Dd 2367 Form PDF Details

The DD Form 2367, identified as the Individual Overseas Housing Allowance (OHA) Report, stands as a crucial document for U.S. service members residing outside the continental United States. This form plays a pivotal role in determining and adjusting the OHA, aimed at offsetting housing costs in foreign locations. Filled with various sections, the form requires detailed information about the service member, including name, pay grade, social security number, and specifics about their current overseas residence, such as address, lease or ownership status, and whether the rent or mortgage is paid in local currency or U.S. dollars. It also delves into whether the service member pays utilities separately or if these costs are included in their rental agreement, a critical element in calculating the total housing allowance. Additional inquiries seek to understand the living arrangements, asking if the residence is shared with other service members or dependents, which can affect the allowance. Part B of the form calls for certifications from the service member and a housing officer or appropriate official to validate the information provided, ensuring accuracy and compliance. The form embodies the intricate process of managing housing allowances overseas, balancing the need for adequate support with safeguarding against fraudulent claims, as emphasized by the warning against making false statements. This bureaucratic yet essential instrument ensures service members are fairly compensated for their housing expenses while stationed abroad, reflecting the broader commitment to support the welfare of those serving the nation in foreign capacities.

QuestionAnswer
Form NameDd 2367 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesdd 2367 fillable form, dd form 2367 fillable, form 2367, dd form 2367

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INDIVIDUAL OVERSEAS HOUSING ALLOWANCE

(OHA) REPORT

Before completing, read Privacy Act Statement and Warning on reverse side.

INTERAGENCY REPORT CONTROL NUMBER

0374-DOD-AR

REPORT CONTROL SYMBOL

DD-P&R(AR)1697

PART A - IDENTIFICATION AND HOUSING INFORMATION

1. SERVICEMEMBER

 

3. SERVICEMEMBER' S RESIDENCE ADDRESS (Street, Apt . No., City,

 

 

 

 

Country)

 

 

a. NAME (Last, First, Middle Initial)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b. PAY GRADE

c. SSN

4. EFFECTIVE DATE OF LEASE/RENTAL/SALE AGREEMENT

 

 

 

 

(YYYYMMDD)

 

 

 

 

 

 

 

 

 

 

d. DUTY STATION OR HOMEPORT

5. IN WHAT CURRENCY IS YOUR RENT OR MORTGAGE PAID? (X one)

(1) St at ion Name

 

(See Instructions on reverse side if you pay rent three or more months in advance.)

 

 

 

 

 

 

 

 

 

 

 

 

 

a. LOCAL CURRENCY (Specify name of currency. Report amount in Item 6.)

 

 

 

 

 

 

 

 

 

(2) Cit y

 

 

b. U.S. DOLLARS

 

 

 

 

 

 

 

6. X THE APPROPRIATE BOX TO INDICATE WHETHER YOUR

 

 

 

 

RESIDENCE IS LEASED OR OWNED AND GIVE THE MONTHLY

(3) Count ry

(4) Dut y Phone

RENTAL AMOUNT OR THE PURCHASE PRICE IN THE CURRENCY

 

 

 

 

 

 

 

 

YOU SPECIFIED IN QUESTION 5.

 

 

 

 

 

 

 

 

 

 

 

2. ARE YOU ENTITLED TO A COST-OF-LIVING OR OVERSEAS

 

a. LEASED/RENTED (Enter monthly rent below .

If sharing, report

HOUSING ALLOWANCE FOR DEPENDENTS RESIDING

 

TOTAL rent, not your share.)

 

 

ELSEWHERE? (X one)

 

 

 

 

 

 

 

 

 

 

 

YES (Specify location)

 

 

b. OWNED (Enter original purchase price. Include only cost of home,

 

 

 

 

 

EXCLUDE closing costs, taxes, etc.)

 

 

 

NO or NOT APPLICABLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOMEOWNERS, SKIP QUESTION 7 AND GO DIRECTLY TO QUESTION 8.

