If you are a United States citizen or a green card holder, and you have been married to your spouse for less than two years at the time of filing, you will need to file form Da 2171. This form is used to determine whether you meet the requirements for alien relative status. It is important to note that meeting the requirements for this status does not guarantee that your application will be approved. There are many factors that are considered when making a decision on an alien relative petition. ensuring that you complete all required forms and provide all supporting documentation will help ensure that your application has the best chance of being approved. If you have any questions about this process, please do not hesitate to contact us for assistance.
Question | Answer |
---|---|
Form Name | Da 2171 Form |
Form Length | 5 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 1 min 15 sec |
Other names | fc form 2171 pdf, ETS, fc form 2171, da form 2171 |
REQUEST FOR TUITION ASSISTANCE - ARMY CONTINUING EDUCATION SYSTEM
For use of this form, see AR
CONTROL NUMBER
|
DATA REQUIRED BY THE PRIVACY ACT OF 1974 |
|
|
AUTHORITY |
Title 10 USC 2007; Title 10 USC 2005 |
PRINCIPAL PURPOSE(S) |
Used to show courses for which the service member is receiving tuition assistance from the Army. Service members who, |
|
due to reasons within their control, fail to complete a course for which they are receiving tuition assistance must reimburse |
|
the Army an amount equal to the tuition assistance received. |
ROUTINE USES |
Used as a record of courses in progress for which the service member is receiving tuition assistance. |
|
Used as a means by which the Army can recoup monies for courses which the service member has failed to complete for |
|
reasons within his or her control. |
DISCLOSURE |
Disclosure of information is mandatory. DA Form 2171 is the only authority which can be used to recoup monies from a |
|
service member who fails to complete courses for reasons within his or her control. |
APPLICANT WILL COMPLETE ITEMS 1 THROUGH 10. USE TYPEWRITER, IF POSSIBLE, OTHERWISE HEAVY PEN
1. APPLICANT'S NAME (Last, First, MI)
2.SSN
3.ETS
4.MOS
5.ORGANIZATION AND LOCATION OF ASSIGNMENT
6A. NAME OF SCHOOL
6B. ADDRESS OF SCHOOL (Include ZIP Code)
6C. LOCATION OF CLASS
6D. PURPOSE (Formally Declared Goal)
7.Course Data
DEPARTMENT AND COURSE NUMBER A
TITLE OF COURSES
B
|
|
NUMBER OF |
DAYS OF |
HOURS OF |
SEMESTER OR |
WEEK |
MEETING |
QUARTER |
|
|
HOURS |
C |
D |
E |
|
|
|
CREDIT
HOUR COST
F
COURSE COST LESS FEES AND BOOKS
G
AMOUNT
PAID
H
8A. COURSE BEGINS
8B. COURSE ENDS
9.COST TO GOV'T
10.I have read the pertinent portions of AR
A.SIGNATURE OF APPLICANT
B.OFFICE TELEPHONE NUMBER
C.DATE
11.Applicant's Unit Commander or Authorized Representative
Courses listed above have specific relevance and/or general value to the Army. Soldier has potential for continued service; is not flagged IAW AR
and anticipated duties will permit class attendance.
A.TYPED NAME OF APPLICANT'S UNIT COMMANDER OR AUTHORIZED REPRESENTATIVE
B.SIGNATURE
C.DATE
12.Tuition Assistance in the Amount Indicated in Item 9 Above is Approved
A.TYPED NAME OF CONTRACTING OFFICER'S REPRESENTATIVE OR EDUCATION SERVICES OFFICER
B.SIGNATURE
C.DATE
13.Fiscal
A. |
CONTRACT NUMBER |
B. |
CHARGEABLE TO ORDER NUMBER |
|
|
|
|
C. |
ACCOUNTING CLASSIFICATION |
D. |
INSTITUTIONS WILL MAIL INVOICES AND GRADE REPORTS TO |
|
|
|
|
By accepting tuition assistance for payment, institution agrees to notify ESO of course withdrawal within five days and submit to ESO official grade
reports within 30 days of course completion.
