Dd Form 2754 PDF Details

Dd Form 2754 is a Department of Defense form used to request or order items that are not typically stocked by the organization. The form can be used to request and track the delivery of items from other organizations or to order items for resale. The form is also used to record information about requisitioned items, such as quantities, prices, and delivery dates. The Dd Form 2754 must be completed in triplicate and signed by an authorized individual. Completed forms should be submitted to the organization's supply chain management office.

QuestionAnswer
Form NameDd Form 2754
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesdd form 2754, dd 2754 dec 2017, form 2754 form, dd jrotc worksheet

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JUNIOR RESERVE OFFICER TRAINING CORPS (JROTC) INSTRUCTOR

PAY CERTIFICATION WORKSHEET FOR ENTITLEMENT COMPUTATION

PRIVACY ACT STATEMENT

AUTHORITY: 10 U.S.C. Section 2031; 37 U.S.C. 403 and 405; DoDI 1205.13, Junior Reserve Officer Training Corps (JROTC) Program; DoDFMR 7000.14-R, Vol. 10, Chapter 21; and E.O. 9397.

PRINCIPAL PURPOSE: To obtain data used to determine Junior ROTC Instructor corresponding active duty entitlements. These entitlement amounts will be used in the computation of the amount to be reimbursed to the school district on behalf of that instructor.

ROUTINE USE(S): In addition to those disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act, these records or information

contained therein may specifically be disclosed outside the DoD as a routine use pursuant to 5 U.S.C. 552a(b)(3) as follows: The DoD "Blanket Routine Uses" published at the beginning of the DoD compilation of systems of records notices apply.

DISCLOSURE: Disclosure of this information is voluntary, however, failure to provide the requested information may impede, delay, or reduce the amount of BAH, OHA, and COLA to be used in the reimbursement computation.

INSTRUCTIONS

This form will be used to certify Basic Allowance for Housing (BAH), Overseas Housing Allowance (OHA), and Cost of Living Allowance (COLA). Part A must be completed by instructors employed within CONUS; Part A, and Section II of Part B must be completed by instructors in Alaska and Hawaii; Part A, and all of Part B must be completed by instructors employed overseas. Specific instructions are provided for several items. Supporting documentation required to be submitted with this form by each instructor is listed for each section.

PART A

BAH (Applies to CONUS and Overseas Locations)

1.NAME (Last, First, Middle Initial)

2. RETIRED GRADE 3. SSN

4. BRANCH OF SERVICE RETIRED FROM

ARMY

 

NAVY

 

COAST

AIR FORCE

 

MARINES

 

GUARD

 

 

 

 

 

 

 

 

 

 

5. CURRENT ADDRESS OF INSTRUCTOR

A. STREET (Include apartment or suite number)

B. CITY

C. STATE

D. ZIP CODE

E. DAYTIME TELEPHONE NO.

(Include Area Code)

6. EMPLOYING SCHOOL INFORMATION

A. NAME AND ADDRESS OF SCHOOL (Include ZIP Code)

B. NAME AND ADDRESS OF SCHOOL DISTRICT (Include ZIP Code)

(1)TELEPHONE NUMBER (Include Area Code)

(2)FAX NUMBER (Include Area Code)

(1)TELEPHONE NUMBER (Include Area Code)

(2)FAX NUMBER (Include Area Code)

C. SCHOOL (UNIT) IDENTIFICATION

7.MARITAL STATUS (X one) (If not married, go to Item 9)

8.STATUS OF SPOUSE (X one) (If Spouse is Active Duty or JROTC Instructor, complete Items 8 and 9.)

