Dd Form 137 3 – Fill Out and Use This PDF

The DD Form 137-3 serves a crucial purpose in verifying the dependency of a parent on a military member to determine eligibility for certain military benefits. It's a detailed document requiring thorough information regarding the parent's financial dependency, residence, and the member's contribution towards their support. Filling out and submitting this form accurately is essential for military personnel seeking to secure or maintain benefits for their parents. Click the button below to start the process of filling out your form.

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Dd Form 137 3 PDF Details

The DD Form 137-3, officially titled Dependency Statement - Parent, plays a crucial role in assessing eligibility for military benefits based on parental dependency. This form, marked by its Controlled Unclassified Information (CUI) status when completed, provides a structured way for service members to declare financial responsibility for a parent, thereby potentially unlocking a range of entitlements such as Basic Allowance for Housing (BAH), travel allowances, and more. Valid through June 30, 2024, as per its current Office of Management and Budget (OMB) approval, completing this document requires thoughtful collation of varied data points—from the parent's personal and financial information to detailed household expenses and the submitter's contributions. A comprehensive response can take between 30 to 60 minutes, reflecting the form's thorough nature. Special attention is given to instructions for ensuring completeness and accuracy, including notarization requirements for signatures, to speed up the processing time. The document also holistically addresses the aspects of privacy and data disclosure, underlining the voluntary nature of submission but with a caveat; the absence of this information may suspend related entitlements. Designed with precision, the form is a binding document, safeguarding against the falsification of information through explicit penalty provisions. Its conclusion is marked by a section for remarks and the necessary signatures, underscoring the legal responsibility assumed by all parties involved.

Question	Answer
Form Name	Dd Form 137 3
Form Length	5 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min 15 sec
Other names	dd137, military dependency form for parents, 137 3, dd 0137 3

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CUI (when filled in)

DEPENDENCY STATEMENT - PARENT

OMB No. 0730-0014 OMB approval expires June 30, 2024

The public reporting burden for this collection of information, 0730-0014, is estimated to average 30-60 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at whs.mc- alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

PLEASE RETURN COMPLETED FORM TO YOUR LOCAL SERVING PERSONNEL/PAYROLL OFFICE.

PRIVACY ACT STATEMENT

AUTHORITY: 5 U.S.C. 301, Departmental Regulations; 37 U.S.C., Pay and Allowances of the Uniformed Services; DoD Directive 5154.29, DoD Pay and Allowances Policy and Procedures; DoD 7000.14-R, DoD Financial Management Manual, Volume 7A, Military Pay Policy and Procedures - Active Duty and Reserve Pay; and Joint Travel Regulations (JTR) current edition.

PURPOSE(S): The information will be used to determine the relationship and dependency of the claimed dependents and determine the member's entitlement of authorized benefits.

ROUTINE USE(S): To the Treasury Department to provide information on check issues and electronic fund transfers. To Federal, state, and local governmental agencies in response to an official request for information with respect to law enforcement, investigatory procedures, criminal prosecution, civil court action and regulatory order. Additional routine uses can be found within the applicable system of records notices, T7344, Defense Joint Military Pay System-Reserve Component; T7340, Defense Joint Military Pay System-Active Component; and M01040-3, Marine Corps Manpower Management Information System Records, located at: http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-Component-Notices/

DISCLOSURE: Voluntary: however, failure to provide this information will result in a suspension of the dependent entitlements until the member can provide the required certification.

INSTRUCTIONS

The member must complete Items 1 and 2, and sign and date the form. Parent or parent(s) representative (if parent is unable to complete the form due to health or physical disability) must complete Items 3 through 12, sign and date the form, and have the form notarized. If a representative completes the form for the parent(s), include in the Remarks section the name of the individual, the relationship, and the reason the form was not completed by parent(s). If the member is deceased, information furnished must reflect the 12 months prior to member's death.