DA FORM 2171, APR 89 |
Copy 1 - Institution |
USAPPC V1.00
REQUEST FOR TUITION ASSISTANCE - ARMY CONTINUING EDUCATION SYSTEM
For use of this form, see AR
CONTROL NUMBER
|
DATA REQUIRED BY THE PRIVACY ACT OF 1974 |
|
|
AUTHORITY |
Title 10 USC 2007; Title 10 USC 2005 |
PRINCIPAL PURPOSE(S) |
Used to show courses for which the service member is receiving tuition assistance from the Army. Service members who, |
|
due to reasons within their control, fail to complete a course for which they are receiving tuition assistance must reimburse |
|
the Army an amount equal to the tuition assistance received. |
ROUTINE USES |
Used as a record of courses in progress for which the service member is receiving tuition assistance. |
|
Used as a means by which the Army can recoup monies for courses which the service member has failed to complete for |
|
reasons within his or her control. |
DISCLOSURE |
Disclosure of information is mandatory. DA Form 2171 is the only authority which can be used to recoup monies from a |
|
service member who fails to complete courses for reasons within his or her control. |
APPLICANT WILL COMPLETE ITEMS 1 THROUGH 10. USE TYPEWRITER, IF POSSIBLE, OTHERWISE HEAVY PEN
1. APPLICANT'S NAME (Last, First, MI)
2.SSN
3.ETS
4.MOS
5.ORGANIZATION AND LOCATION OF ASSIGNMENT
6A. NAME OF SCHOOL
6B. ADDRESS OF SCHOOL (Include ZIP Code)
6C. LOCATION OF CLASS
6D. PURPOSE (Formally Declared Goal)
7.Course Data
DEPARTMENT AND COURSE NUMBER A
TITLE OF COURSES
B
|
|
NUMBER OF |
DAYS OF |
HOURS OF |
SEMESTER OR |
WEEK |
MEETING |
QUARTER |
|
|
HOURS |
C |
D |
E |
|
|
|
CREDIT
HOUR COST
F
COURSE COST LESS FEES AND BOOKS
G
AMOUNT
PAID
H
8A. COURSE BEGINS
8B. COURSE ENDS
9.COST TO GOV'T
10.I have read the pertinent portions of AR
A.SIGNATURE OF APPLICANT
B.OFFICE TELEPHONE NUMBER
C.DATE
11.Applicant's Unit Commander or Authorized Representative
Courses listed above have specific relevance and/or general value to the Army. Soldier has potential for continued service; is not flagged IAW AR
and anticipated duties will permit class attendance.
A.TYPED NAME OF APPLICANT'S UNIT COMMANDER OR AUTHORIZED REPRESENTATIVE
B.SIGNATURE
C.DATE
12.Tuition Assistance in the Amount Indicated in Item 9 Above is Approved
A.TYPED NAME OF CONTRACTING OFFICER'S REPRESENTATIVE OR EDUCATION SERVICES OFFICER
B.SIGNATURE
C.DATE
13.Fiscal
A. |
CONTRACT NUMBER |
B. |
CHARGEABLE TO ORDER NUMBER |
|
|
|
|
C. |
ACCOUNTING CLASSIFICATION |
D. |
INSTITUTIONS WILL MAIL INVOICES AND GRADE REPORTS TO |
|
|
|
|
By accepting tuition assistance for payment, institution agrees to notify ESO of course withdrawal within five days and submit to ESO official grade
reports within 30 days of course completion.
DA FORM 2171, APR 89 |
Copy 2 - Commercial Accounts, Finance and Accounting Office (F&AO) |
USAPPC V1.00
REQUEST FOR TUITION ASSISTANCE - ARMY CONTINUING EDUCATION SYSTEM
For use of this form, see AR
CONTROL NUMBER
|
DATA REQUIRED BY THE PRIVACY ACT OF 1974 |
|
|
AUTHORITY |
Title 10 USC 2007; Title 10 USC 2005 |
PRINCIPAL PURPOSE(S) |
Used to show courses for which the service member is receiving tuition assistance from the Army. Service members who, |
|
due to reasons within their control, fail to complete a course for which they are receiving tuition assistance must reimburse |
|
the Army an amount equal to the tuition assistance received. |
ROUTINE USES |
Used as a record of courses in progress for which the service member is receiving tuition assistance. |
|
Used as a means by which the Army can recoup monies for courses which the service member has failed to complete for |
|
reasons within his or her control. |
DISCLOSURE |
Disclosure of information is mandatory. DA Form 2171 is the only authority which can be used to recoup monies from a |
|
service member who fails to complete courses for reasons within his or her control. |
APPLICANT WILL COMPLETE ITEMS 1 THROUGH 10. USE TYPEWRITER, IF POSSIBLE, OTHERWISE HEAVY PEN
1. APPLICANT'S NAME (Last, First, MI)
2.SSN
3.ETS
4.MOS
5.ORGANIZATION AND LOCATION OF ASSIGNMENT
6A. NAME OF SCHOOL
6B. ADDRESS OF SCHOOL (Include ZIP Code)
6C. LOCATION OF CLASS
6D. PURPOSE (Formally Declared Goal)
7.Course Data
DEPARTMENT AND COURSE NUMBER A
TITLE OF COURSES
B
|
|
NUMBER OF |
DAYS OF |
HOURS OF |
SEMESTER OR |
WEEK |
MEETING |
QUARTER |
|
|
HOURS |
C |
D |
E |
|
|
|
CREDIT
HOUR COST
F
COURSE COST LESS FEES AND BOOKS
G
AMOUNT
PAID
H
8A. COURSE BEGINS
8B. COURSE ENDS
9.COST TO GOV'T
10.I have read the pertinent portions of AR
A.SIGNATURE OF APPLICANT
B.OFFICE TELEPHONE NUMBER
C.DATE
11.Applicant's Unit Commander or Authorized Representative
Courses listed above have specific relevance and/or general value to the Army. Soldier has potential for continued service; is not flagged IAW AR
and anticipated duties will permit class attendance.
