Dd Form 137 5 Form Details

Dd form 137 5, also known as the Statement of Personal Property, is a document used by individuals and businesses to list their personal belongings. The form is used to identify any assets that may be seized in the event of a legal judgement against the individual or business. The form must be completed accurately and honestly, and updated regularly to reflect any changes in ownership or possession of assets. A failure to complete or update the form can result in penalties, including seizure of assets.

In the list, there's some good information relating to the dd form 137 5. Prior to fill out the form, it's worth reading a little more about it.

QuestionAnswer
Form NameDd Form 137 5
Form Length5 pages
Fillable?Yes
Fillable fields260
Avg. time to fill out26 min 39 sec
Other namesdd 137 5 form, dd 137 5, dd form 137 5, 137 5 dd

Form Preview Example

NATIONAL GUARD RESERVE

DEPENDENCY STATEMENT -

CONTROL NUMBER

OMB No. 0730-0014

 

 

OMB approval expires

INCAPACITATED CHILD OVER AGE 21

 

 

Jul 31, 2017

 

 

The public reporting burden for this collection of information is estimated to average 50 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 this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services, Executive Services Directorate, Directives Division, 4800 Mark Center Drive, Alexandria, VA 22350-3100 (0730-0014). 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 DO NOT RETURN YOUR FORM TO THE ABOVE ORGANIZATION. RETURN

COMPLETED FORM TO YOUR LOCAL SERVING PERSONNEL/PAYROLL OFFICE.

PRIVACY ACT STATEMENT

AUTHORITY: 5 U.S.C. Section 301; Departmental Regulations; 37 U.S.C. Section 404, Travel and Transportation Allowances general; DoD Directive 5154.29, DoD Pay and Allowances Policy and Procedures, Joint Travel Regulation, Chapter 10; and E.O. 9397 (SSN), as amended.

PRINCIPAL 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): In addition to those generally permitted under 5 U.S.C. 552(b), as amended, of the Privacy Act, these records or information

contained therein may specifically be disclosed outside of DoD as a routine use pursuant to 5. U.S.C. 552a(b)(3) as follows: The DoD Blanket Routine Uses published at http://dpcld.defense.gov/Privacy/SORNsIndex/BlanketRoutineUses.aspx apply.

Applicable SORNs: DJMS-AC/RC, DRAS: http://dpcld.defense.gov/Privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/570191/t7340.aspx http://dpcld.defense.gov/Privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/570195/t7344.aspx http://dpcld.defense.gov/Privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/570196/t7347b.aspx

USMC MCTFS: http://dpcld.defense.gov/Privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/570625/m01040-3.aspx

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

INSTRUCTIONS

The member must complete the form in its entirety, sign and date the form, and have it notarized. If the child resides alone or with someone other than the member, the member completes Items 1, 2, and 16, signs and dates the form, and the child or child's representative completes Items 3 through 15, signs and dates the form, and has it notarized. If the member is deceased, the child or child's representative completes the form in its entirety, signs and dates the form, and has it notarized. Information furnished must reflect the 12 months prior to member's death. Verification of income is required.

NOTE: 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.

1.ENTITLEMENTS REQUESTED (X and complete as applicable)

a. TYPE

 

 

b. FIRST APPLICATION?

 

c. LAST APPLICATION WAS

 

BAH

 

USIP CARD

 

YES (If No, give date of last application)

 

 

APPROVED

 

TRAVEL ALLOWANCE

 

NO (YYYYMMDD)

 

 

DISAPPROVED

 

 

 

 

 

 

 

 

 

 

2. MEMBER INFORMATION

a.NAME (Last, First, Middle Initial)

b. SSN

c. RANK

d.STATUS (X and complete as applicable)

ACTIVE DUTY

RETIRED

ARMY

MARINE CORPS

NAVY

AIR FORCE

DECEASED (Date of death) (YYYYMMDD) 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

 

 

h. E-MAIL ADDRESS

i.MARITAL STATUS (X one)

SINGLE SEPARATED

MARRIED DIVORCED

WIDOWED

3. MEMBER'S CHILD

a.NAME (Last, First, Middle Initial)

b. SSN

c. DATE OF BIRTH (YYYYMMDD)

d. RELATIONSHIP TO MEMBER (X one)

 

 

 

 

 

 

LEGITIMATE CHILD

 

CHILD BORN OUT OF WEDLOCK

 

ADOPTED CHILD

 

STEPCHILD

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

f. HAS CHILD EVER BEEN MARRIED? (If Yes, attach a copy of annulment

 

 

 

 

 

 

 

decree, final divorce decree, or death certificate of child's spouse.)

