DD 93 Template

DD 93 Template

The DD Form 93, also known as the Record of Emergency Data, is a crucial document used by service members to provide vital information about their emergency contacts and beneficiaries. This form ensures that, in case of an emergency, the military can quickly reach out to the right people and manage important decisions. Understanding how to properly fill out the DD 93 is essential for every service member, so take the first step by clicking the button below to get started.

Table of Contents

The DD 93 form, also known as the Record of Emergency Data, plays a crucial role in ensuring that military personnel have their vital information accurately recorded and readily accessible in case of emergencies. This form serves as a lifeline for service members, allowing them to designate beneficiaries for benefits and provide essential details about their medical and personal preferences. By filling out the DD 93, individuals can specify who should be contacted in the event of an emergency, outline their wishes regarding medical treatment, and ensure that their loved ones are informed and prepared. The importance of this document cannot be overstated, as it not only facilitates communication during critical times but also helps to alleviate stress for both service members and their families. Understanding how to complete the DD 93 form correctly is essential for anyone in the military, as it directly impacts the support and resources available to them and their loved ones in times of need.

DD 93 Sample

RECORD OF EMERGENCY DATA
PRIVACY ACT STATEMENT
AUTHORITY: 5 USC 552, 10 USC 655, 1475 to 1480 and 2771, 38 USC 1970, 44 USC 3101, and EO 9397 (SSN).
PRINCIPAL PURPOSES: This form is used by military personnel and Department of Defense civilian and contractor personnel, collectively referred to
as civilians, when applicable. For military personnel, it is used to designate beneficiaries for certain benefits in the event of the Service member's
death. It is also a guide for disposition of that member's pay and allowances if captured, missing or interned. It also shows names and addresses of
the person(s) the Service member desires to be notified in case of emergency or death. For civilian personnel, it is used to expedite the notification
process in the event of an emergency and/or the death of the member. The purpose of soliciting the SSN is to provide positive identification. All items
may not be applicable.
ROUTINE USES: None.
DISCLOSURE: Voluntary; however, failure to provide accurate personal identifier information and other solicited information will delay notification and
the processing of benefits to designated beneficiaries if applicable.
INSTRUCTIONS TO SERVICE MEMBER
1. NAME (Last, First, Middle Initial) 2. SSN
3a. SERVICE/CIVILIAN CATEGORY
b. REPORTING UNIT CODE/DUTY STATION
4a. SPOUSE NAME (If applicable) (Last, First, Middle Initial) b. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER
5. CHILDREN
a. NAME (Last, First, Middle Initial)
b. RELATIONSHIP
c. DATE OF BIRTH
(YYYYMMDD)
d. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER
DD FORM 93, JAN 2008
PREVIOUS EDITION IS OBSOLETE.
This extremely important form is to be used by you to show the
names and addresses of your spouse, children, parents, and any
other person(s) you would like notified if you become a casualty.
Not every item on this form is applicable to you. This form is used
by the Department of Defense (DoD) to expedite notification in
the case of emergencies or death. It does not have a legal impact
on other forms you may have completed with the DoD or your
employer.
This extremely important form is to be used by you to show the names and
addresses of your spouse, children, parents, and any other person(s) you
would like notified if you become a casualty (other family members or fiance),
and, to designate beneficiaries for certain benefits if you die. IT IS YOUR
RESPONSIBILITY to keep your Record of Emergency Data up to date to show
your desires as to beneficiaries to receive certain death payments, and to
show changes in your family or other personnel listed, for example, as a result
of marriage, civil court action, death, or address change.
INSTRUCTIONS TO CIVILIANS
ARMY NAVY
MARINE CORPS AIR FORCE
CIVILIAN CONTRACTORDoD
SINGLE DIVORCED WIDOWED
Adobe Professional X
IMPORTANT: This form is divided into two sections: Section 1 - Emergency Contact Information and Section 2 - Benefits Related
Information. READ THE INSTRUCTIONS ON PAGES 3 AND 4 BEFORE COMPLETING THIS FORM.
SECTION 1 - EMERGENCY CONTACT INFORMATION
6a. FATHER NAME (Last, First, Middle Initial) b. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER
7a. MOTHER NAME (Last, First, Middle Initial) b. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER
8a. DO NOT NOTIFY DUE TO ILL HEALTH b. NOTIFY INSTEAD
10. CONTRACTING AGENCY AND TELEPHONE NUMBER (Contractors only)
9a. DESIGNATED PERSON(S) (Military only)
b. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER
11a. BENEFICIARY(IES) FOR DEATH GRATUITY
(Military only)
c. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER d. PERCENTAGE
