DD Form 1172-2 at a glance
What it is: DD Form 1172-2 is the Application for Identification Card/DEERS Enrollment; read the Agency Disclosure Notice, Privacy Act Statement, and Instructions prior to completing the form.
Where and when to file: Return the completed form to a Real-time Automated Personnel Identification System work station.
The principal purpose of DD Form 1172-2 is to apply for and enroll in the Defense Enrollment Eligibility Reporting System (DEERS) for DoD benefits and privileges.
A filled-in DD Form 1172-2 example: a sponsor fills out Sections I and II
How to fill out DD Form 1172-2, box by box
Section I - Sponsor/Employee Information
In Section I, Sponsor/Employee Information, enter 1. Name (Last, First, Middle), 2. Sex, 3. SSN or DoD ID No., 4. Status and 5. Organization.
Enter 6. Pay Grade, 7. Gen. Cat, 8. Citizenship, 9. Date of Birth (YYYYMMDD) and 10. Place of Birth.
Enter 11. Current Home Address, 12. City, 13. State, 14. ZIP Code and 15. Country.
Enter 16. Primary Email Address; the form also has a box for Permission to use for benefits notifications.
Enter 17. Telephone Number (Include Area Code/DSN).
Enter 18. City of Duty Location, 19. State of Duty Location and 20. Country of Duty Location.
Section II - Sponsor/Employee Declaration and Remarks
In Section II, Sponsor/Employee Declaration and Remarks, enter 21. Remarks and cite legal documentation, as applicable.
By signing, the sponsor/employee certifies the information provided in connection with the eligibility requirements of this form is true and accurate to the best of their knowledge. ALL changes to the sponsor/employee or dependent(s) eligibility must be reported within 30 days of the change. Should the sponsor/employee neglect to report changes, the sponsor/employee and/or dependent(s) may be held responsible for recoupment for any accrued healthcare costs. If not signed in the presence of the authorizing/verifying official, the signature must be notarized.
Sign 22. Sponsor/Employee Signature and enter 23. Date Signed (YYYYMMDD).
Section III - Authorized By
Section III, Authorized By, has 24. Sponsoring Office Name, 25. Contract Number, 26. Sponsoring Office Address (Street, City, State, ZIP Code), 27. Sponsoring Office Telephone Number (Include Area Code/DSN), 28. Office Email Address and 29. Overseas Assignment (Country).
Section III also has 30. Overseas Assignment Begin Date, 31. Overseas Assignment End Date, 32. Eligibility Effective Date and 33. Eligibility Expiration Date, each as (YYYYMMDD).
The sponsoring official certifies, based on personal knowledge and available documentation, that the individual is in a status eligible for and requires an identification card in the performance of their duties with the DoD or Uniformed Services, and enters 34. Sponsoring Official Name (Last, First, Middle), 35. Unit/Organization Name, 36. Title, 37. Pay Grade, 38. Signature and 39. Date Verified (YYYYMMDD).
Section IV - Verified By
Section IV of this form should only be completed if benefits or sponsorship is being requested for/by an eligible sponsor or their dependent.
Section IV, Verified By, has 40. Verifying Official Name (Last, First, Middle Initial), 41. Site Identification, 42. Telephone Number (Include Area Code/DSN) and 43. Signature.
Section V - Dependent Information
In Section V, Dependent Information (Attach additional pages if necessary), enter 44. Name (Last, First, Middle), 45. Sex, 46. Date of Birth (YYYYMMDD), 47. Relationship and 48. SSN or DoD ID No.
Enter 49. Current Home Address, 50. Primary Email Address with Permission to use for benefits notifications (18 and over), and 51. Telephone Number (Include Area Code/DSN).
Enter 52. City, 53. State, 54. ZIP Code, 55. Country, 56. Eligibility Effective Date (YYYYMMDD) and 57. Eligibility Expiration Date (YYYYMMDD).
Enter 58. Name (Last, First, Middle), 59. Sex, 60. Date of Birth (YYYYMMDD), 61. Relationship, 62. SSN or DoD ID No., 63. Current Home Address and 64. Primary Email Address.
Enter 65. Telephone Number (Include Area Code/DSN), the Permission to use for benefits notifications (18 and over) box, 66. City, 67. State, 68. ZIP Code, 69. Country, 70. Eligibility Effective Date (YYYYMMDD) and 71. Eligibility Expiration Date (YYYYMMDD).
Section VI - Receipt
In Section VI, Receipt, sign 72. Signature to acknowledge receipt of the new card and the cardholder's responsibility to report changes to benefit eligibility within 30 days of the change, and enter 73. Date Issued (YYYYMMDD).
More rules for DD Form 1172-2
Disclosure is voluntary; however, failure to provide information may result in denial of a Uniformed Services Identification Card and/or non-enrollment in the Defense Enrollment Eligibility Reporting System, refusal to grant access to DoD installations, buildings, facilities, computer systems and networks.
The instructions for completing the DD Form 1172-2 should be closely followed to ensure accurate data collection and to preclude over collection of information; they can be found at http://www.cac.mil/Portals/53/Documents/1172-2-Instructions.pdf.
Common questions about DD Form 1172-2
What is a DD form 1172 2?
DD Form 1172-2 is the Application for Identification Card/DEERS Enrollment; read the Agency Disclosure Notice, Privacy Act Statement, and Instructions prior to completing the form. The DoD benefits and privileges include, but are not limited to, medical coverage, Identification Cards, access to installations, buildings or facilities, and access to computer systems and networks.
Is there a deadline?
This form is valid for issue of DoD ID Card for 90 days from date of verification.
Where do I file it?
Return the completed form to a Real-time Automated Personnel Identification System work station.
Is there a penalty?
Penalty for presenting false claims or making false statements in connection with claims: fine of up to $10,000 or imprisonment for up to five years or both (checked October 20, 2026).
Sources
[1] DD Form 1172-2 (FEB 2025), Application for Identification Card/DEERS Enrollment, Washington Headquarters Services (the Official source link on this page).