2593

Waiver of Assignment Period for Program Managers/Deputy Program Managers, Department of Defense

CANCELLED

DD2594

Separation Pay Worksheet

CANCELLED

DD2595

Program Manager/Deputy Program Manager - Waiver Request, Department of Defense

CANCELLED

DD2597

Program Executive Officer - Waiver Request, Department of Defense

CANCELLED

DD2599

DoD General/Flag Officer/Civilian Equivalent - Critical Acquisition Position Assignment Waiver Request

CANCELLED

DD2600

Report of DoD Passports and Passport Agent Services

CANCELLED

DD2601

Senior Contracting Official - Waiver Request, Department of Defense

CANCELLED

DD2602

Critical Acquisition Position - Rotation Review Summary, Department of Defense

JUL 1998

DD2603

Officer Promotion Rate Comparisons

JUL 1998

DD2604

Notification of Substantial Impact

CANCELLED

DD2605

Annual Summary of Operations, Department of Defense Child Development Program

DEC 2002

DD2606

Request for Care Record, Department of Defense Child Development Program

JUL 1998

DD2607

Third Party Collection Program - Collection Source Analysis

SEP 1992

DD2608

Third Party Collection Program - Insurance Type Report

CANCELLED

DD2609

Reserve Officers Training Corps Resources Summary Report

JUN 2000

DD2610

Reserve Officers Training Corps Manpower Resources

JUN 2000

DD2611

Reserve Officers Training Corps Enrollment Data

JUN 2000

DD2612

Reserve Officers Training Corps Scholarship Data

CANCELLED

DD2613

Reserve Officers Training Corps Nonscholarship Data

CANCELLED

DD2614

Reserve Officers Training Corps Commissions

CANCELLED

DD2615

Supplemental Training in Support of Reserve Officers Training Corps

CANCELLED

DD2616

Advance Change/Study Notice (ACSN)

CANCELLED

DD2617

Engineering Release Record (ERR)

MAR 2013

DD2617C

Engineering Release Record (ERR) (Continuation Sheet)

AUG 2013

DD2618

Survivor Benefit Plan (SBP) Open Enrollment Election

CANCELLED

DD2619

Military Working Dog Master Problem List

JUN 2013

DD2620

Request for Laboratory Determination of Rabies

AUG 2013

DD2621

Veterinary Vaccination and Trilingual Health Certificate

JUN 1992

DD2622

Animal Release

JUN 2013

DD2623

Animal Home Quarantine

JUN 2013

DD2624

Specimen Custody Document - Drug Testing

FEB 1998

DD2625

Controlled Cryptographic Item (CCI) Briefing

OCT 1996

DD2626

Performance Evaluation (Construction)(DoD Exception to SF 1420)

JUN 1994

DD2627

Request for Government Approval for Aircrew Qualifications and Training

APR 2006

DD2628

Request for Approval of Contractor Flight Crewmember

APR 2006

DD2630

Software Description Annotated Outline

AUG 1992

DD2631

Performance Evaluation (Architect-Engineer) (DoD Exception to SF 1421)

APR 1999

DD2632

Medical Examination Review Board (DoDMERB) Body Fat Determination

CANCELLED

DD2635

Korean Conflict Prisoner of War (POW) Claim (Stocked & Issued by OASD(FM&P))

CANCELLED

DD2636

Child Development Program, Department of Defense Certificate to Operate the (Stocked & Issued by OUSD(P&R))

JUN 2003

DD2637

Physical Security Evaluation Guide (Stocked & Issued by OASD (FM&P)(SO/LIC/CT)

JAN 1993

DD2638

Waterside Security Evaluation Guide (Stocked & Issued by OASD(FM&P) (SO/LIC/CT)

JAN 1993

DD2641

Trafficability Test Data

AUG 1993

DD2642

CHAMPUS Claim Patient's Request for Medical Payment

APR 2007

DD2643

High Cost Foreign Lease

SEP 1993

DD2644

Voter Registration Application

CANCELLED

DD2645

Voter Registration Information

NOV 2008

DD2646

School Age Care Program Annual Summary of Operations, Department of Defense

DEC 2002

DD2647

Reimbursable Project Worksheet

JAN 1993

DD2648 TEST

Preseparation Counseling Checklist for Active Component (AC) Service Members

JAN 2011

DD2648-1 TEST

Transition Assistance Program (TAP) Checklist for Deactivationg / Demobilizing National Guard and Reserve Service Members

