Dd Form 2654 PDF Details

The Department of Defense's DD Form 2654 is a Certificate of Foreign Medical Review that is used to document an applicant's medical history for the purpose of determining their eligibility for service in the United States Armed Forces. The form must be completed by a licensed medical or osteopathic physician and can be used to verify international medical experience or training. Completing the DD Form 2654 can be cumbersome, so using a reliable online tool like DoDMERB e-Forms can help ensure accuracy and timeliness. umatic completion of this important document. The Department of Defense's DD Form 2654 is a Certificate of Foreign Medical Review that is used to document an applicant's medical history for the purpose of determining their eligibility for service in the

QuestionAnswer
Form NameDd Form 2654
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namesDD_2654 dd form 2654

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INVOLUNTARY ALLOTM ENT NOTICE AND PROCESSING

PRIVACY ACT STATEM ENT

AUTHORITY: 5 USC 5520a, EO 9397.

PRINCIPAL PURPOSE(S): To not if y a member of t he Armed Services or t he Coast Guard of an involunt ary allot ment applicat ion against t he member' s disposable pay; to provide the member an opportunity to respond to the involuntary allotment applicat ion; and to provide for

act ion by t he member' s commander t o f orw ard t he member' s response t o t he Def ense Finance and Account ing Service (or t he Coast Guard Pay and Personnel Cent er) and, as appropriat e, t o make det erminat ions concerning exigencies of milit ary dut y; and t o provide for appeals of exigency det erminat ions.

ROUTINE USE(S): None.

DISCLOSURE: Volunt ary; how ever, failure to provide a response may result in the involuntary allotment of t he member' s disposable pay.

INSTRUCTIONS

1. These inst ruct ions govern not ice and processing of an applicat ion f or an involunt ary allot ment f rom t he pay of a member of the Armed Forces or the Coast Guard under 5 USC 5520a.

2. Sect ion I, it em 1 is t o be complet ed by t he designat ed Def ense Finance and Account ing Service (DFAS) (or Coast Guard Pay and Personnel Cent er) represent at ive. Af t er complet ing t his sect ion, t he represent at ive w ill mail t he f orm, along w it h t w o copies of t he

DD Form 2653, " Involunt ary Allot ment Applicat ion" and associat ed paperw ork, t o t he commander of t he member ident if ied, and one copy t o t he member.

3. Upon receipt , t he commander w ill det ermine if t he member ident if ied in Sect ion I is in his or her unit . If t he member is no longer assigned or available, or, after receiving t he notice required by Section III, requests an ext ension to respond that is granted, t he commander w ill complet e Sect ion II. If t he member is no longer available under Sect ion II, it em 3, t he commander w ill ret urn t he ent ire f orm and applicat ion package t o DFAS (or t he Coast Guard Pay and Personnel Cent er); if an ext ension is aut horized under Sect ion II, it em 4, t hat w ill cause t he member' s response t o be received by DFAS (or t he Coast Guard Pay and Personnel Cent er) lat er t han t he dat e t he response is due, t hen t he commander must immediat ely provide a copy of Sect ions I and II t o DFAS (or t he Coast Guard Pay and Personnel Center). The address f or mailing is: " DFAS, Cleveland Cent er, Code L, PO Box 998002, Cleveland, OH 44199-8002" (or ot her address as specif ied by DFAS). For t he Coast Guard, t he address is: " Coast Guard Pay and Personnel Cent er (LGL), 444 S.E. Quincy St reet , Topeka, KS 66683-3591." If t he member is assigned, t he commander w ill provide t he member a complet e copy of

DD Form 2653, " Involunt ary Allot ment Applicat ion," and counsel t he member in accordance w it h Sect ion III, it ems 7a - g.

4. Af t er counseling, t he commander w ill complet e Sect ion III, it em 8, and t he member w ill complet e Sect ion III, it em 9. The commander

w ill t hen make and ret ain one copy of t he f orm w it h Sect ion III complet ed. Af t er obt aining a copy, t he commander w ill provide t he member t he signed original and advise t he member t o complet e Sect ion IV prior t o t he dat e t he commander specif ies t hat t he member' s response is due.

5. The member w ill complet e Sect ion IV and ret urn t he original f orm and accompanying evidence or addit ional mat t ers, if any, to t he commander on or bef ore t he due dat e as specif ied by t he commander.

6. Follow ing receipt of t he member' s response, t he commander w ill complet e Sect ion V and f orw ard t he original f orm, t o include any addit ional evidence or ot her mat t ers f rom t he member, t o DFAS (or t he Coast Guard Pay and Personnel Cent er) at t he address listed in paragraph 3 above. Not e, if t he member f ails t o respond by t he due dat e, t he commander w ill complet e Sect ion V on a copy of t he

DDForm 2654 previously ret ained in accordance w it h t he inst ruct ions in paragraph 4 above, and f orw ard t he f orm t o DFAS (or t he Coast Guard Pay and Personnel Cent er).