A.TYPED NAME OF APPLICANT'S UNIT COMMANDER OR AUTHORIZED REPRESENTATIVE
B.SIGNATURE
C.DATE
12.Tuition Assistance in the Amount Indicated in Item 9 Above is Approved
A.TYPED NAME OF CONTRACTING OFFICER'S REPRESENTATIVE OR EDUCATION SERVICES OFFICER
B.SIGNATURE
C.DATE
13.Fiscal
A. |
CONTRACT NUMBER |
B. |
CHARGEABLE TO ORDER NUMBER |
|
|
|
|
C. |
ACCOUNTING CLASSIFICATION |
D. |
INSTITUTIONS WILL MAIL INVOICES AND GRADE REPORTS TO |
|
|
|
|
By accepting tuition assistance for payment, institution agrees to notify ESO of course withdrawal within five days and submit to ESO official grade
reports within 30 days of course completion.
DA FORM 2171, APR 89 |
Copy 3 - Accounting Division Accounts Maintenance Activity (F&AO) |
USAPPC V1.00
REQUEST FOR TUITION ASSISTANCE - ARMY CONTINUING EDUCATION SYSTEM
For use of this form, see AR
CONTROL NUMBER
|
DATA REQUIRED BY THE PRIVACY ACT OF 1974 |
|
|
AUTHORITY |
Title 10 USC 2007; Title 10 USC 2005 |
PRINCIPAL PURPOSE(S) |
Used to show courses for which the service member is receiving tuition assistance from the Army. Service members who, |
|
due to reasons within their control, fail to complete a course for which they are receiving tuition assistance must reimburse |
|
the Army an amount equal to the tuition assistance received. |
ROUTINE USES |
Used as a record of courses in progress for which the service member is receiving tuition assistance. |
|
Used as a means by which the Army can recoup monies for courses which the service member has failed to complete for |
|
reasons within his or her control. |
DISCLOSURE |
Disclosure of information is mandatory. DA Form 2171 is the only authority which can be used to recoup monies from a |
|
service member who fails to complete courses for reasons within his or her control. |
APPLICANT WILL COMPLETE ITEMS 1 THROUGH 10. USE TYPEWRITER, IF POSSIBLE, OTHERWISE HEAVY PEN
1. APPLICANT'S NAME (Last, First, MI)
2.SSN
3.ETS
4.MOS
5.ORGANIZATION AND LOCATION OF ASSIGNMENT
6A. NAME OF SCHOOL
6B. ADDRESS OF SCHOOL (Include ZIP Code)
6C. LOCATION OF CLASS
6D. PURPOSE (Formally Declared Goal)
7.Course Data
DEPARTMENT AND COURSE NUMBER A
TITLE OF COURSES
B
|
|
NUMBER OF |
DAYS OF |
HOURS OF |
SEMESTER OR |
WEEK |
MEETING |
QUARTER |
|
|
HOURS |
C |
D |
E |
|
|
|
CREDIT
HOUR COST
F
COURSE COST LESS FEES AND BOOKS
G
AMOUNT
PAID
H
8A. COURSE BEGINS
8B. COURSE ENDS
9.COST TO GOV'T
10.I have read the pertinent portions of AR
A.SIGNATURE OF APPLICANT
B.OFFICE TELEPHONE NUMBER
C.DATE
11.Applicant's Unit Commander or Authorized Representative
Courses listed above have specific relevance and/or general value to the Army. Soldier has potential for continued service; is not flagged IAW AR
and anticipated duties will permit class attendance.