JAN 2011

DD2652

Application for Department of Defense Child Care Fees

JUN 2009

DD2653

Involuntary Allotment Application

NOV 2007

DD2654

Involuntary Allotment Notice and Processing

DEC 1999

DD2655

Complaint of Discrimination in the Federal Government

JUN 2012

DD2656

Data for Payment of Retired Personnel

APR 2009

DD2656-1

Survivor Benefit Plan (SBP) Election Statement for Former Spouse Coverage

APR 2009

DD2656-2

Survivor Benefit Plan (SBP) Termination Request

APR 2009

DD2656-3

Survivor Benefit Plan (SBP) and Reserve Component Survivor Benefit Plan (RCSBP) Open Enrollment Election

CANCELLED

DD2656-4

Verification for Annuity

CANCELLED

DD2656-4(PHS)

Verification for Annuity (U.S. Public Health Service)

CANCELLED

DD2656-5

Reserve Component Survivor Benefit Plan (RCSBP) Election Certificate

AUG 2011

DD2656-6

Survivor Benefit Plan Election Change Certificate

APR 2009

DD2656-7

Verification for Survivor Annuity

APR 2009

DD2656-8

Survivor Benefit Plan (SBP) Automatic Coverage Fact Sheet

OCT 2003

DD2656-9

Survivor Benefit Plan (SBP) and Reserve Component Survivor Benefit Plan (RCSBP) Open Enrollment Election

CANCELLED

DD2656-10

Survivor Benefit Plan (SBP) / Reserve Component (RC) SBP Request for Deemed Election

APR 2009

DD2656-11

Statement Certifying Number of Months of Survivor Benefit Plan (SBP) Premiums Paid

CANCELLED

DD2657

Daily Statement of Accountability

AUG 1993

DD2658

Returned and Undeliverable Check/Bond Record

AUG 1993

DD2659

Voucher Control Log

AUG 1993

DD2660

Statement of Claimant Requesting Recertified Check

JUN 2012

DD2661

Spoiled/Control Check Record

CANCELLED

DD2662

Recertified Check Register

FEB 2001

DD2663

Foreign Currency Control Record

AUG 1993

DD2664

Currency Exchange Record

FEB 2002

DD2665

Daily Agent Accountability Summary

AUG 1993

DD2666

Transmittal of Statements and Vouchers

AUG 1993

DD2667

Subsidiary Accountability Record

AUG 1993

DD2668

Request for Bid (Purchase/Sale)

AUG 1993

DD2669

Destruction Schedule for Currency

AUG 1993

DD2670

Automated Teller Machine (ATM) Safekeeping Ledger

AUG 2000

DD2671

Disbursing Office ATM Cash Transaction Ledger

CANCELLED

DD2672

Automated Teller Machine (ATM) Cash Balance Sheet

CANCELLED

DD2673

Record of ATM System Manual Withdrawals

CANCELLED

DD2674

Record and Receipt of Deposits and Withdrawals of Safekeeping Funds

SEP 2007

DD2675

Reimbursement Request for Adoption Expenses

SEP 2006

DD2676

Validation of Public or Community Service Employment

CANCELLED

DD2677

Blood Lead Level Reporting, Department of Defense

JUN 1993

DD2678

Well Driller's Log

OCT 1993

DD2679

Piping and Casing Log

OCT 1993

DD2680

Military Water Well Completion Summary Report

OCT 1993

DD2682

Disability Job Fair Questionnaire, Department of Defense (Stocked & Used by WHS(P&S))

SEP 1993

DD2683

Design Criteria Summary Worksheet

FEB 1994

DD2684

Asset Value/Aggressor Likelihood Worksheet

FEB 1994

DD2685

Tactic and Threat Severity Level Worksheet

FEB 1994

DD2686

Forced Entry Design Worksheet

FEB 1994

DD2687

Sitework Elements Cost Worksheet

FEB 1994

DD2688

Building Elements Cost Worksheet

FEB 1994

DD2690

Claim for Special Death Gratuity Benefits (Stocked & Issued by OUSD(P&R)(MPP))

CANCELLED

DD2691

Contractor Bulk Liquid Facilities Report (Stocked & Issued by OUSD(AT&L(DFSC-OP))

SEP 1994

DD2692

Direct Supply Natural Gas Data Requirements

SEP 1994

DD2693

Certificate to Operate the School Age Care Program, Department of Defense (Stocked & Issued by OUSD(P&R)(PFS&E))

JUN 2003

DD2695

Environmental Protection Agency Certification Program Certificate for Processing CFC/HCFC Refrigerants, Department of Defense

