Da Form 3715 PDF Details

The DA 3715 form plays a critical role in the lives of individuals associated with the US Army's nonappropriated funds personnel, guiding the disposition of retirement benefits with precision and statutory compliance. Its use is regulated by Army Regulation 215-3, with oversight by the Department of Defense's proponent agency DCS, G1, ensuring its adherence to both the National Defense Authorization Act for Fiscal Year 1996 and relevant sections of the U.S. Code concerning qualified pension, profit-sharing, and stock bonus plans. The form serves multiple essential functions: facilitating refunds of contributions for terminating employees, processing retirement annuities, structuring survivor benefits, and more, all while safeguarding personal information under the Privacy Act of 1974. Moreover, it outlines routine uses of provided information, including disclosures to federal agencies for issue resolution within their jurisdictions and labor organizations for official requests. Failure to submit requisite information within a year of employment termination attracts automatic refund of contributions and annuity denial, highlighting the importance of timely action. Furthermore, with sections dedicated to general information, retirement fund options, and verification procedures, the DA 3715 form stands as a comprehensive tool for managing retirement and survivor benefits within the US Army's Nonappropriated Fund (NAF) personnel system.

QuestionAnswer
Form NameDa Form 3715
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesretirement letter to employer, army retirement form, us army retirement documents, us army document form

Form Preview Example

 

 

 

 

 

US ARMY NONAPPROPRIATED FUNDS - DISPOSITION OF RETIREMENT BENEFITS

 

 

 

 

 

 

 

For use of this form, see AR 215-3; the proponent agency is DCS, G1.

 

 

 

 

 

 

 

 

DATA REQUIRED BY THE PRIVACY ACT OF 1974

AUTHORITY:

National Defense Authorization Act for Fiscal Year 1996; 26 U.S.C. 401, Qualified Pension, Profit-sharing, and Stock Bonus Plans;

 

 

 

Army Regulation 215-3, Nonappropriated Funds Personnel Policy; and E.O. 9397 (SSN), as amended.

PRINCIPAL PURPOSE: The information you provide is for the purpose of preparing a refund of contribution or to process a retirement annuity.

ROUTINE USES:

This information is used to prepare a refund or deferred annuity as requested from terminating employees; process a monthly

 

 

 

 

annuity payment for retiring employees, and to process survivor benefits. In addition to those disclosures generally permitted

 

 

 

 

under 5 USC 552a (b) (Privacy Act), the information contained therein may specifically be disclosed outside the Department

 

 

 

 

 

of Defense as routine pursuant to 5 U.S.C. 552a (b) 3 as follows: Information may be disclosed to appropriate federal

 

 

 

 

 

agencies, such as Department of Labor and the Equal Employment Opportunity Commission, to resolve and/or adjudicate

 

 

 

 

 

matters falling within their jurisdiction. Records may also be disclosed to labor organizations in response to requests for

DISCLOSURE:

 

 

names of employees and identifying information.

 

 

 

 

 

 

 

 

 

Voluntary. However, failure to provide the information within one year of termination of employment will result in automatic

 

 

 

 

 

refund of contributions and denial of annuity.

 

 

 

 

 

 

 

CITATION:

 

A0215-3 SAMR, NAF Personnel Records (June 1, 2000, 65 FR 35054).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION I - GENERAL INFORMATION

1. EMPLOYEE'S NAME (Last, first, MI)

 

 

 

 

2. SOCIAL SECURITY NUMBER

3. DATE OF BIRTH (YYYYMMDD)

 

 

 

 

 

 

 

 

 

 

 

4a. COMPLETE MAILING ADDRESS

 

 

 

 

 

 

 

4b. E-MAIL ADDRESS

 

 

 

 

 

 

 

 

 

5a. AREA CODE/TELEPHONE NUMBER

 

5b. FAX TELEPHONE NUMBER

 

6. SERVICE COMPUTATION DATE (YYYYMMDD)

 

 

 

 

 

 

 

 

 

 

7. DATE OF SEPARATION AND REASON (YYYYMMDD)

 

 

 

 

8. ACCUMULATED SICK LEAVE HOURS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9. EMPLOYING NAF:

 

 

 

 

 

 

 

 

 

 

 

10. STANDARD NAF NUMBER

 

 

 

 

 

 

 

 

 

 

 

11. MARITAL STATUS

 

 

 

 

 

 

 

12. NAME OF LEGAL SPOUSE (Last, First, MI)

 

 

NOT MARRIED

 

 

MARRIED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13. SOCIAL SECURITY NUMBER OF LEGAL SPOUSE

 

14. DATE OF BIRTH OF LEGAL SPOUSE

15. DATE OF MARRIAGE (YYYYMMDD)

 

 

 

 

 

 

 

 

 

 

 

(YYYYMMDD)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The date of marriage has been verified by satisfactory evidence

and the benefit authorized. A certified copy of the Death Certificate and Statement of

Survivor's Social Security Entitlements are attached.

Annuity Benefits resulting from the death of the employee are payable in accordance with the Army NAF Retirement Plan.

SECTION II - RETIREMENT FUND OPTIONS

16.CHECK ONE:

In accordance with AR 215-3

(

 

 

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I request a refund of my contributions and accumulated interest in full satisfaction of all annuity payable.

(

 

 

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I request my contributions remain in deposit for a maximum of 5 years.

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)

I request an immediate Annuity (Normal or Early Retirement)

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I request a Deferred Annuity payable at age 62.

(

 

 

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I request Disability Retirement.

(

 

 

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I request Disability Retirement due to work related injury.

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)

I request Survivor Benefits.

 

SECTION III - EMPLOYEE'S OR SURVIVOR SIGNATURE

17.

SIGNATURE OF EMPLOYEE/SURVIVOR

 

18. DATE (YYYYMMDD)

 

 

 

 

 

SECTION IV - VERIFICATION AND CPU MAILING ADDRESS AND SIGNATURE

19.

The above information has been verified from the employee's personnel records and DA Form 3473 coded 04 is attached.

 

 

 

 

a. CPU SIGNATURE

 

 

b. DATE (YYYYMMDD)

 

 

 

 

c. MAILING ADDRESS

 

 

d. E-MAIL ADDRESS

 

 

 

 

 

 

DO NOT USE - FOR OFFICIAL USE ONLY

20.

DATE RECEIVED (YYYYMMDD)

21. DATE PROCESSED (YYYYMMDD)

22. PROCESSED BY

 

 

 

 

 

DA FORM 3715, AUG 2019

PREVIOUS EDITIONS ARE OBSOLETE.

APD LC v1.00ES

 

 

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