DD Form 93

Enter full last name, first name, and middle name.

Enter DOD Identification Number (located on DOD Identification Card) or SSN if DOD Identification Card is not issued yet.

Military: Mark X in the appropriate block.

Civilian: Mark two blocks as appropriate. Example: an Army civilian would mark Army and either Civilian or Contractor.

Reporting Unit Code/Duty Station: See Service Directives.

Select marital status.

Spouse Name: Enter last name (if different from Item 1), first name and middle name on the line provided. If single, divorced, or widowed, mark appropriate block.

Address and Telephone Number: Enter the "actual" address and telephone number, not the mailing address. If one of the blocks in 4b is marked, leave blank.

List home, mobile, and other phone numbers as appropriate.

Provide the preferred language spoken by the spouse.

Select from the dropdown menu the DOD affiliation of the spouse, if applicable.

Enter last name (only if different from Item 1) first name and middle name, relationship, and date of birth of all children. If none, so state.

Include children born out of wedlock if acknowledged by member or paternity/maternity has been judicially decreed.

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.

Parent Name: Last name, first name and middle initial.

Address and Telephone Number of Parent: If unknown or deceased, so state. If other than biological or adoptive parent is listed, indicate relationship.

Step parent name, if applicable: last name, first name and middle initial.

Address and telephone number of step parent, if applicable: if deceased, so state.

Address and telephone number of Designated Person(s).

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.

If the member does not wish to designate a beneficiary for the payment of death gratuity, enter "None."

The member should make specific designations, as it expedites payment.

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.

Items 13c and 14b: Enter beneficiary(ies) full mailing address and telephone number to include the ZIP Code.

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.

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 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.

Item 14c: If the member designated two or more beneficiaries, state the percentage to be paid each. The sum shares must equal 100 percent.

Enter the name and relationship of the Person Authorized to Direct Disposition (PADD) of your remains should you die.

Persons typically selected as a PADD include: surviving spouse, blood relative of legal age, or adoptive relatives.

Address and telephone number of PADD.

NOT APPLICABLE to civilians.

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.

If additional space is required, attach a supplemental sheet of standard bond paper with the information.

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).

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).

Date the member or civilian signs the form if not already indicated in the electronic signature block. This item must be completed as an ink entry.

Not every item on this form is applicable to you.

Those items that are considered not applicable to civilians will be left blank.

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. Upon issuance of DOD Identification Card, you will need to submit a new DD Form 93 with your DOD Identification Number to protect your personally identifiable information.

Item 11a 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.