Dd Form 2789 PDF Details

The DD Form 2789, or the Waiver/Remission of Indebtedness Application, stands as a crucial document for individuals seeking financial relief from debts owed to the Department of Defense due to overpayments or erroneous payments. This form, outlined by the DoDFMR (Department of Defense Financial Management Regulation) and subject to the approval of the Office of Management and Budget (OMB), serves active duty military members, Guard/Reserve members, retirees, annuitant pay recipients, and civilian employees alike, providing a structured avenue for disputing debts. The process demands detailed information about the individual's service and financial situation, including the type of claim, personal and contact information, detailed explanation of the debt situation, and justification for the remission or waiver request. Specific guidance is offered for completing the form accurately, emphasizing the importance of attaching all relevant documentation and endorsements, the necessity of acknowledging the debt’s validity prior to submission, and the significant consequences for providing false information. This procedure, while voluntary, remains a critical step toward potentially suspending collection actions and rectifying financial discrepancies, underscoring the form’s value in maintaining financial responsibility and integrity within the military and civilian workforce of the Department of Defense.

QuestionAnswer
Form NameDd Form 2789
Form Length6 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 30 sec
Other namesva form 2789, dd 2789 pdf, dd 2789 waiver, how to form indebtedness

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Prescribed by: DoDFMR, Volume 5, Chapter 31

WAIVER/REMISSION OF INDEBTEDNESS APPLICATION

OMB No.0730-0009

If more space is needed, continue on separate sheet(s). Identify each item by number. For further guidance with completing this form,

OMB approval

expires: 20210731

please visit: www.dfas.mil/waiversandremissions.html

 

The public reporting burden for this collection of information is estimated to average 2 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ORGANIZATION.

-Active duty military, Guard/Reserve, retired or annuitant pay recipients, civilian employees, return completed form to the address listed on the debt notification letter for completion of

-the back side.

-Separated Military or former civilian employees, please see instructions website regarding where to send your claim.

-Current Active Duty Military, Guard, Reserve, Retired or Annuitant Pay Recipients, Civilian Employees: Complete Fields 1-19 For completion of the second page of the form. RETURN

-THE FORM TO: DFAS-IN DEPT 3300 (WAIVER/REMISSION), 8899 East 56TH Street, Indianapolis, IN 46249-3300 Unless instructed to send to a different address on debt notification letter.

-Separated Military or Former Civilian Employees complete fields 1-19. Send form to DFAS-IN DEPT. 3300 (WAIVER/REMISSION), 8899 East 56TH Street, Indianapolis, IN 46249-3300

Read Privacy Act Statement and Instructions beginning on Page 3 before completing form

1. TYPE OF CLAIM (X one)

WAIVER

 

REMISSION (Not applicable for civilians) (If Army, please use DA Forms 3508 and 2823.) Authority for

granting waiver: Active/Retired Military - 10 U.S.C. 2774; National Guard - 32 U.S.C. 716; Civilian - 5 U.S.C. 5584; Annuitant - 10 U.S.C. 1442/1453. Remission: Army - 10 U.S.C. 4837; Navy - 10 U.S.C. 6161; Air Force - 10 U.S.C. 9837.

 

 

 

 

SECTION I - CIVILIAN/MILITARY/RETIREE/ANNUITANT INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. NAME (Last, First, Middle Initial)

 

 

 

 

3. RANK/GRADE

4. SOCIAL SECURITY NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5. AGENCY/SERVICE

 

 

6. STATUS (X applicable block and provide date (Y Y Y Y MMDD) for end of enlistment period (E OE ),

 

ARMY

 

OTHER (S pecify)

 

 

 

retirement (DOR ), separation (DOS ), or service computation date (S CD), as appropriate.)