12a. BENEFICIARY(IES) FOR UNPAID PAY/ALLOWANCES
(Military only) NAME AND RELATIONSHIP
b. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER c. PERCENTAGE
13a. PERSON AUTHORIZED TO DIRECT DISPOSITION (PADD)
(Military only) NAME AND RELATIONSHIP
14. CONTINUATION/REMARKS
15. SIGNATURE OF SERVICE MEMBER/CIVILIAN (Include rank, rate,
or grade if applicable)
16. SIGNATURE OF WITNESS (Include rank, rate, or grade
as appropriate)
17. DATE SIGNED
(YYYYMMDD)
b. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER
SECTION 2 - BENEFITS RELATED INFORMATION
DD FORM 93 (BACK), JAN 2008
b. RELATIONSHIP
All entries explained below are for electronic or typewriter
completion, except those specifically noted. If a computer
or typewriter is not available, print in black or blue-black ink
insuring a legible image on all copies. Include "Jr.," "Sr.,"
"III" or similar designation for each name, if applicable.
When an address is entered, include the appropriate ZIP
Code. If the member cannot provide a current address,
indicate "unknown" in the appropriate item. Addresses
shown as P.O. Box Numbers or RFD numbers should
indicate in Item 14, "Continuations/Remarks", a street
address or general guidance to reach the place of
residence. In addition, the notation "See Item 14" should be
included in the item pertaining to the particular next of kin or
when the space for a particular item is insufficient. If the
address for the person in the item has been shown in a
preceding item, it is unnecessary to repeat the address;
however, the name must be entered. Those items that are
considered not applicable to civilians will be left blank.
ITEM 1. Enter full last name, first name, and middle initial.
ITEM 2. Enter social security number (SSN).
ITEM 3a. Service. Military: Mark X in appropriate block.
Civilian: Mark two blocks as appropriate. Examples: an
Army civilian would mark Army and either Civilian or
Contractor; a DoD civilian, without affiliation to one of the
Military Services, would mark DoD and then either Civilian or
Contractor as appropriate.
ITEM 3b. Reporting Unit Code/Duty Station. See Service
Directives.
ITEM 4a. Spouse Name. Enter last name (if different from
Item 1), first name and middle initial on the line provided. If
single, divorced, or widowed, mark appropriate block.
ITEM 4b. Address and Telephone Number. Enter the
"actual" address and telephone number, not the mailing
address. Include civilian title or military rank and service if
applicable. If one of the blocks in 4a is marked, leave blank.
ITEM 5a-d. Children. Enter last name (only if different from
Item 1) first name and middle initial, relationship, and date of
birth of all children. If none, so state. Include illegitimate
children if acknowledged by member or paternity/maternity
has been judicially decreed. Relationship examples: son,
daughter, stepson or daughter, adopted son or daughter or
ward. Date of birth example: 19950704. For children not
living with the member's current spouse, include address
and name and relationship of person with whom residing in
item 5d.
ITEM 6a. Father Name. Last name, first name and middle
initial.
ITEM 6b. Address and Telephone Number of Father. If
unknown or deceased, so state. Include civilian title or
military rank and service if applicable. If other than natural
father is listed, indicate relationship.
DD FORM 93 (INSTRUCTIONS), JAN 2008
INSTRUCTIONS FOR PREPARING DD FORM 93
(See appropriate Service Directives for supplemental instructions for completion of this form at other than MEPS)
ITEM 7a. Mother Name. Last name, first name and middle
initial.
ITEM 7b. Address and Telephone Number of Mother. If
unknown or deceased, so state. Include civilian title or
military rank and service if applicable. If other than natural
mother is listed, indicate relationship.
ITEM 8. Persons Not to be Notified Due to Ill Health.
a. List relationship, e.g., "Mother," of person(s) listed in
Items 4, 5, 6, or 7 who are not to be notified of a casualty
due to ill health. If more than one child, specify, e.g.,
"daughter Susan." Otherwise, enter "None".
b. List relationship, e.g., "Father" or name and address of
person(s) to be notified in lieu of person(s) listed in item 8a.
If "None" is entered in Item 8a, leave blank.
ITEM 9a. This item will be used to record the name of the
person or persons, if any, other than the member's primary
next of kin or immediate family, to whom information on the
whereabouts and status of the member shall be provided if
the member is placed in a missing status. Reference 10
USC, Section 655. NOT APPLICABLE to civilians.
ITEM 9b. Address and telephone number of Designated
Person(s). NOT APPLICABLE to civilians.
ITEM 10. Contracting Agency and Telephone Number
(Contractors only). NOT APPLICABLE to military
personnel. Civilian contractors will provide the name of
their contracting agency and its telephone number.
Example: XYZ Electric, (703) 555-5689. The telephone
number should be to the company or corporation's
personnel or human resources office.
ITEM 11a. Beneficiary(ies) for Death Gratuity (Military
only). Enter first name(s), middle initial, and last name(s)