 

 

 

 

 

 

 

 

YES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NO

 

 

DD FORM 137-5,

 

 

 

 

PREVIOUS EDITION IS OBSOLETE.

 

Page 1 of 5 Pages

)(% 201

 

 

 

 

 

 

 

 

 

 

 

Adobe Professional X

4. CHILD'S OTHER PARENT(S)

a.

(1) NAME (Last, First, Middle Initial)

b.

(1) NAME (Last, First, Middle Initial)

 

 

 

 

(2) RELATIONSHIP TO CHILD

(2) RELATIONSHIP TO CHILD

 

 

(3) COMPLETE ADDRESS (Street, Apartment Number, City, State, ZIP Code)

(3) COMPLETE ADDRESS (Street, Apartment Number, City, State, ZIP Code)

 

 

 

 

c.IS/ARE OTHER PARENT(S) IN ANY BRANCH OF SERVICE, INCLUDING RESERVE OR NATIONAL GUARD (X one) (If Yes, show rank, name, SSN, and military address.)

YES

NO

d.DOES OTHER PARENT CLAIM CHILD FOR BASIC ALLOWANCE FOR HOUSING (BAH), TRAVEL ALLOWANCE, OR USIP CARD (X one) (If Yes, explain.)

YES

NO

5. CHILD'S RESIDENCE

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

 

HOME OR APARTMENT OF OTHER PARENT

 

 

HOME OR APARTMENT OF FRIEND OR RELATIVE (State relationship)

 

HOME OR APARTMENT OF MEMBER

 

 

 

 

 

 

 

HOME OR APARTMENT OF CHILD

 

 

HOSPITAL OR INSTITUTION

 

HOME OR APARTMENT OF FORMER SPOUSE OF MEMBER

 

OTHER (Explain)

 

STUDENT DORMITORY OR OTHER ON-CAMPUS FACILITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b. OWNER OF RESIDENCE

 

 

 

 

 

 

(1) NAME (Last, First, Middle Initial)

(2) ADDRESS (Street, Apartment Number, City, State, ZIP Code)

 

 

 

c. IS RESIDENCE SUBSIDIZED HOUSING?

d. DATE CHILD STARTED LIVING AT CURRENT ADDRESS (YYYYMMDD)

 

YES

 

NO

 

 

 

 

 

 

6.IF CHILD IS IN HOSPITAL OR INSTITUTION

If child is in a hospital or institution, all of the following information must be furnished. Obtain this information from the hospital or institution.

a. DATE CHILD ENTERED HOSPITAL/INSTITUTION (YYYYMMDD)

b. ANTICIPATED DATE OF DISCHARGE (If known)

c. WILL CHILD RETURN TO MEMBER'S HOME AFTER DISCHARGE? (If "NO," explain where child will reside)

YES

NO

d. CHILD'S EXPENSES IN HOSPITAL OR INSTITUTION

ITEM

PRESENT MONTHLY

TOTAL EXPENSE FOR

ITEM

PRESENT MONTHLY

TOTAL EXPENSE FOR

EXPENSE

PAST 12 MONTHS

EXPENSE

PAST 12 MONTHS

 

 

 

 

 

 

 

 

 

(1) ROOM

 

 

 

(8) EDUCATION

 

 

 

 

 

 

 

 

 

(2) FOOD

 

 

 

(9) TRANSPORTATION

 

 

 

 

 

 

 

 

 

(3) REHABILITATION CLASSES

 

 

 

(10) PERSONAL INSURANCE

 

 

 

 

 

(Specify)

 

 

OR SERVICES

 

 

 

 

 

 

 

 

 

 

 

 

 

(4) SPECIALIZED EQUIPMENT

 

 

 

 

 

 

 

 

 

 

(11) OTHER (Specify)

 

 