 

 

7. UTILITIES (Excluding telephone) (X appropriate block)

8. TO DETERMINE IF YOU ARE A "SHARER" FOR HOUSING ALLOW-

 

 

 

 

ANCE PURPOSES, ENTER AN X IN THE BOX AT LEFT FOR EACH

 

a. I SEPARATELY PAY FOR ALL UTILITIES. NONE ARE IN-

 

CATEGORY OF INDIVIDUAL OCCUPYING YOUR RESIDENCE. FOR

 

CLUDED IN RENTAL/LEASE AGREEMENT WITH LANDLORD.

 

EACH CATEGORY YOU X, ENTER THE NUMBER REQUESTED IN

 

 

 

 

THE BOX AT RIGHT, THEN RECORD THE TOTAL IN THE BOX AT

 

b. I DO NOT SEPARATELY PAY FOR ANY UTILITIES (excluding

 

THE BOTTOM. (NOTE: Do not count dependents unless covered by

 

telephone). ALL UTILITIES ARE INCLUDED IN RENTAL/LEASE

category c.)

 

 

 

 

 

 

 

 

 

 

 

AGREEMENT AND PAID BY LANDLORD.

X

a. MYSELF

 

1

 

 

 

 

 

 

 

c. I SEPARATELY PAY FOR SOME UTILITIES (excluding telephone)

 

b. SPOUSE WHO IS ALSO A SERVICEMEMBER (Enter " 1" )

 

 

AND SOME ARE INCLUDED IN RENTAL/LEASE AGREEMENT

 

 

 

 

 

 

 

c. SPOUSE OR OTHER DEPENDENT WHO IS A FEDERAL

 

 

WITH LANDLORD. (Complete items (1) - (5) below indicating

 

 

 

 

CIVILIAN EMPLOYEE ENTITLED TO LIVING

 

 

utilities/services of w hich your landlord provides the MAJORITY.)

 

QUARTERS ALLOWANCE (Enter number)

 

 

 

 

(1) Elect ricit y

 

 

d. OTHER SERVICEMEMBERS ENTITLED TO A HOUSING

 

 

 

(2) Heat ing

 

 

ALLOWANCE (Enter number)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(3) Air conditioning (X if w indow units used and landlord

 

e. EXCLUDING DEPENDENTS, ANY OTHERS NOT

 

 

 

 

 

 

COVERED ABOVE WHO PAY A PORTION OF THE

 

 

 

provides electricity.)

 

 

RENT, MORTGAGE, AND/OR UTILITIES (Enter number)

 

 

 

(4) Wat er or Sew er

 

TOTAL (8a through e) (If result exceeds " 1" , you are considered a

 

 

 

 

 

 

" sharer" .)

 

1

 

 

(5) Trash Disposal

 

 

 

 

 

 

 

 

9. If Block 8.b. or 8.d. is marked, report their full name(s), Social Security Number(s) and Branch of Service in "Remarks" on reverse.

PART B - CERTIFICATIONS

10. SERVICEMEMBER. I certify that:

a.The information I have reported is true and correct.

b.I will immediately inform my commanding officer if any changes occur to the information I have reported.

c.The attached copy of my housing lease/rental/sale agreement (or certification from landlord) is true and correct, if applicable.

d.I have read the overseas housing allowance briefing sheet provided by my commander or authorized representative, if applicable.

e. SIGNATURE

f . DATE SIGNED

 

(YYYYMMDD)

 

 

11. HOUSING OFFICER or APPROPRIATE OFFICIAL.

Ihave reviewed and verified the member' s lease/rental/sale agreement and information from it was properly reported.

a.MIHA/MISCELLANEOUS PAYMENT AUTHORIZED? (X one)

 

(1) Yes

 

(2) No.

 

 

 

 

 

 

 

 

 

If Yes, ent it lement is:

 

(a) Init ial

 

(b) Subsequent

b. SIGNATURE

 

 

 

c. DATE SIGNED

 

 

 

 

 

 

(YYYYMMDD)

d. TITLE

 

 

 

 

 

 

 

 

12. CERTIFYING OFFICIAL. I have reviewed this action and certify the entitlement. If applicable to this action, member has read the overseas housing allowance briefing sheet and is aware of his/her entitlements and responsibility to report any changes.

a. TYPE HOUSING ALLOWANCE ACTION (X one)

b. MIHA/MISCELLANEOUS ENTITLEMENT (X one)

 

 

(1)

St art

 

(3)

St op

 

(5) * Cancel

 

(1) Init ial

 

(2) Subsequent

 

 

(3) None

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(2)

Change

 

(4)

Correct

 

(6) * Report

c. EFFECTIVE DATE OF ACTION (YYYYMMDD)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

* For Air Force use only

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

d. DOES MEMBER HAVE COMMAND-SPONSORED DEPENDENTS IN AREA OF PERMANENT DUTY STATION?