of the person(s) to receive death gratuity pay. A member
may designate one or more persons to receive all or a
portion of the death gratuity pay. The designation of a
person to receive a portion of the amount shall indicate the
percentage of the amount, to be specified only in 10 percent
increments, that the person may receive. If the member
does not wish to designate a beneficiary for the payment of
death gratuity, enter "None," or if the full amount is not
designated, the payment or balance will be paid as follows:
(1) To the surviving spouse of the person, if any;
(2) To any surviving children of the person and the
descendants of any deceased children by representation;
(3) To the surviving parents or the survivor of them;
(4) To the duly appointed executor or administrator of the
estate of the person;
(5) If there are none of the above, to other next of kin of the
person entitled under the laws of domicile of the person at
the time of the person's death.
The member should make specific designations, as it
expedites payment.
ITEM 11a. (Continued) Seek legal advice if naming a minor
child as a beneficiary. If a member has a spouse but
designates a person other than the spouse to receive all or a
portion of the death gratuity pay, the Service concerned is
required to provide notice of the designation to the spouse.
NOT APPLICABLE to civilians.
Item 11b. Relationship. NOT APPLICABLE to civilians.
ITEM 11c. Enter beneficiary(ies) full mailing address and
telephone number to include the ZIP Code. NOT
APPLICABLE to civilians.
ITEM 11d. Show the percentage to be paid to each person.
Enter 10%, 20%, 30%, up to 100% as appropriate. The sum
shares must equal 100 percent. If no percent is indicated and
more than one person is named, the money is paid in equal
shares to the persons named. NOT APPLICABLE to
civilians.
ITEM 12a. Beneficiary(ies) for Unpaid Pay/Allowance
(Military only). Enter first name(s), middle initial, last
name(s) and relationship of person to receive unpaid pay
and allowances at the time of death. The member may
indicate anyone to receive this payment. If the member
designated two or more beneficiaries, state the percentage
to be paid each in item 10c. If the member does not wish to
designate a beneficiary, enter "By Law." The member is
urged to designate a beneficiary for unpaid pay and
allowances as payment will be made to the person in order
of precedence by law (10 USC 2771) in the absence of a
designation. Seek legal advice if naming a minor child as
beneficiary. NOT APPLICABLE to civilians.
ITEM 12b. Enter beneficiary(ies) full mailing address and
telephone number to include the ZIP Code. NOT
APPLICABLE to civilians.
ITEM 12c. If the member designated two or more
beneficiaries, state the percentage to be paid each in this
section. The sum shares must equal 100 percent. NOT
APPLICABLE to civilians.
ITEM 13a. Enter the name and relationship of the Person
Authorized to Direct Disposition (PADD) of your remains
should you become a casualty. Only the following persons
may be named as a PADD: surviving spouse, blood relative
of legal age, or adoptive relatives of the decedent. If neither
of these three can be found, a person standing in loco
parentis may be named. NOT APPLICABLE to civilians.
INSTRUCTIONS FOR PREPARING DD FORM 93
(Continued)
DD FORM 93 (INSTRUCTIONS) (BACK), JAN 2008
ITEM 13b. Address and telephone number of PADD. NOT
APPLICABLE to civilians.
ITEM 14. Continuations/Remarks. Use this item for remarks
or continuation of other items, if necessary. Prefix entry with
the number of the item being continued; for example, 5/John
J./son/ 19851220/321 Pecan Drive, Schertz TX 78151. Also
use this item to list name, address, and relationship of other
persons the member desires to be notified. Other
dependents may also be listed. This block offers the
greatest amount of flexibility for the member to record other
important information not otherwise requested but
considered extremely useful in the casualty notification and
assistance process. Besides continuing information from
other blocks on this form, the member may desire to include
additional information such as: NOK language barriers,
location or existence of a Will, additional private insurance
information, other family member contact numbers, etc. If
additional space is required, attach a supplemental sheet of
standard bond paper with the information.
ITEM 15. Signature of Service Member/Civilian. Check and
verify all entries and sign all copies in ink as follows: First
name, middle initial, last name. Include rank, rate, or grade
if applicable. May be electronically signed (see DoD
Instruction 1300.18 for guidelines).
ITEM 16. Signature of Witness. Have a witness
(disinterested person) sign all copies in ink as follows: First
name, middle initial, last name. Include rank, rate, or grade
as appropriate. A witness signature is not required for
electronic versions of the DD Form 93 (see DoD Instruction
1300.18).
ITEM 17. Date the member or civilian signs the form. This
item is an ink entry and must be completed on all copies.
▼ DD 93 PDF Form

