Dd Form 137 6 – Fill Out and Use This PDF

The DD Form 137-6 is a vital document for National Guard and Reserve members who need to establish the dependency status of full-time students aged 21 to 22. This form helps in determining the eligibility for Basic Allowance for Housing (BAH) and other authorized benefits, ensuring accurate support for dependents. Completing this form requires attention to detail and understanding the necessary documentation, such as proof of enrollment and member's financial contributions. Ready to start filling out your form? Click the button below for assistance.

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Dd Form 137 6 PDF Details

The DD Form 137-6, titled "National Guard Reserve Dependency Statement - Full Time Student 21-22 Years of Age," acts as a pivotal document for members of the United States National Guard and Reserves who seek to establish the dependency status of their full-time student children aged 21 to 22. This comprehensive form, approved by the Office of Management and Budget (OMB No. 0730-0014) with the current approval expiring on February 28, 2021, necessitates an estimated 30 to 60 minutes to complete. It encompasses a detailed investigation into the student's relationship, dependency, and the verifying member’s eligibility for authorized benefits such as Basic Allowance for Housing (BAH). The form requires meticulous completion, including a notarized statement, to ensure thorough evaluation and verification by the serving personnel or payroll office. Failure to provide complete and accurate information can lead to a suspension of dependent entitlements, highlighting the form's critical role in maintaining the financial support system for eligible students within the military community. Understanding the prerequisites and correctly submitting the DD Form 137-6 is essential for members to navigate this procedure smoothly and uphold their dependents' entitlements.

Question	Answer
Form Name	Dd Form 137 6
Form Length	4 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min
Other names	2008, dd, Washington, dd 137 6

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NATIONAL GUARD RESERVE

DEPENDENCY STATEMENT - FULL TIME STUDENT

21 - 22 YEARS OF AGE

OMB No. 0730-0014 OMB approval expires

February 28, 2021

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.

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 funds 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 certificate.

INSTRUCTIONS: This form is used to determine Basic Allowance for Housing (BAH) eligibility for students 21 - 22 years of age. Member completes items 1 and 15. Member, student, or student's custodian completes Items 2 through 14, and has the form notarized. Answer every question. If any question does not apply, write "NOT APPLICABLE" or "N/A" in that block. Report and verify any income in GROSS amounts. A verification of enrollment at an institution of higher learning is required. Verification must be on official school letterhead, and include the school's name and address, the student's status (full-time or part-time), the projected graduation date, and the school's official stamp. Proof of member's contribution (dependent support allotments, cancelled checks, copies of money order receipts, etc., is required.

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.DoD ID NUMBER

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. STUDENT

a. NAME (Last, First, Middle Initial)	b. DoD ID NUMBER		c. DATE OF BIRTH (YYYYMMDD)

d. COMPLETE ADDRESS (Street, Apartment Number, City, State, ZIP Code)	e. HAS STUDENT EVER BEEN MARRIED? (If Yes, attach a copy of annulment
	decree, final divorce decree, or death certificate of student's spouse.)
		YES
		YES
		NO
4. SCHOOL INFORMATION

a. NAME OF SCHOOL

b. COMPLETE SCHOOL ADDRESS (Street, City, State, ZIP Code)

c. X ALL MONTHS STUDENT ATTENDS SCHOOL

YEAR

JAN

FEB

MAR

APR

MAY

JUN

JUL

AUG

SEP

OCT

NOV

DEC

d. DOES STUDENT ATTEND SCHOOL ON A FULL-TIME BASIS?				e. MONTH AND YEAR STUDENT EXPECTS TO GRADUATE
	YES	NO
DD FORM 137-6, MAR 2018			PREVIOUS EDITION IS OBSOLETE.		Page 1 of 4 Pages

5. STUDENT'S OTHER PARENT(S)

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

(2) RELATIONSHIP TO STUDENT

(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

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

YES

6. STUDENT'S RESIDENCE

a.ADDRESS WHERE STUDENT RESIDES WHILE ATTENDING SCHOOL (Street, Apartment Number, City, State, ZIP Code)

