Form Information
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FORM NUMBER: DD2548

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TITLE: HEALTH INSURANCE COVERAGE FOR MILITARY DEPENDENTS AND RETIREES, SURVEY OF

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EDITION DATE: 19890901 CANCELLATION DATE: 19980811

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AVAILABLE FILE FORMATS: PLEASE NOTE:
Fillable Adobe: If no hyperlink appears next to a format, the form is not available electronically. To
Perform Pro: obtain hard copies of current forms not available in electronic format, please contact
Form Flow 2.0: your own Military Service or DoD Component Forms Management Officer.
Form Flow 99: Cancelled forms are not available in electronic formats. Click on link for a list of
Other: Forms Management POCs.

Forms Management POCs

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REMARKS: OMB EXPIRED SEP 30, 1992, FORM CANCELED BY OPR 1998/08/11 -- FORM NO LONGER NEEDED
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ISSUANCES: DOD 7750.5-M
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SPONSOR / POC: IG SUB-SPONSOR:
NUMBER OF PAGES: 1
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USERS*: A N AF
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PRESCRIBED OR ADOPTED?: P

DISPOSITION:

FUNCTION CODE: 7750

FORM CONTROLLED: N

MANDATORY PRINT SPECIFICATIONS:

RCS:

IRCN:

OMB: 0704-0301

PRIVACY ACT IMPLICATIONS: Y
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* All revisions and/or cancellations must be coordinated through these USERS.

DISPOSITION: S = Do NOT use previous edition. U = Use previous edition until supply is depleted.