Document Attributes

Fact Name Description
Purpose The DD Form 93 is used by service members to record their emergency contact information and beneficiary designations.
Who Uses It This form is utilized by active duty members of the Armed Forces, including the Army, Navy, Air Force, Marine Corps, and Coast Guard.
Submission Service members must submit the completed DD 93 to their personnel office or unit administrator.
Updates It is essential for service members to update the DD 93 whenever there are changes in their personal circumstances, such as marriage or divorce.
Governing Law The DD 93 is governed by Department of Defense directives and regulations, ensuring compliance with military policies.
Importance This form plays a critical role in ensuring that service members' wishes are honored in emergencies and that their loved ones are notified promptly.

DD 93: Usage Instruction

Filling out the DD 93 form is an important step in ensuring that your personal information is correctly recorded. This information is used for various administrative purposes. Follow these steps to complete the form accurately.

  1. Start by writing your full name in the designated section at the top of the form.
  2. Provide your Social Security Number (SSN) in the appropriate box.
  3. Fill in your date of birth. Make sure to use the correct format.
  4. Indicate your marital status by checking the relevant box.
  5. List your spouse's name, if applicable, along with their SSN and date of birth.
  6. Provide information about your children, including their names, SSNs, and dates of birth.
  7. Include details for any other beneficiaries you wish to designate.
  8. Sign and date the form at the bottom to certify that the information is correct.

Once you have completed the form, review it for accuracy. Make sure all information is legible and correctly filled out before submitting it to the appropriate office.

Frequently Asked Questions

  1. What is the DD 93 form?

    The DD 93, or the Record of Emergency Data, is a vital document used by members of the U.S. Armed Forces. This form allows service members to provide important personal information that is crucial in case of an emergency. It includes details such as beneficiaries for death benefits, emergency contacts, and important medical information.

  2. Who needs to complete the DD 93 form?

    All active duty members of the military, as well as reservists and National Guard members, are required to complete the DD 93 form. It is essential for ensuring that the military can contact the right individuals in emergencies and manage benefits appropriately.

  3. How often should the DD 93 form be updated?

    Service members should review and update their DD 93 form regularly, especially after significant life events such as marriage, divorce, the birth of a child, or the death of a beneficiary. Keeping this information current is critical for ensuring that emergency contacts and beneficiaries are accurate.