SEP 1994

DD2696

Environmental Protection Agency Certification Program CFC/HCFC Refrigerant Processing Certificate Verification, Department of Defense

SEP 1994

DD2697

Medical Assessment, Report of

FEB 1995

DD2698

Transitional Compensation, Application for

JAN 1995

DD2701

Initial Information for Victims and Witnesses of Crime

AUG 2013

DD2702

Court-Martial Information for Victims and Witnesses of Crime

MAY 2004

DD2703

Post-Trial Information for Victims and Witnesses of Crime

MAY 2004

DD2704

Victim/Witness Certification and Election Concerning Prisoner Status

MAR 2013

DD2705

Notification to Victim/Witness of Prisoner Status

MAR 2013

DD2706

Annual Report on Victim and Witness Assistance

MAR 2013

DD2707

Confinement Order

MAR 2013

DD2707-1

Department of Defense Report of Result of Trial

MAR 2013

DD2708

Receipt for Pre-Trial/Post Trial Prisoner or Detained

MAR 2013

DD2709

Privacy Act Statement

CANCELLED

DD2710

Prisoner Background Summary

MAR 2013

DD2710-1

Prisoner Sentence Computation

MAR 2013

DD2711

Initial Custody Classification

MAR 2013

DD2711-1

Custody Reclassification

MAR 2013

DD2711-2

Custody Initial/Reclassification Summary Addendum

CANCELLED

DD2712

Prisoner Evaluation

MAR 2013

DD2713

Prisoner Observation Report

MAR 2013

DD2714

Prisoner Disciplinary Report/Action

MAR 2013

DD2715

Clemency/Parole Submission

MAR 2013

DD2715-1

Disposition Board Recommendation

MAR 2013

DD2715-2

Prisoner Summary Data

MAR 2013

DD2715-3

Prisoner Restoration/Return to Duty, Clemency and Parole Statement

MAR 2013

DD2716

Parole Acknowledgement Letter

MAR 2013

DD2716-1

Department of Defense Certificate of Supervised Release

MAR 2013

DD2717

Department of Defense Voluntary/Involuntary Appellate Leave Action

MAR 2013

DD2718

Prisoner Release Order

MAR 2013

DD2719

Correctional Facility Continuation Sheet

MAR 2013

DD2720

Annual Correction Report

MAR 2013

DD2720-1

Annual Clemency/Parole Report

CANCELLED

DD2721

Service Academy Resources Summary Report

CANCELLED

DD2722

Academy Capitalized Investments Report

CANCELLED

DD2723

Academy Manpower Resources Report

CANCELLED

DD2724

Academy Class Demographics Data

CANCELLED

DD2725

Academy Commissioning Data

CANCELLED

DD2726

Academy Administration/Faculty Demographic Data

CANCELLED

DD2727

Academy Preparatory School Enrollment Data

CANCELLED

DD2728

Academy Preparatory School Administration/Faculty Demographic Data

CANCELLED

DD2729

National Security Education Program (NSEP) Proposal Budget Estimate Worksheet (Stocked & Used by NDU)

CANCELLED

DD2730

National Security Education Program (NSEP) Proposal Cover Sheet (Stocked & Used by NDU)

CANCELLED

DD2731

ORGAN and Tissue Donor Card

MAR 1995

DD2732

Central Referral System (CRS) Registration (Stocked & Issued by OUSD(AT&L))

APR 1995

DD2733

Chemical Weapons Exposure Data Collection (Stocked & Issued by OUSD(P&R))

CANCELLED

DD2734/1

Contract Performance Report, Format 1 Work Breakdown Structure

APR 2005

DD2734/2

Contract Performance Report, Format 2 Organizational Categories

APR 2005

DD2734/3

Contract Performance Report, Format 3 Baseline

APR 2005

DD2734/4

Contract Performance Report, Format 4 Staffing

APR 2005

DD2734/5

Contract Performance Report, Format 5 Explanations and Problem Analyses

APR 2005

DD2735

Cost/Schedule Status Report

CANCELLED

DD2736

Chemical Weapons Research Commendation (Stocked & Issued by OUSD(P&R))

CANCELLED

DD2737

Industrial Capabilities Questionnaire

SEP 2007

DD2737/1

Industrial Capabilities Questionnaire Section 1 - Facility Description

CANCELLED

DD2737/2

Industrial Capabilities Questionnaire Section 2 - Business Profile

CANCELLED

DD2737/3

Industrial Capabilities Questionnaire Section 3 - Labor

CANCELLED

DD2737/4

Industrial Capabilities Questionnaire Section 4 - Material Issues

CANCELLED

DD2737/5

Industrial Capabilities Questionnaire Section 5 - Production Capabilities of Facility