7. Wit hin 5 w orking days f rom t he dat e of f orw arding t o DFAS (or t he Coast Guard Pay and Personnel Cent er), t he commander w ill provide t he member a copy of t he complet ed DD Form 2654.

SECTION I - NOTIFICATION OF APPLICATION FOR INVOLUNTARY ALLOTM ENT

1 . M EM BER IDENTIFICATION

A. NAM E (Last , First , Middle Init ial)

B. SSN

C. RANK

D. BRANCH OF SERVICE

 

 

 

 

2 . DATE RESPONSE DUE (YYYYMMDD) (If not received by t his dat e, an involunt ary allot ment may be aut omat ically processed.)

SECTION II - COM M ANDER' S DETERM INATION OF M EM BER' S AVAILABILITY AND EXTENSIONS TO RESPOND

3 . M EM BER AVAILABILITY

On

 

(dat e - YYYYMMDD), I received t his f orm and an applicat ion f or an involunt ary allot ment f rom t he pay

of t he member ident if ied. The above named member is not available f or purposes of processing an involunt ary allot ment because t he member is as indicat ed below . Of f icial document at ion support ing t his det erminat ion is at t ached.

a.Ret ired (Including placement on t he Temporary or Permanent Disabled Ret ired List ).

b.In a prisoner of w ar st at us.

c.In a missing in act ion st at us.

d.Not assigned or at t ached t o t his unit or organizat ion.

DD FORM 2 6 5 4 , DEC 1 9 9 9

PREVIOUS EDITION IS OBSOLETE.

Page 1 of 4 Pages

SECTION II (Cont inued)

4 . EXTENSION

I have det ermined t hat an ext ension is necessary unt il

not ice and counseling or unable t o respond in a t imely manner above dat e if any f urt her ext ensions are necessary.

(YYYYMMDD) because t he member is not available f or (explain in Remarks sect ion below ). I w ill not if y you prior t o t he

5 . REM ARKS

6 . COM M ANDER OR DESIGNEE

A. SIGNATURE

B. SIGNATURE BLOCK

C. DATE SIGNED (YYYYM M DD)

 

 

 

SECTION III - NOTICE TO M EM BER BY COM M ANDER OR AUTHORIZED DESIGNEE

7 . NOTICE

You are hereby not if ied t hat an applicat ion f or t he est ablishment of an involunt ary allot ment f or t he lesser of 25% of your pay subject t o involunt ary allot ment or t he maximum percent age of pay subject t o garnishment proceedings under t he applicable st at e law has been received. Along w it h t his not ice, I am providing you a copy of t he ent ire applicat ion package.

Addit ionally, you are not if ied t hat :

a.You must respond w it hin 15 calendar days f rom t he dat e of t his not if icat ion by eit her consent ing t o t he involunt ary allot ment or cont est ing it . For good cause show n, I may grant an ext ension of reasonable t ime (normally not exceeding 30 calendar days, except during t imes of deployment , w ar, nat ional emergency, or ot her similar sit uat ions) t o submit a response. Addit ionally, if you f ail t o respond w it hin t he specif ied dat e (or any approved ext ended dat e), your f ailure t o respond w ill be indicat ed in Sect ion V of t his f orm, w hich w ill t hen be sent back t o t he designat ed Def ense Finance and Account ing Service (DFAS) (or Coast Guard Pay and Personnel Cent er) of f icial f or appropriat e act ion.

b.You may cont est t his applicat ion f or any of t he reasons described in Sect ion IV of t his f orm.

c.If you cont est t he applicat ion, you must provide evidence (document ary or ot herw ise) support ing your reasons f or

cont est ing t he applicat ion. Any evidence you submit may be disclosed t o t he applicant f or t his involunt ary allot ment .

d.You may, if reasonably available, consult w it h a legal assist ance at t orney, or a civilian at t orney at no expense t o t he government . If a legal assist ance at t orney is available, you should immediat ely arrange f or an appoint ment . If a legal

assist ance at t orney is not available, you may request a reasonable delay t o enable you t o obt ain legal assist ance. If you have

f ailed t o exercise due diligence in seeking assist ance, I w ill deny a request f or delay.