(5)MEDICAL CARE

(6)CLOTHING

(7)LAUNDRY/DRY CLEANING

DD FORM 137-5, )(% 201

Page 2 of 5 Pages

6. IF CHILD IS IN HOSPITAL OR INSTITUTION (Continued)

e. CHILD'S EXPENSES IN HOSPITAL OR INSTITUTION ARE PAID BY:

 

 

SOURCE

PRESENT MONTHLY

TOTAL EXPENSE FOR

SOURCE

PRESENT MONTHLY

TOTAL EXPENSE FOR

 

 

EXPENSE

PAST 12 MONTHS

EXPENSE

PAST 12 MONTHS

 

 

 

 

 

 

 

 

 

 

 

 

(1)

 

(a) CIVILIAN MEDICAL

 

 

(3) STATE OR LOCAL AGENCY

 

 

 

 

 

 

 

 

U

 

TREATMENT FACILITY

 

 

(Give name and address

 

 

S

 

 

 

 

 

 

 

I

 

(CHAMPUS)

 

 

in Remarks section)

 

 

P

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

 

(b) MILITARY MEDICAL

 

 

(4) MEMBER

 

 

A

 

TREATMENT FACILITY

 

 

 

 

R

 

 

 

 

 

 

D

 

 

 

 

 

 

 

(2) PRIVATE INSURANCE

 

 

(5) OTHER (Explain and give

 

 

 

(Give name and address

 

 

name and address in

 

 

 

in Remarks section)

 

 

Remarks section)

 

 

 

 

 

 

 

 

 

 

7. PERSONS LIVING IN HOUSEHOLD WITH CHILD

When child resides in a hospital or institution and Item 6 is completed, do not complete this item. List all persons who live in the household, including claimed child. If employed, show hours per week worked. Continue in Remarks if more space is needed.

a. NAME (Last, First, Middle Initial)

b.RELATIONSHIP TO CHILD

c. AGE

d. MARRIED (X)

e. EMPLOYED

YES

NO

HOURS PER WEEK

NO (X)

 

 

 

 

8. HOUSEHOLD EXPENSES

When child resides in a hospital or institution and Item 6 is completed, do not complete this item. 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 child resides in the member's household or in a dwelling owned by the member, use Fair Rental Value (FRV) for dwelling. If child does not reside in member's household or in a dwelling owned by member, list actual mortgage, rent, or FRV if dwelling is mortgage-free. If FRV is used, give a brief explanation of how Fair Rental Value was obtained using the Remarks section.

FAIR RENTAL VALUE (FRV): FRV is a single monthly sum for the entire dwelling where the child 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.

 

ITEM

 

(1)

(2)

ITEM

(1)

(2)

 

 

PRESENT MONTHLY

TOTAL EXPENSE FOR

PRESENT MONTHLY

TOTAL EXPENSE FOR

 

 

 

 

EXPENSE

PAST 12 MONTHS

 

EXPENSE

PAST 12 MONTHS

a. (X one)

 

 

 

d. FURNITURE AND

 

 

 

RENT

 

FRV

 

 

 

 

 

 

 

 

APPLIANCES

 

 

 

MORTGAGE

 

 

 

 

 

 

 

 

 

 

 

 

 

(Specify amount of tax and

 

 

 

 

 

 

 

 

 

 

 

insurance if applicable)

 

 

 

 

 

 

TAX

 

 

 

e. REPAIRS ON HOME

 

 

 

 

 

 

 

 

 

INSURANCE

 

 

 

 

 

 

b. FOOD

 

 

 

f. OTHER (Itemize in Remarks

 

 

 

 

 

 

 

 

 

 

c. UTILITIES (Heat, power,

 

 

 

 

 

 

section)

 

 

water, and telephone)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9.CHILD'S PERSONAL EXPENSES

When child resides in a hospital or institution and Item 6 is completed, do not complete this item. List all of the child'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

 

 

 

 

 

 

(If auto is registered in

 

 

b. LAUNDRY AND DRY

 

 

 

child's name)

 

 

CLEANING

 

 

 

 

 

 

 

 

 

h. MONTHLY TRANSPORTA-

 

 

 

 

 

 

 

 

c. MEDICAL (Do not include

 

 

 

TION PAYMENTS (Specify

 