CANCELLED

DD2737/6

Industrial Capabilities Questionnaire Section 6 - Technology

CANCELLED

DD2737/7

Industrial Capabilities Questionnaire Section 7 - Customer Base

CANCELLED

DD2737/8

Industrial Capabilities Questionnaire Section 8 - Manufactured Item

CANCELLED

DD2738

Substance Classification Test Results

CANCELLED

DD2739

Ammunition Classification Test Results

CANCELLED

DD2740

Based Reuse Status (Stocked and Issued by OUSD(AT&L))

MAY 2005

DD2741

Ecclesiastical Endorsing Organization Verification/Reverification Information, Department of Defense

CANCELLED

DD2742

Optical Archive History Log

FEB 1996

DD2743

Optical/Tape Inventory

FEB 1996

DD2744

Emergency/Auxiliary Generator Operating Log

MAY 1996

DD2745

Enemy Prisoner of War (EPW) Capture Tag

MAY 1996

DD2746

Ready Reserve Mobilization Income Insurance Certificate

CANCELLED

DD2747

Department of Defense Export Loan Guarantee Application (Stocked & Issued by OUSD(AT&L))

CANCELLED

DD2748

Depot Capacity and/or Utilization Summary Sheet (Stocked & Issued by OUSD(AT&L))

DEC 1996

DD2749

Technical Assistance for Public Participation (TAPP) Application

OCT 2003

DD2750

Department of Defense Civilian Identification Card

CANCELLED

DD2750S

Department of Defense Civilian Identification Card (Purple)

CANCELLED

DD2751

463L System Pallet and Net Control Report (Stocked and issued by OUSD(AT&L))

OCT 1997

DD2752

National Security Education Program (NSEP) Service Agreement for Scholarship and Fellowship Awards

OCT 2011

DD2753

National Security Education Program (NSEP) Service Agreement Report (SAR) for Scholarship and Fellowship Awards

OCT 2011

DD2754

Junior Reserve Officer Training Corps (JROTC) Instructor Pay Certification Worksheet for Entitlement Computation

SEP 2007

DD2755

Weight-Based Assessment of Military Postal Service - Incoming

MAY 1997

DD2756

Weight-Based Assessment of Military Postal Service - Outgoing

MAY 1997

DD2757

Welding Examination Record

JUN 1997

DD2758

Welding Certification Card

JUN 1997

DD2759TEST

Report of Other Transactions for Prototype Projects

DEC 2000

DD2760

Qualification to Possess Firearms or Ammunition

DEC 2002

DD2761

Personal Check Cashing Agreement

APR 2007

DD2762

Direct Deposit Authorization

CANCELLED

DD2764

United States DoD/Uniformed Services Civilian Geneva Conventions Identification Card

APR 1998

DD2764S

United States DoD/Uniformed Services Civilian Geneva Conventions Identification Card (TAN)

CANCELLED

DD2765

Department of Defense/Uniformed Services Identification and Privilege Card

APR 1998

DD2765S

Department of Defense/Uniformed Services Identification and Privilege Card (TAN)

CANCELLED

DD2766

Adult Preventive and Chronic Care Flowsheet

MAR 1998

DD2766C

Adult Preventive and Chronic Care Flowsheet (Continuation Sheet)

MAR 1998

DD2767

Junior Reserve Officer Training Corps (JROTC) Instructor Annual Certification of Pay and Data

SEP 2007

DD2768

Military Air Passenger/Cargo Request

MAR 1998

DD2769

Application for Annuity - Certain Military Surviving Spouses

OCT 2012

DD2770

Abbreviated Medical Record

APR 1998

DD2772

Contract Discrepancy Report

SEP 1998

DD2773

Report of Contractor Services

SEP 1998

DD2774

Cold War Certificate of Recognition

JUL 2001

DD2775

Pallet Identifier

SEP 1998

DD2776

Dangerous Cargo Load List

SEP 1998

DD2777

Mobilization Movement Control (MOBCON) Request for Convoy Clearance or Special Hauling Permit

SEP 1998

DD2778

Travelope

SEP 1998

DD2780

Port Call Request - Fax Sheet (Passenger Reservation Center)

SEP 1998

DD2781

Container Packing Certificate or Vehicle Packing Declaration

AUG 2013

DD2782

Request for Shipment of Privately Owned Vehicle (POV) Through CONUS Alternate Port