e. If you cont est t he involunt ary allot ment on t he grounds t hat exigencies of milit ary dut y caused your absence f rom an appearance at t he judicial proceeding at w hich t he judgment w as rendered, t hen I w ill review and make t he f inal det erminat ion on t his cont ent ion. My decision w ill be ref lect ed in Sect ion V of t his f orm w hich w ill be f orw arded t o t he designat ed DFAS (or Coast Guard Pay and Personnel Cent er) of f icial f or appropriat e act ion. I w ill consider t he f ollow ing w hen making t his

det erminat ion:

(1)That exigencies of milit ary dut y are def ined as " a milit ary assignment or mission essent ial dut y t hat , because of it s urgency, import ance, durat ion, locat ion, or isolat ion, necessit at es t he absence of a member of t he milit ary services f rom appearance at a judicial proceeding. Absence f rom an appearance in a judicial proceeding is normally presumed t o be caused by exigencies of milit ary dut y during periods of w ar, nat ional emergency, or w hen t he member is deployed."

(2)Whet her t he milit ary dut ies in quest ion w ere of such paramount import ance t hat t hey prevent ed making you available t o at t end t he judicial proceedings, or rendered you unable t o t imely respond t o process, mot ions, pleadings, or orders of t he court .

f . If you cont est t he involunt ary allot ment on any basis ot her t han exigencies of milit ary dut y, you must ret urn t his f orm and your response t o me. This f orm, t he applicat ion package, and your response w ill t hen be ret urned t o t he designat ed DFAS (or Coast Guard Pay and Personnel Cent er) of f icial w ho w ill consider your response and det ermine w het her t o est ablish t he involunt ary allot ment . The designat ed DFAS (or Coast Guard Pay and Personnel Cent er) of f icial has decision aut horit y on all issues ot her t han exigencies of milit ary dut y.

DD FORM 2 6 5 4 , DEC 1 9 9 9

Page 2 of 4 Pages

SECTION III (Cont inued)

g.If you f ail t o respond t o me w it hin t he t ime period specif ied (including any ext ensions aut horized by me), I shall indicat e your f ailure t o respond in Sect ion V of t his f orm, and mail t his f orm and t he applicat ion package back t o t he designat ed DFAS (or Coast Guard Pay and Personnel Cent er) of f icial f or appropriat e act ion.

8 . COM M ANDER OR DESIGNEE

A. SIGNATURE

B. SIGNATURE BLOCK

C. DATE SIGNED (YYYYMMDD)

9 . M EM BER ACKNOWLEDGM ENT

I hereby acknow ledge t hat t he commander or his or her designee has counseled me in accordance w it h Sect ion III of t his f orm; t hat I am being given an opport unit y t o review t his f orm and t he applicat ion package; I may seek legal assist ance prior t o responding; I have received a copy of DD Form 2653 and t he ent ire applicat ion package f or t his involunt ary allot ment ; and t hat I must complet e Sect ion IV of t his f orm and ret urn t he f orm t o my commander.

A. SIGNATURE

B. DATE SIGNED (YYYYMMDD)

SECTION IV - M EM BER RESPONSE

1 0 . M EM BER WILL INITIAL IN THE APPROPRIATE SPACE(S):

a. I acknow ledge t hat t his is a valid judgment and consent t o t he est ablishment of an involunt ary allot ment .

b. I cont est t his Involunt ary Allot ment Applicat ion f or t he f ollow ing reasons (If cont est ing, you must explain t he reason in

it em 11, " Remarks," and provide appropriat e evidence t o support t he reason.):

(1)

That my right s under t he Soldiers' and Sailors' Civil Relief Act w ere not complied w it h during t he judicial

proceeding upon w hich t his applicat ion is based.

(2)

That exigencies of milit ary dut y caused my absence f rom appearance in a judicial proceeding f orming t he

basis f or t he judgment upon w hich t his applicat ion is sought .

(3)

That inf ormat ion cont ained in t he applicat ion is f alse or erroneous in mat erial part .

(4)

The judgment has been f ully sat isf ied, superseded, or set aside.

(5)

The judgment has been mat erially amended, or part ially sat isf ied. (Provide evidence of t he amount sat isf ied and

t he amount w hich remains in ef f ect .)

(6)

There is a legal impediment t o t he est ablishment of t he involunt ary allot ment . (For example, t he judgment debt

has been discharged in bankrupt cy, or you have f iled f or prot ect ion f rom t he credit or(s) under t he bankrupt cy law s of t he

Unit ed St at es, or t he applicant is not t he judgment credit or or a proper successor in int erest t o t he credit or.)

1 1 . REM ARKS (Use addit ional sheet s if necessary.)