 

 

 

 

 

 

 

 

 

NAVY

 

 

 

 

 

ACTIVE

EOE:

 

 

 

SEPARATED

DOS:

 

 

 

 

 

 

 

 

 

 

 

AIR FORCE

 

 

 

 

GUARD/RESERVE

EOE:

 

 

 

DOD CIVILIAN

SCD:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MARINE CORPS

 

 

 

 

RETIRED

DOR:

 

 

 

ANNUITANT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7. CURRENT COMPLETE MAILING ADDRESS (S treet, City, S tate,

8. PLACE OF ASSIGNMENT OR

9. TELEPHONE (Include DS N or area code)

 

 

ZIP Code)

 

 

 

 

 

EMPLOYMENT

 

 

 

 

 

 

 

 

 

 

 

 

a. WORK

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b. HOME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

c. E-MAIL ADDRESS:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10. TYPE OF DEBT OR ERRONEOUS PAYMENT

11. GROSS DEBT AMOUNT

12. STATE THE DATE AND HOW YOU FIRST BECAME AWARE OF DEBT OR ERRONEOUS PAYMENT. (Attach notification, if available.)

13.IF YOU WERE AWARE OF DEBT OR ERRONEOUS PAYMENT, EXPLAIN THE ACTIONS YOU TOOK TO CORRECT SITUATION.

14.REASON FOR REQUESTING WAIVER/REMISSION AND WHY YOU BELIEVE IT SHOULD BE APPROVED (Financial hardship applies ONLY to RE MIS S ION and if claimed, a financial statement must be attached to include all supporting documentation.)

15.FOR ANNUITANTS, PROVIDE NAME, SSN AND DATE DECEASED OF MILITARY MEMBER/SPONSOR.

16.a. ATTACH COPIES OF ALL PERTINENT DOCUMENTS (S uch as R equest for BAH, S tatement of S ervice, S eparation Worksheet, DD Form 214, Travel Voucher, Notification of Personnel Action). (If not available, please explain.)

b.HR POINT OF CONTACT (Civilian employees):

c. HR POC PHONE:

17.a. IF MILITARY OR CIVILIAN, DID YOU RECEIVE LEAVE AND EARNINGS STATEMENT(S)?

b.IF MILITARY OR CIVILIAN, DID YOU REQUEST THEM ON MYPAY?

c.IF RETIREE OR ANNUITANT, DID YOU RECEIVE AN ACCOUNT STATEMENT?

d.IF RETIREE OR ANNUITANT, DID YOU REVIEW THEM?

(If answer to a. or c. is Y es, attach a copy of statement covering before, during, and after period. If No, explain why.)

YES YES YES YES

NO NO NO NO

18. HAVE YOU FILED FOR A CORRECTION OF MILITARY RECORDS?

 

YES

 

19. I certify the above statements are true and correct to the best of my knowledge. The information presented may be referred to the

NO

appropriate investigating office for verification. I understand the penalty for a false claim is a maximum fine of $10,000 or a maximum imprisonment of 5 years, or both.

a. SIGNATURE (Electronic/Typed not accepted)

b. JOB TITLE/CAREER FIELD

c. DATE SIGNED

DD FORM 2789, JUNE 2019

PREVIOUS EDITION IS OBSOLETE.

Page 1 of 6 Pages

Adobe Professional X

20.COMMANDER'S OR SUPERVISOR'S ENDORSEMENT (R equired for active duty, reserves, guard, and Federal civilian employees. Use separate sheet of paper if needed.)

 

 

 

 

 

 

 

 

 

 

21. RECOMMENDATION:

 

APPROVE

 

PARTIAL $

 

DENY

RECOMMEND COLLECTION RATE $

22.a. COMMANDER'S OR

SUPERVISOR'S NAME

 

b. SIGNATURE (Electronic/Typed not accepted)

 

c. DATE SIGNED

(Please print)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION II - REPORT OF INVESTIGATION

To be completed and signed by appropriate payroll/travel office. (Not applicable for retirees, annuitants, or out-of-service military members.)

