DD Form 1561 PDF Details

The DD Form 1561, "Statement to Substantiate Payment of Family Separation Allowance (FSA)," serves as a crucial document for military members seeking to apply for FSA, a benefit intended to compensate for the additional expenses incurred when service members are separated from their families due to military obligations. Its authority is grounded in Title 37 of the U.S. Code, Section 427, ensuring its adherence to legal standards and its enforcement. The form's primary purpose is to meticulously evaluate a service member's eligibility for FSA by requiring detailed information about their family situation, deployment status, and the nature of their separation from dependents. It enables the substantiation of FSA payments and incorporates essential privacy considerations, acknowledging the sensitive nature of the personal information it collects. Additionally, the form plays a significant role in maintaining an accurate and traceable record within the service member's pay account, facilitating audits, and assisting in the rectification of erroneous payments. By setting clear criteria for eligibility and requiring service members to certify their familial and deployment circumstances, the DD Form 1561 establishes a structured process for claiming FSA, thereby aiming to ensure that only those truly eligible for the allowance receive it, while also providing a mechanism for accountability and recovery of funds in cases of overpayment.

QuestionAnswer
Form Name DD Form 1561
Form Length 1 pages
Fillable? No
Fillable fields 0
Avg. time to fill out 15 sec
Other names payment fsa, fsa form 2006, da 1561, dd form 1561 dec 2017, statement to substantiate payment of family separation allowance (fsa)

Form Preview Example

STATEMENT TO SUBSTANTIATE PAYMENT OF FAMILY SEPARATION ALLOWANCE (FSA)

PRIVACY ACT STATEMENT

AUTHORITY:Title 37, U.S. Code, Section 427.

PRINCIPAL PURPOSE: To evaluate member's application for FSA.

ROUTINE USES: a. Serves as substantiating document for FSA payments and input into the member's pay account.

b.Provides an audit trail for validating propriety of payments and to assist in collecting erroneous payments.

c.Provides a record in service member's pay account and for safekeeping.

DISCLOSURE:Disclosure of your social security number and other personal information is voluntary. However, if requested information is not provided, FSA will not be considered.

1.NAME OF MEMBER (Last, First, Middle Initial)

2. GRADE

3. SOCIAL SECURITY NUMBER 4. BRANCH AND ORGANIZATION

PART I - MEMBER COMPLETES THIS SECTION TO SUBSTANTIATE ENTITLEMENT TO FSA

5.TYPE II (X as applicable)

FSA-T (Temporary)

FSA-R (Restricted)

FSA-S (Ship)

7.DATE (DDMMYY) DEPARTED RESIDENCE TO UNIT HOME STATION (Mobilized Members)

6. COMPLETE CURRENT ADDRESS(ES) OF DEPENDENT(S)

8. I CERTIFY TO THE FOLLOWING FACTS (X applicable box(es))

a. I am not divorced or legally separated from my spouse.

b. My dependent child (children) was (were) not in the legal custody of another person when I received my military orders.

c. My dependent (other than my spouse; see line f. below) is not a member of the military service on active duty.

d. My sole dependent is not in an institution for a known period of over 1 year or a period expected to exceed 1 year.

e.I am claiming FSA for my parent(s) for whom I have a current and approved dependency status and am residing with, and I maintain a residence(s) for my dependent(s). I have assumed the liability and responsibilities thereof at the address(es) shown above, where I likely reside during periods of leave or such other times as my duty assignment may permit.

f.I am married to another military member currently serving on active duty and my spouse before being separated by execution of my military orders.

was

was not residing with me immediately

Spouse's SSN:

g. My last TDY or deployment, if any,

was

Branch and Component:

was not within the last 30 days from this TDY or deployment.