  4. Where can I obtain the DD 93 form?

    The DD 93 form can be obtained through various channels:

    • Military installations
    • The official Department of Defense website
    • Your unit's administrative office

    It is typically available as a downloadable PDF, making it easy to fill out and print.

  5. What happens if I do not complete the DD 93 form?

    Failing to complete the DD 93 form can lead to complications during emergencies. Without this information, the military may struggle to contact your designated emergency contacts or beneficiaries. This could delay necessary actions during critical situations and may affect the distribution of benefits after a service member's death.

  6. Is the information on the DD 93 form confidential?

    Yes, the information provided on the DD 93 form is treated with confidentiality. It is used solely for official purposes, such as emergency notifications and benefit distribution. However, it is advisable to share your completed form with trusted family members or friends who may need to act on your behalf in an emergency.

Common mistakes

Filling out the DD 93 form, which is crucial for service members to designate beneficiaries for certain benefits, can be a straightforward process. However, many people make mistakes that can lead to complications down the line. One common error is failing to update the form regularly. Life changes, such as marriage, divorce, or the birth of a child, can affect who should receive benefits. If the form is not updated, it may lead to unintended beneficiaries receiving funds or benefits.

Another mistake is not clearly identifying beneficiaries. When listing individuals, it’s important to provide full names and relationships. Simply writing "my spouse" without including their name can create confusion. This lack of clarity might result in delays or disputes when benefits are distributed. Always ensure that the information is complete and accurate.

Some individuals overlook the importance of signing and dating the form. A DD 93 that is not properly signed may be considered invalid. Without a signature, the designated beneficiaries may not receive the benefits intended for them. Always double-check that the form is signed and dated before submission.

Lastly, many people fail to keep a copy of the completed DD 93 form. This oversight can create problems if questions arise later about the beneficiaries. Keeping a personal copy ensures that you have a reference point and can clarify any discrepancies. It’s a simple step that can save time and frustration in the future.

Documents used along the form

The DD 93 form, also known as the Record of Emergency Data, is an essential document for military personnel. It provides critical information regarding a service member's emergency contacts and beneficiaries. Along with the DD 93, several other forms and documents are commonly used to ensure that service members' affairs are properly managed. Here’s a list of these important documents:

  • DD 214 - This form serves as a certificate of release or discharge from active duty. It summarizes a service member's military service and is often required for veterans' benefits.
  • SF 180 - The Standard Form 180 is used to request military records. It is crucial for veterans seeking copies of their service records for various purposes, including benefits and claims.
  • DD 1172-2 - This form is the Application for Uniformed Services Identification Card/DEERS Enrollment. It is necessary for enrolling dependents in the Defense Enrollment Eligibility Reporting System (DEERS).
  • VA Form 21-526EZ - This is the Application for Disability Compensation and Related Compensation Benefits. Veterans use this form to apply for disability benefits from the Department of Veterans Affairs.
  • DD 2656 - The Data for Payment of Retired Personnel form is used to provide information needed for retirement pay. It ensures that retired service members receive their entitled benefits.
  • SF 50 - The Notification of Personnel Action form documents changes in employment status for federal employees. It is often required for various employment-related benefits.
  • Form W-4 - This is the Employee's Withholding Certificate. It helps determine the amount of federal income tax to withhold from a service member’s paychecks.

These documents play significant roles in managing the various aspects of military life and benefits. Keeping them organized and readily available can help ensure that service members and their families navigate any necessary processes smoothly.

Similar forms

The DD 93 form, also known as the Record of Emergency Data, is an important document used by military personnel to provide essential information regarding their beneficiaries and emergency contacts. Below are four documents that share similarities with the DD 93 form:

  • SF 1176 - Declaration of Marital Status: This form is used to declare marital status for military personnel. Like the DD 93, it helps establish legal relationships and beneficiaries, ensuring that the correct individuals are recognized for benefits and entitlements.
  • DD Form 214 - Certificate of Release or Discharge from Active Duty: This document summarizes a service member's military career. Similar to the DD 93, it contains critical information about the service member, including discharge status and benefits eligibility, which is essential for both personal and legal purposes.
  • DD Form 2656 - Data for Payment of Retired Personnel: This form collects information needed for the payment of retirement benefits. It parallels the DD 93 by requiring personal data and beneficiary information to ensure that payments are directed to the correct individuals.
  • DA Form 2823 - Sworn Statement: This document is used to record a service member's sworn testimony. While its primary function is different, it also collects important personal information and can be used in legal contexts, similar to how the DD 93 is utilized for emergency and beneficiary matters.