NOTES: Answer all questions. If any question does not apply, write "NOT APPLICABLE" or "N/A" in that block. Use the Remarks section when required. Incomplete answers will delay final action on the application. Verification of all income is required. Proof of member's contribution is required when applying for Basic Allowance for Housing (BAH). Parent must be more than 50% dependent upon member.

1.ENTITLEMENTS REQUESTED (X and complete as applicable)

a. TYPE
BAH	USIP CARD

TRAVEL ALLOWANCE

2. MEMBER INFORMATION

b. FIRST APPLICATION?

YES (If No, give date of last application)

NO (YYYYMMDD)

c. LAST APPLICATION WAS

APPROVED DISAPPROVED

a. NAME (Last, First, Middle Initial)

b. DoD ID NUMBER

c. RANK

d. STATUS (X and complete as applicable)
ACTIVE DUTY	NATIONAL GUARD	ARMY	NAVY
RETIRED	RESERVE	MARINE CORPS	AIR FORCE

DECEASED (Date of death) (YYYMMDD) OTHER (Specify)

e. COMPLETE RESIDENCE ADDRESS (Street, Apartment Number, City, State, ZIP Code)

f. COMPLETE MILITARY ADDRESS (Include assignment: squadron and base)

g. TELEPHONE NUMBERS (Include DSN or Area Code)

(1) WORK

(2) HOME

3. PARENT(S) INFORMATION

h. E-MAIL ADDRESS

i. MARITAL STATUS (X one)

SINGLE SEPARATED

MARRIED DIVORCED

WIDOWED

a.	(1) NAME (Last, First, Middle Initial)			b.	(1) NAME (Last, First, Middle Initial)

(2) DOD ID NUMBER		(3) DATE OF BIRTH (YYYYMMDD)		(2) DOD ID NUMBER			(3) DATE OF BIRTH (YYYYMMDD)

(4) RELATIONSHIP				(4) RELATIONSHIP

DD FORM 137-3, MAR 2018			CUI (when	filled in)		Category: PRVCY		Page 1 of 5
						Controlled by: DFAS
PREVIOUS EDITION IS OBSOLETE.						Distribution/DISTRO: FEDCON
						POC: (888) 332-7411

CUI (when filled in)

3. PARENT(S) INFORMATION (Continued)

a.	(5) COMPLETE ADDRESS (Street, Apartment Number, City, State, ZIP Code)	b.	(5) COMPLETE ADDRESS (Street, Apartment Number, City, State, ZIP Code)

(6) TELEPHONE NUMBER (Include Area Code)		(6) TELEPHONE NUMBER (Include Area Code)

(7) PRESENT OCCUPATION OR BUSINESS		(7) PRESENT OCCUPATION OR BUSINESS

(8)NAME AND ADDRESS OF EMPLOYER (If unemployed, state reason, date (8) NAME AND ADDRESS OF EMPLOYER (If unemployed, state reason, date

unemployment began, and date unemployment is expected to resume.)

c. MARITAL STATUS (X one)		d. IF SPOUSE IS DECEASED OR LEGALLY SEPARATED FROM PARENT,
MARRIED	DIVORCED	GIVE DATE OF DEATH, DIVORCE OR SEPARATION (YYYYMMDD)
MARRIED	DIVORCED
SINGLE	LIVING APART UNTIL LEGAL
WIDOWED	SEPARATION

e. IF PARENT AND SPOUSE LIVE APART OR SPOUSE DOES NOT SUPPORT PARENT, GIVE REASON:

f. CHILDREN (List all parent's living children regardless of age. Show the average monthly contribution to parent from each child. Continue in Remarks section if more space is needed.)

(1) NAME

(Last, First, Middle Initial)

(2)DOD ID NUMBER (Service Members Only)

(3)BRANCH OF SERVICE (If on Active Duty)

(4)MONTHLY CONTRIBUTION TO PARENT

g. DOES ANY OTHER CHILD CLAIM PARENT FOR BAH, TRAVEL ALLOWANCE, OR USIP CARD? (If Yes, give child's name, DoD ID Number, and branch of service.)