23. INFORMATION ON DEBT OR ERRONEOUS PAYMENT(S)

a. GROSS DEBT AMOUNT

b. TYPE(S) OF PAYMENT(S)

 

 

c. DATE(S) OF PAYMENT(S)

 

 

 

 

 

d. (X and complete as applicable)

 

YES

NO

(5) DATE THE DEBT WAS DISCOVERED

(1) HAS THE DEBT BEEN VALIDATED?

 

 

 

 

(2) HAS THE DEBT BEEN POSTED TO THE DEBTOR'S RECORDS?

 

 

(6) NAVY ONLY: AMOUNT UNCOLLECTED AS OF

(3) REMISSION: HAS THE COLLECTION ACTION BEEN SUSPENDED?

 

 

DATE OF THE COMMANDER'S SIGNATURE:

 

 

 

 

$

(4) WAIVER: HAS FINANCE OFFICE SUSPENDED COLLECTION IAW DODFMR, VOL. 5, CH. 31?

 

 

24.A DEBT COMPUTATION MUST ACCOMPANY THIS APPLICATION. It must include dates of erroneous payments, what was paid (broken down by month by entitlements), what should have been paid, and the difference. The total debt must equal the debt posted to the debtor's record. Indicate any entitlements or credits used to offset the debt. This application will be returned without action if the computation is not included. See instructions website for examples.

a. ENTITLEMENT

b. DATE(S)

c. WAS PAID

d. SHOULD HAVE BEEN PAID

e. DIFFERENCE

25.DETAILED STATEMENT OF HOW AND WHY ERROR OCCURRED.

26.IS THERE ANY INDICATION OF FRAUD, MISREPRESENTATION, FAULT, OR LACK OF GOOD FAITH ON THE PART OF THE CLAIMANT?

YES (Explain)

NO

27.STATEMENT AS TO WHETHER OR NOT THE CLAIMANT KNEW OR SHOULD HAVE BEEN AWARE OF RECEIVING AN ERRONEOUS PAYMENT. (Furnish facts and circumstances to support answer, state whether claimant received documents, and provide copies, if available. Use a separate sheet of paper if additional space is required.)

28.REMARKS (Attach a separate sheet of paper, if needed.)

29. RECOMMENDATION:

APPROVE

PARTIAL $

DENY

30. DESIGNATED FINANCIAL AGENT

a.SIGNATURE (Electronic/Typed not accepted)

b. TITLE

c. DATE SIGNED

31a. COMPLETE UNIT MAILING ADDRESS

b. POINT OF CONTACT NAME

c. TELEPHONE

d. DSN

 

 

e. ADSN/DSSN/UIC

f. E-MAIL ADDRESS

 

 

DD FORM 2789, JUNE 2019

Page 2 of 6 Pages

PRIVACY ACT STATEMENT

AUTHORITY: Waiver authority: 10 U.S.C. 1442, "Recovery of Annuity Erroneously Paid;" 10 U.S.C. 1453, "Recovery of Amounts Erroneously Paid;" 10 U.S.C. 2774, "Claims for Overpayment of Pay and Allowances and of Travel and Transportation Allowances;" 32 U.S.C. 716, "Claims for Overpayment of Pay and Allowances, and Travel and Transportation; and E.O. 9397 (SSN), as amended. Remissions authority: Navy 10 U.S.C. 6161; Air Force 10 U.S.C. 9837

PRINCIPAL PURPOSES(S): To be used by civilian employees (current, former, or retired) and military members (active, separated or retired), and annuitants to request waiver of indebtedness collection for erroneous payments of salary or pay and allowances and expense reimbursement or allowances for travel, transportation, and relocation; or in the case of enlisted members, remission of debts.

