DD Form 2767 at a glance
What it is: DD Form 2767 (DEC 2017) is the JROTC Instructor Annual Certification of Pay and Data Form.
Who signs: For the SCHOOL OFFICIAL, enter the TYPED NAME (Last, First, Middle Initial), TITLE and TELEPHONE (Include Area Code), then the SIGNATURE and the DATE (YYYYMMDD). The instructor enters the INSTRUCTOR SIGNATURE and the DATE (YYYYMMDD).
This form is to be submitted to the appropriate Military Service JROTC Instructor Reimbursement Office (JIRO) within 30 days of the instructor's employment, termination, and on a yearly basis when requested by the JIRO (normally at the end of the school year).
A filled-in DD Form 2767 example: a school official certifies a new instructor
How to fill out DD Form 2767, box by box
Instructor name, DoD ID number, sex, status, branch of service and retired grade
Enter the INSTRUCTOR NAME (Last, First, Middle Initial) and the DoD ID NUMBER.
For SEX, mark X one: FEMALE or MALE.
For STATUS, mark X one: NEW, RETURN or RETIRE/RESIGN.
For branch of service (Retired from), mark Army, Air Force, Navy, Marine Corps or Coast Guard.
Enter the RETIRED GRADE.
Name and address of school
Enter the NAME AND ADDRESS OF SCHOOL (Include ZIP Code), mark YES or NO for NEW ADDRESS?, and enter the SCHOOL/UNIT IDENTIFICATION NUMBER.
Name and address of school district
Enter the NAME AND ADDRESS OF SCHOOL DISTRICT (Include ZIP Code), mark YES or NO for NEW ADDRESS?, and enter the DISTRICT IDENTIFICATION OR AREA NUMBER.
Current school year dates of work for JROTC
Enter the CURRENT SCHOOL YEAR DATES OF WORK FOR JROTC, a. FROM (YYYYMMDD) and b. TO (YYYYMMDD); this is not required for new hires.
Upcoming employment period dates of work
Enter the UPCOMING EMPLOYMENT PERIOD DATES OF WORK, a. BEGINNING (YYYYMMDD) and b. ENDING (YYYYMMDD); you MUST complete a separate sheet for any break in contract dates.
Show the inclusive dates during which the individual will be performing DUTIES IN DIRECT SUPPORT OF JROTC, and for which the minimum required salary will be due. Include only the period of time during which the instructor will ACTUALLY be working in support of JROTC. These dates are subject to physical verification at any time by a representative from the applicable Military Service JROTC Headquarters.
The school must immediately notify the appropriate JIRO of any changes to dates indicated.
School official
Instructor certification
By signing, the instructor certifies that they have been hired to instruct at the school for the inclusive work period indicated and that the salary will be for JROTC duties.
More rules for DD Form 2767
The principal purpose is to determine the inclusive work dates of each instructor for employment period of JROTC Instructor duties.
The Military Service is authorized to reimburse the school for one-half the Minimum Instructor Pay unless other arrangements have been approved. Reimbursement to the school/school district is only authorized for the period of time the instructor is covered by a valid contract, and is receiving a salary equal to or greater than Minimum Instructor Pay as computed by the Military Service.
Disclosure is voluntary; however, failure to provide the requested information may impede or delay the reimbursement to the school.
Sources
[1] DD Form 2767 (DEC 2017), JROTC Instructor Annual Certification of Pay and Data Form, U.S. Department of Defense (the Official source link on this page).