1 2 . M EM BER

A. SIGNATURE

B. DATE SIGNED (YYYYMMDD)

DD FORM 2 6 5 4 , DEC 1 9 9 9

Page 3 of 4 Pages

SECTION V - COM M ANDER' S ACTION AND DETERM INATIONS

1 3 . COM M ANDER OR DESIGNEE WILL INITIAL IN THE APPROPRIATE SPACE:

a.The member has complet ed Sect ion IV of t his f orm and t he member' s response (t o include any addit ional submissions) is hereby f orw arded f or appropriat e act ion.

b. The member ref used t o respond by t he aut horized suspense dat e and t his f orm is hereby ret urned w it hout Sect ion IV complet ed by t he member.

1 4 . COM PLETE ONLY IF THE M EM BER ASSERTED "EXIGENCIES OF M ILITARY DUTY" AS REASON FOR CONTESTING THE INVOLUNTARY ALLOTM ENT APPLICATION (Init ial in t he appropriat e space)

a.Exigencies of milit ary dut y DID NOT CAUSE t he absence of t he member f rom an appearance in t he judicial proceeding upon w hich t his Involunt ary Allot ment Applicat ion is sought .

b.Exigencies of milit ary dut y CAUSED t he absence of t he member f rom an appearance in t he judicial proceeding upon

which t his applicat ion f or involunt ary allot ment is sought . Exigency exist ed due t o:

(X as applicable and explain in it em 15, " Remarks." )

(1) Deployment

(2) War

(3) Nat ional Emergency

(4) Ot her (e.g., Major Exercise)

1 5 . REM ARKS

NOTE: Commander must provide member a copy of t his f orm w it hin 5 days of mailing t o t he designat ed DFAS (or Coast Guard Pay and Personnel Center) official.

1 6 . IF THE APPLICANT CHOOSES TO APPEAL M Y EXIGENCY DETERM INATION, THE APPEAL M UST BE SENT TO:

A. TITLE OF APPEAL AUTHORITY

B. STREET ADDRESS

c. CITY

d. STATE

e. ZIP CODE

1 7 . COM M ANDER OR DESIGNEE

A. SIGNATURE

B. SIGNATURE BLOCK

C. DATE SIGNED (YYYYMMDD)

DD FORM 2 6 5 4 , DEC 1 9 9 9

Page 4 of 4 Pages

How to Edit Dd Form 2654 Online for Free

You can fill out Dd Form 2654 instantly by using our online tool for PDF editing. In order to make our tool better and simpler to work with, we continuously design new features, with our users' suggestions in mind. With a few basic steps, you'll be able to start your PDF journey:

Step 1: Click the "Get Form" button at the top of this webpage to open our tool.

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It's easy to finish the form using this practical guide! This is what you must do:

1. Fill out your Dd Form 2654 with a group of essential blanks. Note all the information you need and make sure absolutely nothing is left out!

Part no. 1 of submitting Dd Form 2654

2. Now that this segment is completed, you need to put in the needed particulars in SECTION II Continued, EXTENSION, I have determined that an, YYYYMMDD because the member is not, notice and counseling or unable to, REMARKS, COM M ANDER OR DESIGNEE, a SIGNATURE, b SIGNATURE BLOCK, c DATE SIGNED YYYYMMDD, SECTION III NOTICE TO M EM BER BY, and NOTICE You are hereby notified allowing you to proceed to the third stage.

The best way to prepare Dd Form 2654 part 2

3. The next stage is easy - fill in every one of the fields in COM M ANDER OR DESIGNEE, a SIGNATURE, b SIGNATURE BLOCK, c DATE SIGNED YYYYMMDD, M EM BER ACKNOWLEDGM ENT I hereby, a SIGNATURE, b DATE SIGNED YYYYMMDD, SECTION IV M EM BER RESPONSE, M EM BER WILL INITIAL IN THE, a I acknow ledge that this is a, b I contest this Involuntary, That my rights under the Soldiers, and That exigencies of military duty in order to finish the current step.

b I contest this Involuntary, That exigencies of military duty, and M EM BER ACKNOWLEDGM ENT I hereby inside Dd Form 2654

4. To move ahead, this next part involves completing a couple of empty form fields. Included in these are That information contained in the, The judgment has been fully, The judgment has been materially, There is a legal impediment to, and REMARKS Use additional sheets if, which are key to moving forward with this particular PDF.

Part number 4 for filling in Dd Form 2654

5. And finally, this final segment is what you have to wrap up before using the PDF. The blanks in question are the next: M EM BER, a SIGNATURE, b DATE SIGNED YYYYMMDD, DD FORM DEC, and Page of Pages.

How one can fill out Dd Form 2654 step 5

Be extremely mindful when completing b DATE SIGNED YYYYMMDD and Page of Pages, because this is the section where a lot of people make some mistakes.

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