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

STUDENT'S OWN HOME OR APARTMENT		HOME OR APARTMENT OF OTHER PARENT
HOME OR APARTMENT OF MEMBER		HOME OR APARTMENT OF FRIEND OR RELATIVE (State relationship)
HOME OR APARTMENT OF MEMBER'S FORMER SPOUSE
HOME OR APARTMENT OF MEMBER'S WIDOW OR WIDOWER		OTHER (Explain)
STUDENT DORMITORY OR OTHER ON-CAMPUS FACILITY

c. ADDRESS WHERE STUDENT RESIDES, IN EXCESS OF 90 DAYS, WHILE NOT ATTENDING SCHOOL (Street, Apartment Number, City, State, ZIP Code)

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

STUDENT'S OWN HOME OR APARTMENT HOME OR APARTMENT OF MEMBER

HOME OR APARTMENT OF MEMBER'S FORMER SPOUSE HOME OR APARTMENT OF MEMBER'S WIDOW OR WIDOWER STUDENT DORMITORY OR OTHER ON-CAMPUS FACILITY

HOME OR APARTMENT OF OTHER PARENT

HOME OR APARTMENT OF FRIEND OR RELATIVE (State relationship)

OTHER (Explain)

7. PERSONS LIVING IN HOUSEHOLD WITH STUDENT

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

a. NAME (Last, First, Middle Initial)

b.RELATIONSHIP TO STUDENT

c. AGE

d. MARRIED (X)		e. EMPLOYED
YES	NO	HOURS PER WEEK	NO (X)

8. 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 student resides in the member's household or in a dwelling owned by the member, use Fair Rental Value (FRV) for dwelling. If student 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 student 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)
	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
	MORTGAGE
	(Specify amount of tax and
	(Specify amount of tax and
	insurance if applicable)				e. REPAIRS ON HOME
	TAX				e. REPAIRS ON HOME
	TAX
	INSURANCE
b. FOOD					f. OTHER (Itemize in Remarks
					section)
c. UTILITIES (Heat, power,					section)
c. UTILITIES (Heat, power,
water, and telephone)

DD FORM 137-6, MAR 2018							Page 2 of 4 Pages

9. STUDENT'S PERSONAL EXPENSES. List all of the student's personal expenses regardless of who is paying for them.

ITEM	AVERAGE MONTHLY	ITEM
ITEM	EXPENSE	ITEM
	EXPENSE

a. CLOTHING		f. PERSONAL TAXES (Specify)
a. CLOTHING

b. LAUNDRY AND DRY CLEANING		g. PRIVATE AUTO PAYMENTS (If auto is
b. LAUNDRY AND DRY CLEANING		registered in student's name)
		registered in student's name)

c. MEDICAL (Do not include expenses paid		h. MONTHLY TRANSPORTATION PAYMENTS
c. MEDICAL (Do not include expenses paid		(Include gas, oil, insurance, repairs, and
by insurance, welfare, or Medicare)		(Include gas, oil, insurance, repairs, and
by insurance, welfare, or Medicare)		public transportation)
		public transportation)

d. VALUE OF USIP CARD (Verification of		i. OTHER (Specify)
amount is required)

e. PERSONAL INSURANCE (Specify)

AVERAGE MONTHLY

EXPENSE

10.STUDENT'S SCHOOL EXPENSES. List all of the student's school expenses even if covered by scholarship, grant, or other financial aid.

ITEM	AVERAGE MONTHLY	ITEM	AVERAGE MONTHLY
ITEM	EXPENSE	ITEM	EXPENSE
	EXPENSE		EXPENSE

a. TUITION		e. BOARD (Food)

b. BOOKS		f. OTHER SCHOOL EXPENSES (Specify)
b. BOOKS

c. SPECIAL FEES

d. ROOM (Rent)