ROUTINE USE(S): For a complete list of routine uses, visit the applicable systems of records notices:

T7332, Defense Debt Management System: http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/ Article/570181/t7332/

T7335, Defense Civilian Pay System: http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570184/ t7335/

T7340, Defense Joint Military Pay System – Active Component: http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN- Article-View/

Article/570191/t7340/

T7344, Defense Joint Military Pay System – Reserve Component: http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN- Article-View/

Article/570195/t7344/

DISCLOSURE: Voluntary; however, failure to provide this information will result in initiating administrative or salary offset procedures under the provision of the Debt Collection Act of 1982 (Pub. L. 97-365, as amended by Pub L. 104-134, the Debt Collection Improvement Act of 1996).

INSTRUCTIONS FOR COMPLETING DD FORM 2789,

WAIVER/REMISSION OF INDEBTEDNESS APPLICATION

Please note: If you do not agree with the validity of your debt, a waiver request cannot be processed. You must first agree that the debt

is valid. This is not admission to or agreement that you should be responsible for the repayment of the debt. It merely means that you agree that you received an erroneous payment or an overpayment. Once you agree with the validity of the debt you may file for waiver at that time. Please visit www.dfas.mil/waiversandremissions for guidance with completing and submitting your waiver.

To complete the DD Form 2789, please follow instructions below. Please note that an incomplete DD Form 2789 will delay the processing of the Remission/Waiver consideration. Carefully read and complete all information as requested, and be sure to include any required documentation with your submission. If DFAS does not receive a valid DD Form 2789, the indebtedness will continue to be collected. For sections 10 through 16, if you need additional space for this information you can attach a typed and a signed document. All fields must be filled out. If some fields do not apply to you, please put Not Applicable (N/A).

INSTRUCTIONS BY SECTION:

 

 

 

 

 

 

 

 

 

 

 

1.

 

Type of claim (Remission/Waiver)

Place an “X in appropriate box. All service members may apply for

 

 

(Required)

Remission. (Army, Navy, AF, and USMC). Waiver applicants please

 

 

 

refer to http://www.dfas.mil/waiversandremissions.html

 

 

 

for the Remission process.

 

 

 

 

USMC-please refer to

 

 

 

http://www.dfas.mil/waiversandremissions.html

 

 

 

to reference address. The debt had to occur while on Active Duty,

 

 

 

not National Guard Bureau, or Reserve Duty.

 

 

 

 

AF/USMC-use DD Form 2789. Please refer to

 

 

 

http://www.dtic.mil/whs/directives/infomgt/forms/eforms/dd2789.pdf

 

 

 

and send the DD Form 2789 to your agency.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

use DA Form 3508. Please refer to http://

 

 

 

 

Army -

 

 

 

 

 

armypubs.army.mil/eforms/pdf/a3508.pdf

 

 

 

 

 

 

 

 

 

 

 

 

and send the DA Form 3508 to the Army (HRC).

DD FORM 2789, JUNE 2019

 

 

 

 

 

 

Page 3 of 6 Pages

INSTRUCTIONS: Page 1, Section I - Civilian/Military/Retiree/Annuitant Information

2.Name (Required)

3.

Rank/Grade (status at the time of debt)

Civilians: Grade.

 

 

(Required)

Military: Rank.

 

 

 

Retirees: Retired rank/rate.

 

 

 

Annuitants: Not applicable.

 

 

 

 

 

 

4.

Social Security Number (Required)

Debtor’s Social Security Number.

 

 

 

 

 

5.

Agency/Service (Required)

Civilian: Check “Other” and specify what Agency at the time

 

 

 

of debt.

 

 

 

Military: Mark branch of Service.

 

 

 

Retirees: Mark branch of Service.

 

 

 

Annuitants: Mark “Other” and specify “Annuitant”.

 

 

 

 

 

6.

Status at the time of debt (Required)

Active: Fill in “EOE”.

 

 

 

Guard/Reserve: Fill in “EOE.

 

 

Please “X” the applicable box and provide date

Retired: Fill in “DOR”.

 

 

(YYYYMMDD) for end of enlistment period (EOE),

Separated: Fill in “DOS”.

 

 

retirement (DOR), or service computation date (SCD),

DOD Civilian: Fill in “SCD”.