 

 

(1) Yes

 

 

(2) No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

e. SIGNATURE

 

 

 

 

f . TITLE

 

 

 

 

 

 

g. DATE SIGNED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(YYYYMMDD)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DD FORM 2367, MAY 1999 (EG)

PREVIOUS EDITION MAY BE USED.

WHS/DIOR, May 99

Adobe Professional 7.0

PRIVACY ACT STATEMENT

AUTHORITY: 37 USC Sect ion 405, and EO 9397.

PRINCIPAL PURPOSE(S): To det ermine eligibilit y f or, t o st art , adjust or t erminat e Overseas Housing Allow ance.

ROUTINE USE(S): In addit ion t o being used by of f icials and employees of t he applicant ' s Unif ormed Service in det ermining eligibilit y, t he inf ormat ion provided herein may be provided t o law enf orcement personnel invest igat ing t hose suspect ed of

f raudulent ly obt aining allow ances. Inf ormat ion may also be disclosed under cert ain circumst ances t o ot her Federal agencies, members of Congress, St at e and local government , and U.S. and St at e court s.

DISCLOSURE: Volunt ary; how ever, f ailure t o provide SSN may preclude t imely considerat ion of your request f or an allow ance det erminat ion.

WARNING: Making a f alse st at ement or claim against t he U.S. Government is punishable by court s-mart ial.

The penalt y f or w illf ully making a f alse claim or a f alse st at ement in connect ion w it h claims is a maximum f ine of $10,000 or imprisonment f or f ive years, or bot h.

SPECIAL INSTRUCTIONS FOR MEMBERS PAYING THREE OR MORE MONTHS RENT IN ADVANCE

In cert ain count ries it is cust omary t o pay advance rent rat her t han mont h-t o-mont h rent . If you pay your rent more t han t hree mont hs in advance, X block 5b. (U.S. Dollars) even t hough you paid your advance rent in local currency. In Part C,

"Remarks," ent er t he f ollow ing inf ormat ion:

(1)" Rent paid _____ mont hs in advance."

(2)Amount of advance rent (in local currency, if t hat is how you paid).

(3)Exchange rat e at w hich you convert ed your dollars t o local currency t o pay t he advance rent , if applicable. Comput e mont hly rent as f ollow s and report in It em 6.a.:

(1)Divide advance rent by number of mont hs rent paid in advance t o det ermine mont hly rent .

(2)If applicable, convert mont hly rent t o dollars by dividing by exchange rat e at w hich you convert ed your dollars t o local currency.

Those paying rent in advance should realize t hat rent al ceilings set by t he Depart ment of Def ense may decrease due t o periodic exchange rat e f luct uat ions. Accordingly, t heir OHA, w hich is comput ed as a mont hly ent it lement , may also decrease during t he mont hs w hen rent al payment s are not act ually being made.

If upon expirat ion of t he advance rent al period t he member must again pay rent t hree or more mont hs in advance, anot her

DDForm 2367 must be complet ed unless t he derived rent al amount previously report ed in It em 6.a. remains unchanged.

PART C - REMARKS

DD FORM 2367 (BACK), MAY 1999

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2. Your next stage is usually to complete these blanks: Heating Air conditioning X if w, provides electricity, Water or Sew er, Trash Disposal, d OTHER SERVICEMEMBERS ENTITLED TO, ALLOWANCE Enter number, EXCLUDING DEPENDENTS ANY OTHERS, NOT, TOTAL a through e If result, sharer, Block b or d is marked report, PART B CERTIFICATIONS, SERVICEMEMBER I certify that, HOUSING OFFICER or APPROPRIATE, and The information I.

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Be very attentive when filling in HOUSING OFFICER or APPROPRIATE and PART B CERTIFICATIONS, since this is the section where most people make mistakes.

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