YES

4. PARENT'S RESIDENCE

a. TYPE OF RESIDENCE (X and complete as applicable)

		HOME OR APARTMENT OF PARENT				HOME OR APARTMENT OF FRIEND OR RELATIVE (State relationship)
		HOME OR APARTMENT OF MEMBER
		HOME OR APARTMENT OF MEMBER
		(Date began residing with member)				HOSPITAL OR INSTITUTION
						OTHER (Explain)
						OTHER (Explain)

b. OWNER OF RESIDENCE

(1) NAME (Last, First, Middle Initial)				(2) ADDRESS (Street, Apartment Number, City, State, ZIP Code)

c. IS RESIDENCE			d. DATE PARENT STARTED	LIVING AT	e. IS CURRENT ADDRESS PARENT'S PERMANENT ADDRESS?
		SUBSIDIZED HOUSING?	CURRENT ADDRESS (YYYYMMDD)		YES	(If No, explain where else parent lives and number of months there each year.)
		SUBSIDIZED HOUSING?	CURRENT ADDRESS (YYYYMMDD)
		YES
		YES			NO
		NO
		NO

	DD FORM 137-3, MAR		2018	CUI (when filled in)			Page 2 of 5

PREVIOUS EDITION IS OBSOLETE.

CUI (when filled in)

5. PERSONS LIVING IN HOUSEHOLD WITH PARENT

List all persons who live in the household, including claimed parent. If employed, show hours per week worked. Continue in Remarks if more space is needed.

a. NAME (Last, First, Middle Initial)

b.RELATIONSHIP TO PARENT

c. AGE

d. MARRIED (X)			e. EMPLOYED

	YES	NO	HOURS PER WEEK	NO (X)

f.MONTHLY CONTRIBUTION TO PARENT

6. HOUSEHOLD EXPENSES

List the household expenses for all persons living in the home. If expense was one-time only, such as purchase of a new chair, do not show this as a monthly expense; list it as an expense for the past 12 months. If parent resides in the member's household or in a dwelling owned by the member, use Fair Rental Value (FRV) for dwelling. If FRV is used, give a brief explanation of how Fair Rental Value was obtained using the Remarks section. However, if parent resides in and owns home mortgage free, enter "None" in mortgage/rent/FRV block.

FAIR RENTAL VALUE (FRV): FRV is a single monthly sum for the entire dwelling where the parent lives. This sum is an amount the owner can reasonably expect to receive from a stranger to rent the dwelling. FRV will not include food, utilities, furniture, and home repairs, which are listed separately.

	(1)		(2)		(1)	(2)
ITEM		PRESENT MONTHLY	TOTAL EXPENSE FOR	ITEM	PRESENT MONTHLY	TOTAL EXPENSE FOR
		EXPENSE	PAST 12 MONTHS		EXPENSE	PAST 12 MONTHS

a. (X one)				d. FURNITURE AND
RENT	FRV			d. FURNITURE AND
RENT	FRV			APPLIANCES
MORTGAGE (Specify				APPLIANCES
MORTGAGE (Specify
amount of tax and
amount of tax and
insurance if applicable)
TAX				e. REPAIRS ON HOME
INSURANCE
INSURANCE

b. FOOD				f. OTHER (Itemize in Remarks
				f. OTHER (Itemize in Remarks
c. UTILITIES (Heat, power,				section)
water, and telephone)

7. PARENT'S PERSONAL EXPENSES

List personal expenses for parent, parent's spouse, and their unmarried minor children who are not fully employed and who live in the same household. Do not list personal expenses for the member, his or her immediate family, or any other person. List all of the parent's personal expenses regardless of who is paying for them.