 

 

as appropriate.

Annuitant: Only need to “X” the box, no date needed.

 

 

 

 

 

 

 

7.

Current mailing address (Required)

Current mailing address

 

 

 

 

 

 

8.

Place of assignment or Employment

Civilian: Employing Agency.

 

 

 

Military: Employing Agency/Assignment.

 

 

 

Retirees: Not applicable (Mark N/A).

 

 

 

Annuitants: Not applicable (Mark N/A).

 

 

 

 

 

9a.

Work Telephone (Required)

Work telephone number (if applicable).

 

 

 

 

 

 

9b.

Home Telephone (Required if no work phone)

Home and/or cell telephone number.

 

 

 

 

 

 

 

 

 

 

9c.

E-Mail Address

.gov or .mil e-mail preferred.

 

 

 

 

 

10

Type of Debt or Pay and Allowance Erroneously Paid

Brief description of debt as stated in debt notification letter.

 

 

 

 

 

 

11.

Gross Debt Amount (Required)

Gross debt amount provided on debt notification letter.

 

 

 

 

 

 

12.

State the date and how you first became aware of

Date debt notification letter (or other correspondence, if

 

 

the erroneous payment.

applicable) was received. Attach copy of notification letter

 

 

(Required)

or other correspondence.

 

 

 

 

 

 

 

 

 

 

13.

If you were aware of the debt or erroneous payment,

Explain any actions taken to correct the debt or prevent debt

 

 

explain the actions you took to correct the situation.

from occurring. If needed, explanation can continue on

 

 

(Required)

additional pages. Any additional explanations and

 

 

 

documentation (emails, letters, etc.) showing your attempts

 

 

 

should be signed and submitted with the completed form.

 

 

 

 

 

14.

Reason for requesting a Remission/Waiver and

Explain why you think your Remission/Waiver request should

 

 

why you feel it should be approved.

be approved. Submit any additional documentation with

 

 

(Required)

the completed form.

 

 

 

 

 

15.

For Annuitants, provide name, SSN, and date of

Retirees: Not Applicable (Mark N/A).

 

 

death of deceased Military member/sponsor.

Annuitants: State deceased spouse/sponsor’s full name, SSN,

 

 

(Required)

and date of death.

 

 

 

 

 

DD FORM 2789, JUNE 2019

 

Page 4 of 6 Pages

 

INSTRUCTIONS: Page 1, Section I - Civilian/Military/Retiree/Annuitant Information (Continued)

 

 

 

 

 

 

16a.

Attach copies of all pertinent documents

Attach any supporting documentation from parts #12

 

(Required)

through #14.

 

 

 

 

 

 

16b.

HR Point Of Contact (POC) (Civilian employees

Write HR contact and Telephone number.

 

only) (Required)

 

 

 

 

 

 

 

 

 

 

 

16c.

HR POC phone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17a.

If Military or Civilian, did you receive Leave

Retirees and Annuitants: Not Applicable.

 

and Earnings Statement(s)? (Required)

 

 

 

 

 

 

 

 

 

 

 

17b.

If Military or Civilian, did you request them on

Retirees and Annuitants: Not Applicable.

 

on My Pay? (Required)

 

 

 

 

 

17c.

If Retiree or Annuitant, did you receive a

Retirees and Annuitants: Mark “Yes” if you received an

 

Retiree Account Statement?

Account Statement regarding the debt. Mark "No" if you did

 

(Required)

not receive an Account Statement regarding the debt.

 

 

If “Yes”, attach a copy of the statement covering before,

 

 

during, and after notification.

 

 

 

 

 

17d.

If Retiree or Annuitant, did you review them?

Retirees and Annuitants: Mark “Yes” if you reviewed the

Account Statement. .Mark “No’ if you did not review the

 

(Required)

 

Account Statement.

 

 

 

 

 

 

 

18.