CANCELLED

DD2783

Request for Privately Owned Vehicle (POV) Shipment - Change in Home Port

CANCELLED

DD2784

Letter of Intent (LOI) Household Goods or Unaccompanied Baggage

NOV 2008

DD2787

Certificate of Warehouseman's Legal Liability Insurance

SEP 1998

DD2788

Child Annuitant's School Certification

NOV 2005

DD2789

Waiver/Remission of Indebtedness Application

MAY 2008

DD2790

Custodianship Certificate to Support Claim on Behalf of Minor Children of Deceased Members of the Armed Forces

NOV 2005

DD2791

Notice of Release/Acknowledgement of Convicted Sex Offender Registration Requirements

MAR 2013

DD2791-1

Prisoner's Acknowledgement of Sex Offender Registration Requirements

CANCELLED

DD2792

Family Member Medical Summary

APR 2011

DD2792-1

Special Education/Early Intervention Summary

APR 2011

DD2793

Volunteer Agreement for Appropriated Fund Activities & Non Appropriated Fund Instrumentalities

MAY 2009

DD2794

Cost and Software Data Reporting (CSDR) Plan

MAY 2011

DD2795

Pre-Deployment Health Assessment (PDHA)

SEP 2012

DD2796

Post-Deployment Health Assessment

SEP 2012

DD2797

TRICARE Senior Prime Enrollment Application (Stocked & Issued by OASD(HA))

DEC 2000

DD2798

Application/Permit for Use of Space on the Pentagon Reservation

DEC 1999

DD2799

Employee Performance Plan and Results Report

NOV 2012

DD2800

Suggestion Evaluation

JUL 1999

DD2807-1

Report of Medical History

AUG 2011

DD2807-2

Medical Prescreen of Report of Medical History

AUG 2011

DD2808

Report of Medical Examination

OCT 2005

DD2809

Agreement to be Signed by Person Authorized to Direct Disposition (PADD) Prior to Private DNA Testing

NOV 1999

DD2810

Personnel Recovery Debriefing Statement

OCT 2006

DD2811

Report of Proceedings by Initial/Subsequent Board of Inquiry or Further Review Board

NOV 1999

DD2812

Commander's Preliminary Assessment and Recommendation Regarding Missing Person

NOV 1999

DD2813

Department of Defense Active Duty/Reserve/Guard/Civilian Forces Dental Examination

OCT 2013

DD2814

Pharmacy Redesign Pilot Program

NOV 2000

DD2815

Alternative Dispute Resolution (ADR) Program Annual Report

MAY 2000

DD2816

Consent for Search and Seizure

OCT 2000

DD2817

Evidence Custody Document

OCT 2000

DD2818

Civilian Rights Advisement Form

OCT 2000

DD2819

Affiliation Agreement

OCT 2000

DD2820

Military Rights Advisement Form

OCT 2000

DD2821

Special Access Program Security Termination Guide

CANCELLED

DD2822

Special Access Program Initial Security Briefing

CANCELLED

DD2823

Command Authorization for Search and Seizure

OCT 2000

DD2824

Voluntary Sworn Statement

OCT 2000

DD2825

Internal Receipt

JUN 2000

DD2826

Trustee Report

MAR 2007

DD2827

Application for Trusteeship

MAR 2007

DD2828

Physician Certification for Child Annuitant

NOV 2006

DD2829

Customer Wait Time Report

NOV 2000

DD2830

General Talent Release

OCT 2000

DD2831

General Release Where Talent Fee or Other Remuneration or Recompense Accrues to the Participant

OCT 2000

DD2832

Release Granting the U.S. Government Permission to Photograph or Otherwise Record the Visual Image or Sound of Private Property

OCT 2000

DD2833

Release Granting the U.S. Government Permission to Record and Reproduce Program Material Transmitted by Educational or Commercial Broadcast Stations

OCT 2000

DD2834

Veterinary Consultation Request

SEP 2002

DD2835

Program Access Request

DEC 2000

DD2836

Special Access Program Indoctrination Agreement

DEC 2000

DD2837

Continued Health Care Benefit Program (CHCBP) Application

MAY 2010

DD2839

Career Status Bonus Election

APR 2009

DD2840

Request for Information Regarding Deceased Debtor

JUN 2008

DD2841

DoD Public Key Infrastructure (PKI) Registration Official Certificate Acceptance and Acknowledgement of Responsibilities

AUG 2009

DD2842

DoD Public Key Infrastructure (PKI) Subscriber Certificate Acceptance and Acknowledgement of Responsibilities