	(1)	(2)		(1)	(2)
ITEM	PRESENT MONTHLY	TOTAL EXPENSE FOR	ITEM	PRESENT MONTHLY	TOTAL EXPENSE FOR
	EXPENSE	PAST 12 MONTHS		EXPENSE	PAST 12 MONTHS
a. CLOTHING			g. PRIVATE AUTO PAYMENTS
a. CLOTHING			(If auto is registered in
			(If auto is registered in
b. LAUNDRY AND DRY			parent's name)
CLEANING			h. MONTHLY TRANSPORTA-
			TION PAYMENTS (Include
c. MEDICAL (Do not include			TION PAYMENTS (Include
c. MEDICAL (Do not include			gas, oil, insurance, repairs,
expenses paid by insurance,			gas, oil, insurance, repairs,
expenses paid by insurance,			and public transportation)
welfare, or Medicare)			and public transportation)
welfare, or Medicare)			i. SCHOOL EXPENSES (Itemize)

d. VALUE OF USIP CARD
d. VALUE OF USIP CARD
(Verification of amount is
required)
e. PERSONAL INSURANCE
(Specify)

			j. OTHER EXPENSES (Itemize)

f. PERSONAL TAXES (Specify)

DD FORM 137-3, MAR 2018	CUI (when filled in)

Page 3 of 5

PREVIOUS EDITION IS OBSOLETE.

CUI (when filled in)

8. PARENT'S ASSETS

List all assets such as real estate (including home), personal property, farm and/or business equipment, automobiles, trucks, cash, savings of any type, stocks, bonds, etc., whether owned separately by parent, jointly with spouse, or jointly by parent or spouse with another person. Assets must be listed even though parent may not be using the income earned by these assets, but is allowing the interest of dividends to accrue.

a. DESCRIPTION

b. PRESENT VALUE

c. PARENT'S EQUITY

d. IS PARENT LIQUIDATING ASSETS? (For example, is parent withdrawing money from savings, or selling stocks and bonds?)

YES	IF YES, HOW MUCH OF PARENT'S CAPITAL IS USED MONTHLY?	$
NO	EXPLAIN:

9. PARENT'S INCOME

All gross income received by parent and parent's spouse, whether taxable or nontaxable, and whether received monthly, quarterly, or yearly, must be listed. If any income received includes funds for children, be sure to show the amount received for them. List income for parents and children separately. If any income received during the past 12 months was a lump-sum (one-time) payment, be sure to state this. Verification documents are required.

	(1) PRESENT	(2) TOTAL INCOME		PARENT/	(1) PRESENT	(2) TOTAL INCOME
SOURCE	MONTHLY	FOR PAST 12	SOURCE	PARENT/	MONTHLY	FOR PAST 12
SOURCE	MONTHLY	FOR PAST 12	SOURCE	CHILDREN	MONTHLY	FOR PAST 12
	INCOME	MONTHS		CHILDREN	INCOME	MONTHS
	INCOME	MONTHS			INCOME	MONTHS

a. WAGES, SALARIES, TIPS, OR				Parent
OTHER CASH GRATUITIES			i. SCHOLARSHIPS OR	Parent
OTHER CASH GRATUITIES
b. INTEREST ON INVESTMENTS,
b. INTEREST ON INVESTMENTS,			EDUCATIONAL GRANTS
BONDS, SAVINGS, TRUST				Child
FUNDS, ETC.
c. INSURANCE OR PUBLIC/			j. SOCIAL SECURITY
GOVERNMENT PENSION			PAYMENTS, DISABILITY	Parent
PAYMENTS, UNEMPLOYMENT OR			OR REGULAR
DISABILITY COMPENSATION			(Specify type)
DISABILITY COMPENSATION
(Specify type)
(Specify type)				Child
				Child

d. NET INCOME FROM RENTAL				Parent
PROPERTY, BUSINESS AND			k. SUPPLEMENTAL	Parent
PROPERTY, BUSINESS AND			k. SUPPLEMENTAL
FARMING (Specify type and			SECURITY INCOME (SSI)	Child
explain in Remarks section)
e. FOREIGN PENSION PAYMENTS			l. VETERANS	Parent
(Specify type and if received			ADMINISTRATION	Parent
based on previous employment,			PAYMENTS (Specify type)
based on previous employment,			PAYMENTS (Specify type)
parent's need, age, military				Child
service, etc., in Remarks section)
f. CONTRIBUTIONS FROM			m. STATE OR LOCAL
PERSONS OTHER THAN			m. STATE OR LOCAL	Parent
PERSONS OTHER THAN			WELFARE AID,	Parent
MEMBER			WELFARE AID,
MEMBER			INCLUDING AID TO
			INCLUDING AID TO
g. TAX REFUNDS (Specify)			DEPENDENT CHILDREN
g. TAX REFUNDS (Specify)			DEPENDENT CHILDREN
			(Include agency in	Child
			Remarks section)	Child
			Remarks section)