A.TYPED NAME OF APPLICANT'S UNIT COMMANDER OR AUTHORIZED REPRESENTATIVE
B.SIGNATURE
C.DATE
12.Tuition Assistance in the Amount Indicated in Item 9 Above is Approved
A.TYPED NAME OF CONTRACTING OFFICER'S REPRESENTATIVE OR EDUCATION SERVICES OFFICER
B.SIGNATURE
C.DATE
13.Fiscal
A. |
CONTRACT NUMBER |
B. |
CHARGEABLE TO ORDER NUMBER |
|
|
|
|
C. |
ACCOUNTING CLASSIFICATION |
D. |
INSTITUTIONS WILL MAIL INVOICES AND GRADE REPORTS TO |
|
|
|
|
By accepting tuition assistance for payment, institution agrees to notify ESO of course withdrawal within five days and submit to ESO official grade
reports within 30 days of course completion.
DA FORM 2171, APR 89 |
Copy 4 - AEC Suspense File |
USAPPC V1.00
REQUEST FOR TUITION ASSISTANCE - ARMY CONTINUING EDUCATION SYSTEM
For use of this form, see AR
CONTROL NUMBER
|
DATA REQUIRED BY THE PRIVACY ACT OF 1974 |
|
|
AUTHORITY |
Title 10 USC 2007; Title 10 USC 2005 |
PRINCIPAL PURPOSE(S) |
Used to show courses for which the service member is receiving tuition assistance from the Army. Service members who, |
|
due to reasons within their control, fail to complete a course for which they are receiving tuition assistance must reimburse |
|
the Army an amount equal to the tuition assistance received. |
ROUTINE USES |
Used as a record of courses in progress for which the service member is receiving tuition assistance. |
|
Used as a means by which the Army can recoup monies for courses which the service member has failed to complete for |
|
reasons within his or her control. |
DISCLOSURE |
Disclosure of information is mandatory. DA Form 2171 is the only authority which can be used to recoup monies from a |
|
service member who fails to complete courses for reasons within his or her control. |
APPLICANT WILL COMPLETE ITEMS 1 THROUGH 10. USE TYPEWRITER, IF POSSIBLE, OTHERWISE HEAVY PEN
1. APPLICANT'S NAME (Last, First, MI)
2.SSN
3.ETS
4.MOS
5.ORGANIZATION AND LOCATION OF ASSIGNMENT
6A. NAME OF SCHOOL
6B. ADDRESS OF SCHOOL (Include ZIP Code)
6C. LOCATION OF CLASS
6D. PURPOSE (Formally Declared Goal)
7.Course Data
DEPARTMENT AND COURSE NUMBER A
TITLE OF COURSES
B
|
|
NUMBER OF |
DAYS OF |
HOURS OF |
SEMESTER OR |
WEEK |
MEETING |
QUARTER |
|
|
HOURS |
C |
D |
E |
|
|
|
CREDIT
HOUR COST
F
COURSE COST LESS FEES AND BOOKS
G
AMOUNT
PAID
H
8A. COURSE BEGINS
8B. COURSE ENDS
9.COST TO GOV'T
10.I have read the pertinent portions of AR
A.SIGNATURE OF APPLICANT
B.OFFICE TELEPHONE NUMBER
C.DATE
11.Applicant's Unit Commander or Authorized Representative
Courses listed above have specific relevance and/or general value to the Army. Soldier has potential for continued service; is not flagged IAW AR
and anticipated duties will permit class attendance.
A.TYPED NAME OF APPLICANT'S UNIT COMMANDER OR AUTHORIZED REPRESENTATIVE
B.SIGNATURE
C.DATE
12.Tuition Assistance in the Amount Indicated in Item 9 Above is Approved
A.TYPED NAME OF CONTRACTING OFFICER'S REPRESENTATIVE OR EDUCATION SERVICES OFFICER
B.SIGNATURE
C.DATE
13.Fiscal
A. |
CONTRACT NUMBER |
B. |
CHARGEABLE TO ORDER NUMBER |
|
|
|
|
C. |
ACCOUNTING CLASSIFICATION |
D. |
INSTITUTIONS WILL MAIL INVOICES AND GRADE REPORTS TO |
|
|
|
|
By accepting tuition assistance for payment, institution agrees to notify ESO of course withdrawal within five days and submit to ESO official grade
reports within 30 days of course completion.
DA FORM 2171, APR 89 |
Copy 5 - DA Form 669 or soldier |
USAPPC V1.00