AUG 2009

DD2843

Classified Material Destruction Record

SEP 2001

DD2844TEST

Post Deployment Medical Assessment

MAR 2002

DD2845

U. S. Department of Defense (National Capital Region) Mass Transportation Benefit Program Application

OCT 2007

DD2846

Contractor Performance Assessment Report (CPAR) - Services Information Technology Operations Support

SEP 2002

DD2847

Contractor Performance Assessment Report (CPAR) - Ship Repair & Overhaul

SEP 2002

DD2848

Contractor Performance Assessment Report (CPAR) - Systems

SEP 2002

DD2851

Request to Correct Thrift Savings Plan Agency Error

NOV 2001

DD2852

Patient Movement Event/Near Miss Report

FEB 2011

DD2853

TRICARE Plus Enrollment Application

FEB 2014

DD2854

TRICARE Plus Disenrollemnt Request

FEB 2014

DD2855

U.S. Military Agriculture and Customs Preclearance Program

SEP 2006

DD2856

DoD Semi-Annual Program Review/Facility Inspection Checklist

MAY 2012

DD2857

Family Subsistence Supplemental Allowance Application

MAY 2009

DD2858

Visual Information Activity Profile

MAY 2004

DD2859

Foreign Activities Questionnaire

JUL 2005

DD2860

Claim for Combat-Related Special Compensation (CRSC)

JUL 2011

DD2861

Cross-Reference

JUN 2003

DD2862

Age 18 Notice - SBP Child Coverage Certification

JUL 2003

DD2863

National Call to Service (NCS), Election of Options

APR 2006

DD2864

VSI Beneficiary Designation

SEP 2003

DD2865

Service Record Information Request

CANCELLED

DD2866

Retiree Change of Address Request/State Tax Withholding Authorization

NOV 2003

DD2867

Income Tax Adjustment Certificate

JUN 2012

DD2868

Request for Withholding (Stocked and Issued by DFAS)

DEC 2003

DD2869

Defense Finance and Account Service 1099-MISC Tax Reporting Program System Access Request

DEC 2007

DD2870

Authorization for Disclosure of Medical or Dental Information

DEC 2003

DD2871

Request to Restrict Medical and Dental Information

DEC 2003

DD2872 Test

Depleted Uranium (DU) Questionnaire

FEB 2004

DD2872-1 Test

Health Survey

FEB 2004

DD2873

Military Protective Order (MPO)

JUL 2004

DD2874

Certificate to Operate Youth Program (Stocked and Issued by OUSD(P&R))

JUL 2004

DD2875

System Authorization Access Request (SAAR)

AUG 2009

DD2876

TRICARE Prime Enrollment, Disenrollment and Primary Care Manager (PCM) Change Form

MAY 2013

DD2877

TRICARE Prime Disenrollemnt Application

CANCELLED

DD2878

Department of Defense Youth Program Inspection Checklist

JUL 2004

DD2879

A Reminder About Your Claim Form

APR 2004

DD2880

Social Security Offset Fact Sheet

CANCELLED

DD2881

NATO Secret (Label)

MAY 2004

DD2882

Pediatric and Adolescent Preventive and Chronic Care Flowsheet

JUN 2004

DD2883

Credit Worthiness Evaluation

JUL 2004

DD2884

DoD Youth Program Annual Summary of Operations

JUL 2004

DD2885

Personal Commercial Solicitation Evaluation

APR 2006

DD2886

Social Security Administration Statement (Annual Recertification)

CANCELLED

DD2887

Application for the Department of Defense (DoD) Stored Value Card (SVC) Programs

FEB 2009

DD2888

Critical Acquisition Position Service Agreement

JUL 2005

DD2889

Critical Acquisition Position Service Agreement Key Leadership Position (KLP)

JUL 2005

DD2890

DoD Multimodal Dangerous Goods Declaration

AUG 2013

DD2890C

DoD Multimodal Dangerous Goods Declaration (Continuation Sheet)

OCT 2005

DD2891

Authorization for Retired Serviceman's Family Protection Plan (RSFPP) and/or Survivor Benefit Plan (SBP) Costs Deduction

OCT 2005

DD2892

Certificate of Eligibility for Retired Members

MAR 2005

DD2893

Victim Advocate Safety Plan

MAR 2005

DD2894

Designation of Beneficiary Information

MAR 2005

DD2895

Agreement to Serve in the Selected Reserve for TRICARE Reserve Select

CANCELLED

DD2896

TRICARE Reserve Select (TRS) Request Form

JUL 2006

DD2896-1

Reserve Component Health Coverage Request (Stocked and Issued by OASD(HA)/TMA)

