DD Form 1561 at a glance
What it is: DD Form 1561 (DEC 2017) is the Statement to Substantiate Payment of Family Separation Allowance (FSA).
Who signs: In 9a, enter the date (DDMMYY); in 9b, the member signs the SIGNATURE OF MEMBER line.
Part I: the member completes this section to substantiate entitlement to FSA.
Part II: the certifying officer completes the appropriate section(s).
Its purpose is to substantiate payment of Family Separation Allowance (FSA), to provide an audit trail for validating propriety of payments and to assist in collecting erroneous payments, and to provide a record in the service member's pay account.
A filled-in DD Form 1561 example: a married service member claims FSA-T
How to fill out DD Form 1561, box by box
Boxes 1 to 4, the member
Enter the name of the member (Last, First, Middle Initial), the grade, the DoD ID number and the branch and organization.
Boxes 5 and 6, TYPE II and the date departed residence
In 5. TYPE II, mark X as applicable: FSA-T (Temporary), FSA-R (Restricted) or FSA-S (Ship).
In 6, enter the date (DDMMYY) you departed residence to unit home station (Mobilized Members).
Box 7, the address of the dependents
In 7, enter the complete current address(es) of dependent(s).
Box 8, the facts you certify
In 8, certify the facts by marking X in each applicable box.
Mark 8a to certify: I am not divorced or legally separated from my spouse.
Mark 8b to certify: my dependent child (children) was (were) not in the legal custody of another person when I received my military orders.
Mark 8c to certify: my dependent (other than my spouse; see 8f) is not a member of the military service on active duty.
Mark 8d to certify: my sole dependent is not in an institution for a known period of over 1 year or a period expected to exceed 1 year.
Mark 8e to certify: 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 in 7, where I likely reside during periods of leave or such other times as my duty assignment may permit.
Mark 8f to certify: I am married to another military member currently serving on active duty and my spouse was or was not residing with me immediately before being separated by execution of my military orders. Mark was or was not, and enter the spouse's DoD ID number and the branch and component.
Mark 8g to certify: my last TDY or deployment, if any, was or was not within the last 30 days from this TDY or deployment. Mark was or was not.
Box 9, what the member understands, and the member's signature
In 9, you understand that you must notify your commanding officer immediately upon any change in dependency status and if your sole dependent or all of your dependents move to or near this station or if your 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 you are in receipt of FSA.
In 9a, enter the date (DDMMYY); in 9b, the member signs the SIGNATURE OF MEMBER line.
Box 10, FSA-T
For FSA-T (box 10): the member has been ordered to and has performed temporary duty (TDY) at the location(s) entered in 10a 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).
For FSA-T (box 10): 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.
For FSA-T (box 10): attach a blank page for continuation if necessary.
For FSA-T (box 10): in each row, enter a. LOCATION, b. INCLUSIVE DATES OF TDY/T (From/To) and c. NO. OF DAYS.
Box 11, FSA-R
For FSA-R (box 11): enter the last permanent duty station the member departed (PCS/detached) from and the date (DDMMYY), the inclusive leave dates en route (DDMMYY), the proceed time (inclusive dates), and the PDS the member reported to and the date (DDMMYY).
For FSA-R (box 11): transportation of dependent(s) is not authorized at government expense to this station or to a place near this station.
Box 12, FSA-S
For FSA-S (box 12): enter (DDMMYY) for the member serving on orders, on board ship, away from homeport commencing, then the name of ship/unit in 12a and the homeport in 12b.
Boxes 13 and 14, the orders and basic allowance for housing
In 13, enter the orders under whose authority travel was performed, and the date of the orders.
In 14, the 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.
Boxes 15 and 16, the certifying officer
Enter the certifying officer's typed name (Last, First, Middle Initial) in 15a, the title in 15b and the organization in 15c, sign in 15d, and enter the date (DDMMYY) in 16.
More rules for DD Form 1561
Providing the information is voluntary; however, if requested information is not provided, FSA will not be considered.
Sources
[1] Form DD 1561 (DEC 2017), Statement to Substantiate Payment of Family Separation Allowance (FSA), U.S. Department of Defense, Washington Headquarters Services (the Official source link on this page).