DD Form 117 at a glance
What it is: This form is the Military Pay Voucher Identification and Certification.
Who signs: Box 10 is the Signature of Disbursing Officer or Deputy.
A filled-in DD Form 117 example: a disbursing officer pays two charges by check
How to fill out DD Form 117, box by box
Department, voucher number and payroll number
Enter the Department in Box 1 and the Voucher Number in Box 2.
Enter the Attachment Pages in Box 3 and the Payroll Number in Box 5.
Enter the Organization and Location in Box 4.
Purpose of payment and paid by
Enter the Purpose of Payment in Box 6.
Enter Paid By in Box 7.
Disbursing officer certification
The Disbursing Officer or Deputy certifies the voucher is correct and proper for payment from the appropriation and/or fund indicated below: enter the Typed Name of Disbursing Officer in Box 8, the DSSN in Box 9 and the Signature of Disbursing Officer or Deputy in Box 10.
Agent officer certification
As Agent Officer to the above Disbursing Officer, certify the amounts shown on the attached money lists have been paid by you to members listed thereon after proper identification: sign in Box 11 and enter the Date Paid in Box 12.
Appropriation charges
Under Appropriation Charges, enter the Appropriation in Box 13 and the Amount in Box 14.
Prepared by and reviewed by
Enter Prepared By in Box 15 and Reviewed By in Box 16.
Check payment
Under Check Payment, enter the Amount in Box 18.
Enter the Paid By Check Numbers in Box 19.
Cash payment
Only for a Cash Payment, enter the Amount in Box 20.
For an individual cash payment, sign the Signature of Payee in Box 21: I acknowledge receipt of cash payment in amount stated.
Sources
[1] DD Form 117, Military Pay Voucher Identification and Certification, Department of Defense (the Official source link on this page).