Have you filed for a Correction of Military

Military and Retirees: Mark “Yes” if you have filed for a

 

Records? (Required)

Correction to Military Record. (Please provide all

 

 

documentation from the Board of Corrections concerning their

 

 

findings). Mark “No” if you have not filed for a Correction to

 

 

Military Record. Annuitants can request a change through

 

 

Annuity Pay Office.

 

 

 

 

 

19a

Signature (Handwritten)

Sign form if you certify that your statements on this form are

true and correct to the best of your knowledge. An unsigned

 

(Required)

 

form is considered invalid, cannot be processed, and will be

 

 

 

 

returned.

 

 

 

 

 

19b.

Job Title/Career Field

Civilian and Military: Career Field Retirees: Mark “Retired”

Annuitants: Mark “Annuitant”.

 

 

 

 

 

 

 

 

19c.

Date signed (Required)

Mark date form was completed and signed. An undated form is

 

 

 

considered invalid, cannot be processed, and will be returned.

 

 

 

 

 

 

 

 

Page 2: Parts 20 through 31. Section I - Active duty/Reserves/Federal Civilian Employees

20.

Commander’s or Supervisor’s Endorsement

Please have your commanding officer or supervisor provide a statement giving his or her opinion on the Waiver/Remission request. Required for Navy active duty and reserves guard. Recommended for Federal civilian employees, active duty Army, Air Force, and USMC.

21.Recommendation

22a.

Commander’s or Supervisor’s Name

 

 

 

 

 

 

22b.

Commander’s or Supervisor’s

 

 

 

Handwritten Signature

 

 

 

 

 

 

22c.

Date Signed

 

 

 

 

 

 

Section II - Report of Investigation. To be completed and signed by Military payroll/travel office/civilian payroll, or finance office. (not applicable for retirees, annuitants, or out of service military members).

 

23a.

Gross Debt Amount

Amount of Gross Debt.

 

 

 

 

 

 

 

 

 

 

 

23b.

Type(s) of Payments

List type of payments included in debt.

 

 

 

 

 

 

 

 

 

DD FORM 2789, JUNE 2019

Page 5 of 6 Pages

 

 

INSTRUCTIONS: Page 2, Section II - Report of Investigation (Continued)

 

 

 

 

 

23c.

 

Date(s) of Payment(s)

List the dates of payments received.

 

 

 

 

 

23d1.

 

Has the debt been validated?

Check yes or no.

 

 

 

 

 

23d2.

 

Has the debt been posted to the debtor’s records?

Check yes or no.

 

 

 

 

 

23d3.

 

Remission: Has the collection action been suspended?

Check yes or no.

 

 

 

 

 

 

23d4.

 

Waiver: Has finance office suspended collection

Check yes or no.

 

 

in accordance with DODFMR Vol 5, Ch-31?

 

 

 

 

 

 

24a.

 

Entitlement

Provide type(s) of entitlement included in debt

 

 

 

 

broken down monthly.

 

 

 

 

 

24b.

 

Dates

Provide exact dates of the indebtedness. The debt

 

 

 

 

must be broken down by month.

24c.

 

Was Paid

Provide the amount member was paid, broken down

 

 

 

 

by month.

24d.

 

Should have been paid

Provide the amount the member should have been paid,

 

 

broken down by month.

 

 

 

 

 

 

 

 

 

24e.

 

Difference

Provide the difference amount between what the member was

 

 

 

 

paid, and should have been paid. The difference amount must

 

 

 

 

 

 

 

 

 

 

 

 

be broken down by month.

 

 

 

 

 

25.

 

Detailed statement of how and why error occurred.

Provide detailed explanation for how and why the error occurred.

 

 

 

 

26.

 

Is there any indication of fraud, misrepresentation,

Check yes or no, if yes, please provide a detailed explanation.

 

 

fault, or lack of good faith on the part of the

 

 

claimant?

 

 

 

 

 

27.