11. STUDENT'S INCOME

All gross income received by or in behalf of the student, whether taxable or nontaxable, and whether received monthly, quarterly, or yearly, must be listed. This includes any income received by persons in the capacity of custodian or administrator for the student. 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
SOURCE	MONTHLY	FOR PAST 12	SOURCE	MONTHLY	FOR PAST 12
	INCOME	MONTHS		INCOME	MONTHS

a. WAGES, SALARIES, TIPS, OR			g. SOCIAL SECURITY PAYMENTS,
a. WAGES, SALARIES, TIPS, OR			DISABILITY OR REGULAR (Specify)
OTHER CASH GRATUITIES			DISABILITY OR REGULAR (Specify)
OTHER CASH GRATUITIES

b. INTEREST ON INVESTMENTS,
BONDS, SAVINGS, TRUST			h. SUPPLEMENTAL
FUNDS, ETC.			h. SUPPLEMENTAL
FUNDS, ETC.			SECURITY INCOME (SSI)
c. INSURANCE OR PUBLIC/			SECURITY INCOME (SSI)
c. INSURANCE OR PUBLIC/
GOVERNMENT PENSION			i. VETERANS ADMINISTRATION
PAYMENTS, UNEMPLOYMENT			PAYMENTS (Specify type)
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
MEMBER			address in Remarks section)

e. SCHOLARSHIPS OR			k. OTHER (Specify)
e. SCHOLARSHIPS OR
EDUCATIONAL GRANTS

f. TAX REFUNDS (Specify)

12. STUDENT'S EMPLOYMENT

a. HAS STUDENT BEEN EMPLOYED DURING THE PAST 12 MONTHS?			YES	NO (If Yes, furnish the following:)
b. NAME OF EMPLOYER	c. DATE EMPLOYMENT			d. DATE EMPLOYMENT	e. MONTHLY SALARY
		STARTED (YYYYMMDD)		ENDED (YYYYMMDD)	(Gross)

f. TYPE OF WORK PERFORMED

g. REASON EMPLOYMENT ENDED

13. MEMBER'S CONTRIBUTION

a. SHOW THE TOTAL AMOUNT THE MEMBER HAS CONTRIBUTED TO THE STUDENT'S SUPPPORT 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)
DD FORM 137-6, MAR 2018			Page 3 of 4 Pages

14.REMARKS (Use a separate sheet of paper 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. MEMBER, STUDENT, OR CUSTODIAN OF STUDENT
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

(2) 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 137-6, MAR 2018

Page 4 of 4 Pages

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1. Start completing the false with a selection of essential fields. Gather all the important information and be sure not a single thing overlooked!

2. Just after performing this section, head on to the subsequent stage and enter all required particulars in these fields - SCHOOL INFORMATION a NAME OF, b COMPLETE SCHOOL ADDRESS Street, c X ALL MONTHS STUDENT ATTENDS, YEAR, JAN, FEB, MAR, APR, MAY, JUN, JUL, AUG, SEP, OCT, and NOV.

People who use this PDF frequently make errors while filling out JUN in this part. Ensure you revise what you enter here.

3. The following step is rather easy, STUDENTS OTHER PARENTS a, NAME Last First Middle Initial, NAME Last First Middle Initial, RELATIONSHIP TO STUDENT, RELATIONSHIP TO STUDENT, COMPLETE ADDRESS Street Apartment, COMPLETE ADDRESS Street Apartment, c ISARE OTHER PARENTS IN ANY, YES, If Yes show rank name SSN and, d DOES OTHER PARENT CLAIM STUDENT, YES, If Yes explain, STUDENTS RESIDENCE a ADDRESS, and b TYPE OF RESIDENCE X and complete - all these empty fields is required to be completed here.

4. This next section requires some additional information. Ensure you complete all the necessary fields - d TYPE OF RESIDENCE X and complete, STUDENTS OWN HOME OR APARTMENT, PERSONS LIVING IN HOUSEHOLD WITH, HOME OR APARTMENT OF OTHER PARENT, OTHER Explain, List all persons who live in the, space is needed, a NAME Last First Middle Initial, b RELATIONSHIP, TO STUDENT, c AGE, d MARRIED X YES NO, e EMPLOYED, HOURS PER WEEK, and NO X - to proceed further in your process!

5. The last point to complete this document is pivotal. Make sure to fill out the mandatory fields, such as EXPENSE, a X one, FRV, RENT MORTGAGE Specify amount of, b FOOD c UTILITIES Heat power DD, water and telephone, PAST MONTHS, d FURNITURE AND, APPLIANCES, e REPAIRS ON HOME, f OTHER Itemize in Remarks, section, EXPENSE, PAST MONTHS, and Page of Pages, prior to submitting. Otherwise, it may generate a flawed and potentially invalid paper!

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