Applicant Form Dd 214 PDF Details

The Department of Defense (DoD) Form 214 is the document that is used to record a member’s military service history. The form can be used to request proof of military service, verify eligibility for benefits, or as documentation for burial at a national cemetery. The form must be completed and signed by the service member and can be obtained from the National Archives or through their online system. In most cases, a copy of the DD 214 will suffice as proof of military service, but there are some instances where additional documentation may be needed. The DD214 has several sections that must be completed in order to provide an accurate record of a servicemember’s time in the military. The first section records personal information such as name

QuestionAnswer
Form NameApplicant Form Dd 214
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesmilitarydischar geAPP applicant form for the us army

Form Preview Example

APPLICATION FOR DD214 (MILITARY DISCHARGE)

The following individuals are authorized to receive a copy of a Military Discharge upon presentation of proper photo identification and certification of their relationship to the veteran:

♦Veteran named on the discharge

♦Family member of the veteran

♦Legal representative of the veteran

♦Government Agency that provides Veteran’s benefits

NUMBER OF COPIES

 

NUMBER OF PAGES

 

 

 

 

 

 

 

 

 

 

 

 

Norwalk

District office

Title of Document

DD214 – Military Discharge

Book & Page/Document Number

Name on DD214

Relationship to above

I ____________________________________ certify (or declare) under penalty of perjury under the laws of

the State of California that the foregoing is true and correct.

DO NOT WRITE IN THIS

SPACE

Date ___________________________ Signature__________________________________________________

DL/ID________________________

Complete your name and address below.

NAME

STREET ADDRESS

CITY

STATE

ZIP CODE

SPECIAL NOTICE TO VETERANS

You may be eligible for a free certified copy if you are applying for a veteran’s pension or certain

other Veteran’s Administration benefits. (Section 6107, Government Code State of California)

THIS DOES NOT APPLY TO SOCIAL SECURITY AND OTHER CIVILIAN BENEFITS, EVEN IF

YOU ARE A VETERAN.

If you believe you qualify for a free certified copy under these provisions, complete the following affidavit.

I hereby apply for a free certified copy of the record as shown on the reverse side and declare under penalty of perjury that the free copy is to be furnished to

_______________________________________ in a claim for _________________________________

FEDERAL OR STATE AGENCYTYPE OF BENEFIT

___________________

________________________________________

_____________________

DATE

SIGNATURE OF VETERAN OR AUTHORIZED AGENT

RELATIONSHIP OF AGENT

NUMBER-STREET

CITY

STATE

ZIP

Note: The free copy issued on this affidavit will bear the following wording:

This certified copy has been issued free of charge on the declaration under penalty of perjury that it is to be used in a claim to the Federal Government or the State of California for veteran’s benefits.

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To be able to fill out this PDF document, make sure that you provide the information you need in every single field:

1. First of all, while completing the Applicant Form Dd 214, begin with the part containing following fields:

Applicant Form Dd 214 writing process described (part 1)

2. After the previous segment is complete, it is time to add the essential details in Complete your name and address, NAME, STREET ADDRESS, and CITY STATE ZIP CODE so that you can move on to the next part.

Complete your name and address, STREET ADDRESS, and CITY STATE ZIP CODE in Applicant Form Dd 214

Be really careful when filling out Complete your name and address and STREET ADDRESS, because this is the section where most users make mistakes.

3. This next stage is usually straightforward - fill in all of the blanks in under penalty of perjury that the, in a claim for , FEDERAL OR STATE AGENCY, TYPE OF BENEFIT, DATE, SIGNATURE OF VETERAN OR AUTHORIZED, RELATIONSHIP OF AGENT, NUMBERSTREET, CITY, STATE, ZIP, Note The free copy issued on this, This certified copy has been, and used in a claim to the Federal to complete this segment.

NUMBERSTREET, This certified copy has been, and FEDERAL OR STATE AGENCY of Applicant Form Dd 214

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