 

expenses paid by insurance,

 

 

 

type)

 

 

welfare, or Medicare)

 

 

 

 

 

 

 

 

 

 

 

 

 

d. VALUE OF USIP CARD

 

 

 

i. SCHOOL EXPENSES

 

 

(Verification of amount is

 

 

 

 

 

 

required)

 

 

 

j. OTHER (Specify)

 

 

e.PERSONAL INSURANCE

(Specify)

f.PERSONAL TAXES (Specify)

DD FORM 137-5, FEB 2016

Page 3 of 5 Pages

10. CHILD'S INCOME

All gross income received by or in behalf of the child, whether taxable or nontaxable, and whether received monthly, quarterly, or yearly, must be listed. This includes any income you receive as custodian or administrator for the child. 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)

(2)

 

(1)

(2)

SOURCE

PRESENT

TOTAL INCOME

SOURCE

PRESENT

TOTAL INCOME

MONTHLY

FOR PAST 12

MONTHLY

FOR PAST 12

 

INCOME

MONTHS

 

INCOME

MONTHS

 

 

 

 

 

 

a. WAGES, SALARIES, TIPS, OR

 

 

g. SOCIAL SECURITY PAYMENTS,

 

 

 

 

DISABILITY OR REGULAR (Specify)

 

 

OTHER CASH GRATUITIES

 

 

 

 

 

 

 

 

 

 

 

b. INTEREST ON INVESTMENTS,

 

 

 

 

 

BONDS, SAVINGS, TRUST

 

 

h. SUPPLEMENTAL

 

 

FUNDS, ETC.

 

 

SECURITY INCOME (SSI)

 

 

 

 

 

 

 

 

c. INSURANCE OR PUBLIC/

 

 

i. VETERANS ADMINISTRATION

 

 

GOVERNMENT PENSION

 

 

PAYMENTS (Specify type)

 

 

PAYMENTS, UNEMPLOYMENT

 

 

 

 

 

OR DISABILITY COMPENSATION

 

 

 

 

 

(Specify type)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

j. STATE OR LOCAL WELFARE AID,

 

 

 

 

 

 

 

d. CONTRIBUTIONS FROM

 

 

INCLUDING AID TO DEPENDENT

 

 

PERSONS OTHER THAN

 

 

CHILDREN (Include agency and

 

 

 

 

address in Remarks section)

 

 

MEMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

e. SCHOLARSHIPS OR

 

 

k. OTHER (Specify)

 

 

 

 

 

 

 

EDUCATIONAL GRANTS

 

 

 

 

 

 

 

 

 

 

 

f. TAX REFUNDS (Specify)

 

 

 

 

 

 

 

 

 

 

 

11.CHILD'S EMPLOYMENT (Show additional periods of work in the Remarks section.)

 

HAS CHILD BEEN EMPLOYED DURING THE PAST 12 MONTHS?

 

 

YES

 

 

NO (If Yes, furnish the following:)

 

(1)

NAME OF EMPLOYER

(2)

DATE EMPLOYMENT

(3) DATE EMPLOYMENT

 

(4) MONTHLY SALARY

 

 

 

 

 

 

 

STARTED (YYYYMMDD)

 

ENDED (YYYYMMDD)

 

(Gross)

a.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(5)

TYPE OF WORK PERFORMED

(6)

REASON EMPLOYMENT ENDED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1)

NAME OF EMPLOYER

(2)

DATE EMPLOYMENT

(3) DATE EMPLOYMENT

 

(4) MONTHLY SALARY

 

 

 

 

 

 

 

STARTED (YYYYMMDD)

 

ENDED (YYYYMMDD)

 

(Gross)

b.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(5)

TYPE OF WORK PERFORMED

(6)

REASON EMPLOYMENT ENDED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1)

NAME OF EMPLOYER

(2)

DATE EMPLOYMENT

(3) DATE EMPLOYMENT

 

(4) MONTHLY SALARY

 

 

 

 

 

 

 

STARTED (YYYYMMDD)

 

ENDED (YYYYMMDD)

 

(Gross)

c.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(5)

TYPE OF WORK PERFORMED

(6)

REASON EMPLOYMENT ENDED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

d. IS OR WAS CHILD'S JOB CONSIDERED AS BEING A "SHELTERED WORKSHOP" - THAT IS, OPEN ONLY TO DISABLED OR HANDICAPPED PEOPLE?