h. OTHER (Specify)			n. PAYMENT OR ALIMONY	Parent
			n. PAYMENT OR ALIMONY	Parent
			FROM SEPARATED OR
			FROM SEPARATED OR
			DIVORCED SPOUSE	Child

o. HAS PARENT OR SPOUSE APPLIED FOR ANY TYPE OF PENSION, SOCIAL SECURITY, VA, DISABILITY, UNEMPLOYMENT, OR RETIREMENT PAYMENTS NOT YET RECEIVED? (If Yes, explain.)

YES

IF PARENT OR SPOUSE HAS REACHED THE ELIGIBILITY AGE FOR SOCIAL SECURITY BENEFITS (Unremarried widow or widower, 60 or older, retired, 62 or older), BUT DOES NOT RECEIVE THEM, FURNISH DISALLOWANCE LETTER FROM THE SOCIAL SECURITY ADMINISTRATION.

DD FORM 137-3, MAR 2018	CUI (when filled in)

Page 4 of 5

PREVIOUS EDITION IS OBSOLETE.

CUI (when filled in)

10. MEMBER'S CONTRIBUTION

a. SHOW THE TOTAL AMOUNT THE MEMBER GAVE PARENT, OR PAID IN PARENT'S BEHALF FOR EACH OF THE PAST 12 MONTHS.

(1) MONTH AND YEAR	(2) AMOUNT	(1) MONTH AND YEAR	(2) AMOUNT	(1) MONTH AND YEAR	(2) AMOUNT

b. MEMBER PROVIDES SUPPORT BY (X one)	ALLOTMENT	PERSONAL CHECK	MONEY ORDER
b. MEMBER PROVIDES SUPPORT BY (X one)
(Verification documentation is required for BAH claims)	OTHER (Explain)
	OTHER (Explain)

11. REMARKS (Use back if necessary)

READ THE PENALTY PROVISIONS, SIGN AND DATE THE FORM, AND HAVE IT NOTARIZED.

NOTE: Whoever, in any matter within the jurisdiction of any department or agency of the United States, knowingly and willfully falsifies, conceals, or covers up by any trick, scheme, or device, a material fact, or makes any false, fictitious, or fraudulent statements or representations, or makes or uses any false writing or document knowing the same to contain any false, fictitious, or fraudulent statement or entry, shall be fined as provided in Title 18, or imprisoned not more than 5 years, or both (U.S. Code, title 18, section 1001). The information provided in this form may be referred to the appropriate Military Service investigative agency.

I make the foregoing claim with full knowledge of the penalties involved for willfully making a false claim. (U.S. Code, title 18, section 287, formerly section 80 provides a penalty as follows: Imprisonment for not more than five years and subject to a fine in the amount provided in this title.)

12.SIGNATURES a. PARENT(S)

I,		(print name) and		(print name)

will immediately notify the service concerned of any changes in residency, financial circumstances, or dependency upon the member.

(1) PARENT'S SIGNATURE

(2)DATE SIGNED (YYYYMMDD)

(3) PARENT'S SIGNATURE

(4)DATE SIGNED (YYYYMMDD)

b. NOTARY PUBLIC

Subscribed and duly sworn (or affirmed) to before me according to law by the above named affiant(s).