JUL 2010

DD2897

Former Spouse Distribution Statement

MAY 2006

DD2898

Department of Defense Senior Professional Pay and Performance Appraisal

AUG 2009

DD2899

Department of Defense Executive Pay and Performance Appraisal

AUG 2009

DD2900

Post Deployment Health Reassessment

SEP 2012

DD2901

Child Abuse or Domestic Violence Related Fatality Notification

MAY 2012

DD2902

Claim for Reimbursement and Payment Voucher for Privately-Purchased Protective, Safety, or Health Equipment Used in Combat

CANCELLED

DD2903-1

Voluntary Separation Incentive Pay Agreement Lump Sum Payment

OCT 2005

DD2903-2

Voluntary Separation Incentive Pay Agreement Bi-Weekly Installment Payment

OCT 2005

DD2903-3

Voluntary Separation Incentive Pay Agreement 6-Month Installment Payment

OCT 2005

DD2904

Application for Voluntary Separation Incentive Pay Under VSIP Phase II

OCT 2005

DD2905

Acquisition, Technology, and Logistics (AT&L) Workforce Position Requirements or Tenure Waiver

DEC 2005

DD2906

Department of Defense National Security Personnel System (NSPS) Performance Appraisal

SEP 2008

DD2906D

Defense Civilian Intelligence Personnel System (DCIPS) Performance Appraisal

OCT 2011

DD2907

Retired Pay Distribution Statement

MAY 2006

DD2908

Propellants Delivery/Services Task Schedule (PDST)

MAY 2006

DD2909

Victim Advocate and Supervisor Statements of Understanding

JUN 2006

DD2910

Victim Reporting Preference Statement

MAY 2013

DD2911

DoD Sexual Assault Forensic Examination Report

SEP 2011

DD2912

Claim for Temporary Quarters Subsistence Expense (TQSE) (Sub-voucher)

JUN 2006

DD2913

Missile Propellants Consolidation and Reporting of Sales

NOV 2006

DD2914

Record of Receipts of Missile Propellants

NOV 2006

DD2915

Propellant Servicing Unit Record

NOV 2006

DD2916

Forecast of Sales Requirements - Missile Propellants and Pressurants

NOV 2006

DD2917

Physical Inventory (Fuels/Missile Propellants)

NOV 2006

DD2918

National Security Personnel System (NSPS) Position Description

JUL 2006

DD2919

Reserve Income Replacement Program (RIRP) Eligibility Verification

JUL 2006

DD2920

DoD MILSPETS DFSP Transfer of Account Document

DEC 2008

DD2921

Physical Inventory Petroleum Products

DEC 2008

DD2921C

Physical Inventory Petroleum Products (Continuation Sheet)

JUN 2009

DD2922

Forensic Laboratory Examination Request

JUL 2006

DD2923

Privacy Act Data Cover Sheet

SEP 2010

DD2924

Monthly Inventory Transactions Report (Missile Propellants)

NOV 2006

DD2925

Missile Fuels/Propellants Inventory Summary Sheet

NOV 2006

DD2926

Annual Foreign Area Officer (FAO) Metrics Report Data Input

OCT 2007

DD2927

Petroleum and Lubricants Sample Identification Tags

JUL 2007

DD2928

Defense Civilian Pay System (DCPS) Payroll Office Access Form

JAN 2014

DD2929

Defense Civilian Pay System (DCPS) Non-Payroll Office Access Form

JAN 2014

DD2930

Privacy Impact Assessment (PIA)

NOV 2008

DD2930A

Adapted Privacy Impact Assessment (PIA)

AUG 2011

DD2931

Chemical, Biological, Radiological, and Nuclear (CBRN) Mission Critical Report

AUG 2009

DD2932

National Language Service Corps Pilot Application

SEP 2009

DD2933

National Language Service Corps (NLSC) Pilot Detailed Skills Self-Assessment

SEP 2009

DD2934

National Language Service Corps (NLSC) Pilot GLOBAL Language Self-Assessment

SEP 2009

DD2935

National Language Service Corps (NLSC) Pilot Language Data Sheet

SEP 2009

DD2936

Request for Approval of DoD Internal Information Collection

JAN 2014

DD2936-1

Request for Sponsorship Transfer of DoD Internal Information Collection

APR 2012

DD2937

Election of Retirement Coverage for Reemployed Civil Service Retirement System (CSRS) and CSRS-Offset Discontinued Service Retirement (DSR) Annuitants