9.I understand that I must notify my commanding officer immediately upon any change in dependency status and if my sole dependent or all of my dependents move to or near this station or if my dependent(s) visit at or near this station for more than 90 continuous days (more than 30 continuous days in the case of FSA-T (Temp) or FSA-S (Ship) while I am in receipt of FSA.

a.DATE (DDMMYY)

b. SIGNATURE OF MEMBER

PART II - CERTIFYING OFFICER COMPLETES THE APPROPRIATE SECTION(S) BELOW

10.TYPE II - FSA-T. Member has been ordered to and has performed temporary duty (TDY) at the location(s) shown below for more than 30 continuous days. This (these) location(s) is (are) outside a reasonable commuting distance from the member's permanent duty station (PDS pertains to active component) or the home of residence (HOR pertains to reserve component). A distance of 50 miles, one way, is normally considered to be within a reasonable commuting distance of a PDS or HOR. "Within a reasonable commuting distance" also may include distances of less than 50 miles and the time required to travel, under unusual conditions, does not exceed 1-1/2 hours. (Attach a blank page for continuation if necessary.)

a. LOCATION

b. INCLUSIVE DATES OF TDY/T (From/To)

c. NO. OF DAYS

11. TYPE II - FSA-R. Member departed (PCS/detached) from

 

 

 

 

 

 

on

 

 

 

 

(Last permanent duty station)

 

 

 

(DDMMYY)

and was on leave en route

, proceed time

 

 

 

 

 

 

(Inclusive leave dates - DDMMYY)

 

 

 

 

(Inclusive dates)

and the member reported to

 

on

 

. Transportation of

 

 

 

 

 

 

 

 

 

 

 

 

 

(PDS)

 

 

 

(DDMMYY)

 

 

 

 

dependent(s) is not authorized at government expense to this station or to a place near this station.

12.

TYPE II - FSA-S. Member was serving on orders, on board ship, away from homeport commencing (DDMMYY)

.

 

 

 

 

 

 

 

 

a. NAME OF SHIP/UNIT

b. HOMEPORT

 

 

 

 

 

 

 

 

 

 

13.

Travel performed under authority of orders

 

, dated

.

 

 

 

 

 

 

 

 

14.Member claiming Type II FSA, is receiving basic allowance for housing (BAH) (or residing in government type quarters) as a member with dependents or member married to a military member.

15.DATE (DDMMYY)

16. CERTIFYING OFFICER

a. TYPED NAME (Last, First, Middle Initial)

b. TITLE

c. ORGANIZATION

d. SIGNATURE

DD FORM 1561, NOV 2006

PREVIOUS EDITION IS OBSOLETE

Adobe Professional 7.0

How to Edit DD Form 1561 Online for Free

latest version dd1561 can be completed online in no time. Simply try FormsPal PDF editing tool to perform the job promptly. Our tool is continually evolving to give the very best user experience possible, and that is because of our resolve for constant development and listening closely to customer feedback. All it requires is a few simple steps:

Step 1: First of all, open the pdf tool by pressing the "Get Form Button" above on this page.

Step 2: The editor allows you to modify almost all PDF documents in various ways. Enhance it by adding any text, correct what's already in the PDF, and place in a signature - all within the reach of several mouse clicks!

For you to fill out this form, be sure you type in the information you need in each and every blank:

1. Complete your latest version dd1561 with a selection of necessary blank fields. Note all of the important information and be sure nothing is overlooked!

Tips to prepare dd form 1561 army pubs portion 1

2. Once your current task is complete, take the next step – fill out all of these fields - a LOCATION, b INCLUSIVE DATES OF TDYT FromTo, c NO OF DAYS, TYPE II FSAR Member departed, Last permanent duty station, DDMMYY, and was on leave en route, and the member reported to, Inclusive leave dates DDMMYY, PDS, DDMMYY, Inclusive dates, Transportation of, proceed time, and dependents is not authorized at with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

proceed time, c NO OF DAYS, and and the member reported to inside dd form 1561 army pubs

It is easy to make errors when completing the proceed time, so make sure to go through it again before you decide to finalize the form.

Step 3: Ensure the information is accurate and just click "Done" to continue further. Make a 7-day free trial option at FormsPal and gain instant access to latest version dd1561 - which you may then make use of as you want from your personal account page. FormsPal guarantees your information privacy by having a protected method that in no way saves or shares any sensitive information involved in the process. Be confident knowing your files are kept protected whenever you use our tools!

DD Form 1561 isn’t the one you’re looking for?

Related Documents