MARRIED SINGLE

DIVORCED SEPARATED

NON-MILITARY

OTHER FEDERAL SERVICE

ACTIVE DUTY MEMBER

INSTRUCTOR (Junior ROTC Program)

9. IF SPOUSE IS ACTIVE DUTY OR INSTRUCTOR

A. SSN

B. BRANCH OF SERVICE

C. DUTY LOCATION

 

 

 

 

 

 

 

 

 

10A. RESIDING IN GOVERNMENT/EMPLOYER PROVIDED QUARTERS (X one)

B. IF YES, DO EITHER YOU OR YOUR SPOUSE PAY RENT?

 

YES

 

NO

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

11. IF NOT MARRIED, DO YOU HAVE DEPENDENTS?

12. DEPENDENT STATUS (X one)

 

(X one)

 

 

 

RESIDING WITH INSTRUCTOR (Go to Item 14)

 

YES

 

NO

 

NOT RESIDING WITH INSTRUCTOR (Complete Item 13)

 

 

 

 

 

 

 

 

 

 

 

13.DEPENDENT(S) ADDRESS (If not residing with instructor)

A. STREET (Include apartment or suite number)

B. CITY

C. STATE

D. ZIP CODE

DD FORM 2754, SEP 2007

PREVIOUS EDITION IS OBSOLETE.

Adobe Professional 7.0

14.DEPENDENT RELATIONSHIP (Enter one of the following codes)

NOTE: If code selected is B, complete all of Item 15. If code C, K. S, T, or W, complete 15c. only. If code A, D, I, L, or R, do not complete Item 15.

WITHOUT DEPENDENT(S)

WITH DEPENDENT OTHER THAN CHILD(REN) WITH DEPENDENT CHILD(REN)

 

I - Instructor married to

A - Spouse

 

 

B - Child in legal custody of

T - Handicapped child

instructor

D - Parent (including "In Loco Parentis"

someone other than instructor

(over age 21)

R - Own right (single)

which is a person who stood in place

C - Child in instructor's custody

W - Instructor married

 

 

of the natural parents)

K - Ward

to instructor with

 

 

L - Parent(s)-in-law

S - Student (age 21 - 22)

dependent child(ren)

 

 

 

 

 

 

15. IF CLAIMING DEPENDENT CHILD(REN)

 

 

 

 

 

 

 

 

 

A. WHO HAS CUSTODY OF CHILD(REN)?

B. IF IN CUSTODY OF FORMER SPOUSE, AND FORMER SPOUSE IS ACTIVE DUTY OR INSTRUCTOR:

 

 

 

 

 

 

 

 

INSTRUCTOR

 

(1) SSN

(2) DUTY LOCATION

 

 

FORMER SPOUSE

 

 

 

 

 

 

 

 

 

 

 

 

OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C. DATE OF BIRTH OF YOUNGEST CHILD

D. IF YOU DO NOT HAVE CUSTODY, DO YOU PAY CHILD SUPPORT?

 

CLAIMED AS A DEPENDENT (YYYYMMDD)

 

 

 

 

 

YES

IF "YES", INDICATE MONTHLY AMOUNT PAID

 

 

 

 

 

 

 

 

 

 

NO

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SUPPORTING DOCUMENTATION REQUIRED FOR ORIGINAL CERTIFICATION OF BAH

CERTIFICATION OF DEPENDENT(S)

1.Spouse - copy of marriage certificate with seal.

2.Child(ren) - copy of birth certificate with seal.

3.Child(ren) not in instructor's custody - divorce decree, legal separation agreement, court order.

SECONDARY DEPENDENT(S)

1.Parent(s) or parent(s)-in-law - court order of guardianship.

2.Ward - Court order of guardianship.

3.Student (age 21 - 22 in school) - letter from learning instutution verifying full time enrollment.

4.Handicapped child over age 21 - medical sufficiency statement.

VERIFICATION OF GOVERNMENT/EMPLOYER PROVIDED QUARTERS ASSIGNED

1.Letter from housing office if assigned to active duty spouse, or

2.Certification letter from school.