DEC 2008

DD2938

Election of Retirement Coverage for Reemployed Federal Employees Retirement System (FERS) Discontinued Service Retirement (DSR) Annuitants

DEC 2008

DD2939

NF-6 Performance Manegement System Executive Performance Agreement

AUG 2012

DD2940

Statement of Entitlement to Educational Assistance for Reserve Components Supporting Contingency Operations and Certain National Emergency Response Operations

JAN 2009

DD2941

Statement of Irrevocable Election of Educational Assistance Benefits Based on Qualifying for Educational Assistance

JAN 2009

DD2942-1

Commissioned Officer Selection and Promotion Statistics - Promotions by Competitive Category

JUN 2009

DD2942-2

Commissioned Officer Selection and Promotion Statistics - Promotions by Race, Gender, and Ethnicity

JUN 2009

DD2942-3

Commissioned Officer Selection and Promotion Statistics - Posthumous Commission Report

JUN 2009

DD2943-1

NAF to NAF Retirement Portability Election to Retain Army Nonappropriated Fund (NAF) Retirement Coverage (CNIC Instrumentality)

CANCELLED

DD2943-2

NAF to NAF Retirement Portability Election to Retain Air Force Nonappropriated Fund (NAF) Retirement Coverage (CNIC Instrumentality)

CANCELLED

DD2943-3

NAF to NAF Retirement Portability Election to Retain Air Force Nonappropriated Fund (NAF) Retirement Coverage (Army Instrumentality)

CANCELLED

DD2943-4

NAF to NAF Retirement Portability Election to Retain Commander, Navy Installations Command (CNIC) Nonappropriated Fund (NAF) Retirement Coverage (Air Force)

CANCELLED

DD2943-5

NAF to NAF Retirement Portability Election to Retain Army Nonappropriated Fund (NAF) Retirement Coverage (Air Force Instrumentality)

CANCELLED

DD2944

Claim for Retroactive Stop Loss Payment

MAR 2010

DD2945

Post-Government Employment Advice Opinion Request

JUL 2013

DD2946

Department of Defense Telework Agreement

DEC 2011

DD2947

TRICARE Young Adult Application

NOV 2012

DD2948

Special Compensation for Assistance w/ Activities of Daily Living (SCAADL) Eligibility

SEP 2011

DD2949

Joint Inspector General Action Request

SEP 2011

DD2950

Department of Defense Sexual Assault Advocate Certification Program Application Packet

OCT 2012

DD2951

Initial Report of Suspected Child Sexual Abuse in a DoD Operated or Sponsored Out-of-Home Care Actvities

JUN 2012

DD2952

Closeout Report of Suspected Child Sexual Abuse in DoD Operated or Sponsored Activities

JUN 2012

DD2953

Vietnam War Commemoration Commemorative Partners Program Application (Civilian Organizations only)

DEC 2013

DD2954

Vietnam War Commemoration Commemorative Partners Program Application (Military Installations only)

DEC 2013

DD2955

Vietnam War Commemoration Commemorative Partner Certification

DEC 2013

DD2956

Vietnam War Commemoration Commemorative Events

DEC 2013

DD2957

Vietnam War Commemoration After-Action Report

DEC 2013

DD2958

Service Member's Individual Transition Plan Checklist

AUG 2013

DD2959

Breach of Personally Identifiable Information (PII) Report

FEB 2013

DD2960

DoD Plain Language Compliance

APR 2013

DD2961

DoD Postsecondary Education Complaint Intake

SEP 2013

DD2962

Personnel Security System Access Request (PSSAR) Defense Manpower Data Center (DMDC)

SEP 2013

DD2963

Service Treatment Record (STR) Certification

MAR 2014

DD2964

Security Cooperation Education and Training (SCET) Team Request Form

JUL 2013

DD2965

Defense Sexual Assault Incident Database (DSAID) Data Form

AUG 2013

DD2966

Shelf Life Expired Material

AUG 2013

DD2967

Domestic Abuse Victim Reporting Option Statement

AUG 2013

DD2971

Conditional Employee or Food Employee Reporting Agreement

NOV 2013

DD2972

Food Facility Risk Assessment Survey

NOV 2013

DD2973

Food Operation Inspection Report

NOV 2013

DD2974

Tactical Kitchen Food Sanitation Inspection

NOV 2013

DD2975

Temporary Food Event Coordinator's Application

NOV 2013

DD2978

Deployment Mental Health Assessment

FEB 2014

 
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