 

 

YES

 

NO (If Yes, and child is currently working, attach a statement from the employer verifying this information.)

 

 

 

 

12. CHILD'S SCHOOL ATTENDANCE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HAS CHILD ATTENDED COLLEGE SINCE AGE 21?

 

 

YES

 

 

NO

(If Yes, furnish the following:)

 

(1) NAME AND ADDRESS OF SCHOOL

 

 

 

 

 

 

 

 

 

(2) (X as applicable)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VOCATIONAL

a.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FOR RECEIVING DEGREE

 

(3) DATES ATTENDED

 

 

 

(4) (X)

 

 

 

FULL-TIME

(5) CHILD'S MAJOR

 

 

 

 

 

 

 

 

 

 

 

 

 

PART-TIME

 

 

 

 

 

(1) NAME AND ADDRESS OF SCHOOL

 

 

 

 

 

 

 

 

 

(2) (X as applicable)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VOCATIONAL

b.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FOR RECEIVING DEGREE

 

(3) DATES ATTENDED

 

 

 

(4) (X)

 

 

 

FULL-TIME

(5) CHILD'S MAJOR

 

 

 

 

 

 

 

 

 

 

 

 

 

PART-TIME

 

 

 

 

DD FORM 137-5, FEB 2016

 

 

 

 

 

 

 

 

 

 

 

 

Page 4 of 5 Pages

13. MEMBER'S CONTRIBUTION

a. SHOW THE TOTAL AMOUNT THE MEMBER HAS CONTRIBUTED TO THE CHILD'S SUPPORT 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

OTHER (Explain)

14. 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.)

15.SIGNATURES a. CUSTODIAN

I/we

(print name(s)) will immediately notify

the service concerned of any change in child's financial circumstances, marital status, physical custody, or change in dependency upon the service member as shown in this form.

(1)SIGNATURE OF PERSON WHO HAS PHYSICAL CUSTODY OF THE CHILD (Can be member or other than member)

(2) RELATIONSHIP TO CHILD

(3)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 137-5, FEB 2016

Page 5 of 5 Pages

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dd 137 5 pdf empty spaces to complete

The system will require you to complete the BAH TRAVEL ALLOWANCE, USIP CARD, YES (If No, APPROVED DISAPPROVED, ACTIVE DUTY RETIRED, NATIONAL GUARD RESERVE, ARMY MARINE CORPS, NAVY AIR FORCE, and DECEASED (Date of death) box.

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Describe the most vital details the (2) HOME, SINGLE MARRIED, SEPARATED DIVORCED, WIDOWED, LEGITIMATE CHILD, CHILD BORN OUT OF WEDLOCK e, ADOPTED CHILD, STEPCHILD, DD FORM 137-5, YES NO, PREVIOUS EDITION IS OBSOLETE, and Page 1 of 5 Pages Adobe area.

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Explain the rights and obligations of the parties within the paragraph (1) NAME (Last, (2) RELATIONSHIP TO CHILD, (2) RELATIONSHIP TO CHILD, (3) COMPLETE ADDRESS (Street, (3) COMPLETE ADDRESS (Street, YES, YES, HOME OR APARTMENT OF OTHER PARENT, and HOME OR APARTMENT OF FRIEND OR.

dd 137 5 pdf (1) NAME (Last, (2) RELATIONSHIP TO CHILD, (2) RELATIONSHIP TO CHILD, (3) COMPLETE ADDRESS (Street, (3) COMPLETE ADDRESS (Street, YES, YES, HOME OR APARTMENT OF OTHER PARENT, and HOME OR APARTMENT OF FRIEND OR blanks to insert

Review the fields HOME OR APARTMENT OF OTHER PARENT, HOSPITAL OR INSTITUTION OTHER, (2) ADDRESS (Street, YES, YES, ITEM, PRESENT MONTHLY, EXPENSE, TOTAL EXPENSE FOR, PAST 12 MONTHS, ITEM, PRESENT MONTHLY, EXPENSE, TOTAL EXPENSE FOR, and PAST 12 MONTHS and then complete them.

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