PART B

SECTION I - OHA (Applies to Overseas Locations Only)

16. ACCOMPANIED (X one)

17A. SHARER (X one)

B. IF YES, NUM BER OF SHARERS

 

 

YES

 

NO

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18A. RENTER STATUS (X one)

B. IF RENTING, PROVIDE RENTAL/LEASE DATES:

 

 

 

 

RENT

 

OTHER

(1) FROM (YYYYMMDD)

 

(2) TO (YYYYMMDD)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OWN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

19A. MONTHLY RENT/MORTGAGE PAYMENT

B. TAXES/INSURANCE AMOUNT (If not included in monthly mortgage

C. CURRENCY TYPE

 

 

 

 

payment)

 

 

 

 

 

 

 

 

 

 

 

 

20A. UTILITIES INCLUDED IN MONTHLY

B. IF "NO", LIST MONTHLY AMOUNT(S) BELOW:

 

 

 

RENT (X one)

 

 

(1) WATER

 

 

(2) TRASH REMOVAL

 

(3) ELECTRIC

(4) GAS

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2 1 . DUTY LOCATION (Cit y and Count ry)

SUPPORTING DOCUMENTATION REQUIRED FOR OHA (Original Certification and Recertification)

1.Copy of rental lease, or proof of mortgage payment amount (copy of payment coupon).

2.Evidence of real estate taxes, and homeowner insurance costs, if not included in mortgage payment if renter status in 18.a. is marked "Own".

SECTION II - COLA (Applies to Overseas Locations, Alaska and Hawaii Only)

22.NUMBER OF DEPENDENTS RESIDING WITH INSTRUCTOR

23.JTR LOCATION (To be filled out by pay technician)

CERTIFICATION

I certify that the information provided is true and correct. Entitlements will not be included in the applicable pay computation without this verification and certification of eligibility.

SIGNATURE OF INSTRUCTOR

DATE SIGNED

DD FORM 2754 (BACK), SEP 2007

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Tips on how to fill out dd2754 doc step 1

2. Once this part is completed, proceed to enter the suitable details in all these - a SSN, b BRANCH OF SERVICE, c DUTY LOCATION, a RESIDING IN GOVERNMENTEMPLOYER, b IF YES DO EITHER YOU OR YOUR, YES, YES, IF NOT MARRIED DO YOU HAVE, DEPENDENT STATUS X one, RESIDING WITH INSTRUCTOR Go to, YES, NOT RESIDING WITH INSTRUCTOR, DEPENDENTS ADDRESS If not, a STREET Include apartment or, and b CITY.

Tips on how to prepare dd2754 doc part 2

3. The following segment is mostly about DEPENDENT RELATIONSHIP Enter one, NOTE If code selected is B, WITHOUT DEPENDENTS I Instructor, WITH DEPENDENT OTHER THAN CHILDREN, WITH DEPENDENT CHILDREN B Child, T Handicapped child over age W, IF CLAIMING DEPENDENT CHILDREN, a WHO HAS CUSTODY OF CHILDREN, b IF IN CUSTODY OF FORMER SPOUSE, INSTRUCTOR, FORMER SPOUSE, OTHER, SSN, DUTY LOCATION, and c DATE OF BIRTH OF YOUNGEST CHILD - type in each one of these fields.

Find out how to fill out dd2754 doc portion 3

4. Completing SECTION I OHA Applies to Overseas, ACCOMPANIED X one, a SHARER X one, b IF YES NUM BER OF SHARERS, YES, YES, a RENTER STATUS X one, b IF RENTING PROVIDE RENTALLEASE, RENT, OWN, OTHER, FROM YYYYMMDD, TO YYYYMMDD, a MONTHLY RENTMORTGAGE PAYMENT b, and c CURRENCY TYPE is crucial in this next form section - ensure that you be patient and be mindful with every empty field!

TO YYYYMMDD, SECTION I  OHA Applies to Overseas, and b IF YES NUM BER OF SHARERS of dd2754 doc

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