This

day of

, at city (or town) of

, county of

and state (or territory) of

(Notary)

(Official Seal)

(Official Title)

c. MEMBER

(1) SIGNATURE

(2) DATE SIGNED (YYYYMMDD)

DD FORM 137-3, MAR 2018

CUI (when filled in)

Page 5 of 5

PREVIOUS EDITION IS OBSOLETE.

How to Edit Dd Form 137 3 Online for Free

Handful of things can be quicker than preparing files making use of this PDF editor. There is not much you need to do to update the dd form 137 parent form - only follow these steps in the next order:

Step 1: To start out, click the orange button "Get Form Now".

Step 2: You're now able to change dd form 137 parent. You possess a variety of options with our multifunctional toolbar - you can include, remove, or customize the content material, highlight the certain elements, as well as undertake similar commands.

The next sections will make up the PDF document that you will be filling in:

Put the asked details in the RELATIONSHIP, RELATIONSHIP, DD FORM MAR PREVIOUS EDITION IS, CUI when filled in, Controlled by DFAS Category PRVCY, and Page of part.

Put down all data you may need in the space PARENTS INFORMATION Continued a, COMPLETE ADDRESS Street Apartment, COMPLETE ADDRESS Street Apartment, TELEPHONE NUMBER Include Area Code, TELEPHONE NUMBER Include Area Code, PRESENT OCCUPATION OR BUSINESS, PRESENT OCCUPATION OR BUSINESS, NAME AND ADDRESS OF EMPLOYER If, NAME AND ADDRESS OF EMPLOYER If, c MARITAL STATUS X one, MARRIED SINGLE WIDOWED, DIVORCED LIVING APART UNTIL LEGAL, d IF SPOUSE IS DECEASED OR LEGALLY, GIVE DATE OF DEATH DIVORCE OR, and e IF PARENT AND SPOUSE LIVE APART.

137 3 PARENTS INFORMATION Continued a, COMPLETE ADDRESS Street Apartment, COMPLETE ADDRESS Street Apartment, TELEPHONE NUMBER Include Area Code, TELEPHONE NUMBER Include Area Code, PRESENT OCCUPATION OR BUSINESS, PRESENT OCCUPATION OR BUSINESS, NAME AND ADDRESS OF EMPLOYER If, NAME AND ADDRESS OF EMPLOYER If, c MARITAL STATUS X one, MARRIED SINGLE WIDOWED, DIVORCED LIVING APART UNTIL LEGAL, d IF SPOUSE IS DECEASED OR LEGALLY, GIVE DATE OF DEATH DIVORCE OR, and e IF PARENT AND SPOUSE LIVE APART blanks to complete

The area NAME Last First Middle Initial, DOD ID NUMBER Service Members Only, BRANCH OF SERVICE If on Active, MONTHLY CONTRIBUTION TO PARENT, g DOES ANY OTHER CHILD CLAIM, YES, PARENTS RESIDENCE a TYPE OF, HOME OR APARTMENT OF PARENT, HOME OR APARTMENT OF MEMBER Date, HOME OR APARTMENT OF FRIEND OR, HOSPITAL OR INSTITUTION, and OTHER Explain should be for you to insert each side's rights and obligations.

137 3 NAME Last First Middle Initial, DOD ID NUMBER Service Members Only, BRANCH OF SERVICE If on Active, MONTHLY CONTRIBUTION TO PARENT, g DOES ANY OTHER CHILD CLAIM, YES, PARENTS RESIDENCE a TYPE OF, HOME OR APARTMENT OF PARENT, HOME OR APARTMENT OF MEMBER Date, HOME OR APARTMENT OF FRIEND OR, HOSPITAL OR INSTITUTION, and OTHER Explain blanks to insert

Finalize by looking at the following sections and completing them as required: b OWNER OF RESIDENCE, NAME Last First Middle Initial, ADDRESS Street Apartment Number, c IS RESIDENCE, SUBSIDIZED HOUSING, d DATE PARENT STARTED LIVING AT, YES, DD FORM MAR PREVIOUS EDITION IS, e IS CURRENT ADDRESS PARENTS, If No explain where else parent, YES, CUI when filled in, and Page of.

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