Dos and Don'ts

Filling out the DD 93 form, also known as the Record of Emergency Data, is an important task for service members. This form provides essential information in case of an emergency. Here are some guidelines to consider when completing it:

  • Do read the instructions carefully before starting.
  • Do ensure all information is accurate and up-to-date.
  • Do list all emergency contacts, including their relationship to you.
  • Do sign and date the form after completing it.
  • Don't leave any required fields blank; fill them all out.
  • Don't use abbreviations that may confuse the reader.
  • Don't forget to review the form for any errors before submission.

By following these tips, you can ensure that your DD 93 form is filled out correctly and effectively. This helps guarantee that your emergency contacts are informed in a timely manner if needed.

Misconceptions

The DD 93 form, also known as the Record of Emergency Data, is an important document for military personnel. However, there are several misconceptions about this form that can lead to confusion. Here are six common misunderstandings:

  • Misconception 1: The DD 93 form is only for active-duty service members.

    • This is not true. While the form is commonly used by active-duty personnel, reservists and National Guard members are also required to complete it. It’s essential for anyone in the military to have this document on file.

  • Misconception 2: Once filled out, the DD 93 form never needs to be updated.

    • This is incorrect. Life changes such as marriage, divorce, or the birth of a child can impact the information on the form. Regular updates ensure that emergency contacts and beneficiaries are current.

  • Misconception 3: The DD 93 form is only about emergency contacts.

    • While emergency contacts are a significant part of the DD 93, it also includes critical information about beneficiaries for benefits and other important data that can affect a service member’s family.

  • Misconception 4: The DD 93 form is not a legal document.

    • This misconception is misleading. The DD 93 is indeed a legal document that can have significant implications for benefits and emergency situations. It is treated seriously by military authorities.

  • Misconception 5: You can submit the DD 93 form online.

    • This is false. The DD 93 must be submitted in person to ensure that all information is accurately recorded and that the service member has the opportunity to discuss any questions with a representative.

  • Misconception 6: Only the service member can fill out the DD 93 form.

    • This is not entirely accurate. While the service member must provide the information, family members can assist in gathering necessary details. However, the final responsibility lies with the service member to ensure accuracy.

Key takeaways

The DD 93 form, also known as the Record of Emergency Data, is an important document for military service members. Here are some key takeaways to consider when filling out and using this form:

  1. Purpose of the Form: The DD 93 form is used to provide essential information about a service member's emergency contacts and beneficiaries.
  2. Who Should Fill It Out: All active duty members, reservists, and National Guard personnel are required to complete this form.
  3. Updating the Form: It is crucial to update the DD 93 whenever there are changes in personal circumstances, such as marriage, divorce, or the birth of a child.
  4. Emergency Contacts: List at least one primary contact, but you can include multiple contacts to ensure that someone is always reachable in case of an emergency.
  5. Beneficiary Information: The form allows you to designate beneficiaries for various benefits, including life insurance and death gratuity.
  6. Clear Instructions: Follow the instructions carefully to ensure that all information is accurate and complete, as errors can lead to complications later.
  7. Signature Requirement: The form must be signed and dated to be valid. This confirms that the information provided is true and correct.
  8. Confidentiality: The information on the DD 93 is sensitive and should be treated with confidentiality to protect your personal data.
  9. Accessing the Form: The DD 93 form can be obtained from your unit's administrative office or downloaded from official military websites.
  10. Importance of Review: Regularly review your DD 93 to ensure that it reflects your current wishes and circumstances, especially before deployments or major life events.

By keeping these key points in mind, service members can ensure that their DD 93 form is filled out correctly and remains up-to-date, providing peace of mind for themselves and their loved ones.