 

Statement as to whether or not the claimant knew

Provide a detailed statement which indicates whether the

 

 

or should have been aware of receiving an erroneous

claimant knew or should have known he or she was receiving

 

 

payment.

erroneous payments.

 

 

 

 

28.

 

Remarks

Provide any additional statements, facts, or remarks.

 

 

 

 

 

 

 

 

29.

 

Recommendation

Provide recommendation for waiver request.

 

 

 

.

Please indicate approve, partial, or deny.

 

 

 

Provide hand written signature of designated financial agent.

 

 

 

30a.

 

Designated Financial Agent Handwritten Signature

 

 

 

 

30b.

 

Title

Provide title of signature of designated financial agent.

 

 

 

 

 

30c.

 

Date Signed

Provide date of signature of designated financial agent.

 

 

 

 

31a.

 

Complete Unit mailing Address

Provide complete mailing address of Unit.

 

 

 

 

31b.

 

Point of Contact Name

Provide point of contact for questions regarding the

 

 

 

 

 

Waiver/Remission request.

 

 

 

 

31c.

 

Telephone

Provide telephone number for the point of contact.

 

 

 

 

31d.

 

DSN

Provide DSN for point of contact.

 

 

 

 

 

31e.

 

ADSN/DSSN/UIC

Provide applicable ADSN, DSSN, UIC.

 

 

 

 

 

31f.

 

E-Mail Address

Provide e-mail address for point of contact.

 

 

 

 

DD FORM 2789, JUNE 2019

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How to Edit Dd Form 2789 Online for Free

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1. Whenever submitting the dd form 2789, ensure to include all of the essential fields in the associated area. It will help to expedite the process, which allows your details to be handled fast and accurately.

Filling in part 1 in form 2789

2. When this section is done, proceed to type in the applicable information in all these - IF YOU WERE AWARE OF DEBT OR, REASON FOR REQUESTING, to REMISSION and if claimed a, FOR ANNUITANTS PROVIDE NAME SSN, a ATTACH COPIES OF ALL PERTINENT, Travel Voucher Notification of, b HR POINT OF CONTACT Civilian, c HR POC PHONE, a IF MILITARY OR CIVILIAN DID YOU, b c d, IF MILITARY OR CIVILIAN DID YOU, YES YES YES YES, and NO NO NO NO.

Writing section 2 in form 2789

Always be extremely mindful when filling in IF YOU WERE AWARE OF DEBT OR and b c d, since this is the part in which a lot of people make a few mistakes.

3. Completing b c d, IF MILITARY OR CIVILIAN DID YOU, YES YES YES YES, If answer to a or c is Yes attach, MILITARY RECORDS, YES, appropriate investigating office, a SIGNATURE ElectronicTyped not, b JOB TITLECAREER FIELD, c DATE SIGNED, DD FORM JUNE, PREVIOUS EDITION IS OBSOLETE, Page of Pages Adobe Professional, and NO NO NO NO is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

Completing segment 3 of form 2789

4. Filling out COMMANDERS OR SUPERVISORS, paper if needed, RECOMMENDATION a COMMANDERS OR, APPROVE, Please print, PARTIAL b SIGNATURE, DENY, RECOMMEND COLLECTION RATE c DATE, To be completed and signed by, SECTION II REPORT OF INVESTIGATION, INFORMATION ON DEBT OR ERRONEOUS, b TYPES OF PAYMENTS, c DATES OF PAYMENTS, d X and complete as applicable, and DATE OF THE COMMANDERS SIGNATURE is key in this fourth section - ensure that you take your time and be attentive with each and every field!

form 2789 completion process explained (step 4)

5. The form needs to be wrapped up with this area. Below you will notice a full list of form fields that require specific information to allow your document submission to be complete: DETAILED STATEMENT OF HOW AND WHY, IS THERE ANY INDICATION OF FRAUD, STATEMENT AS TO WHETHER OR NOT, PAYMENT Furnish facts and, and REMARKS Attach a separate sheet.

How one can fill out form 2789 step 5

Step 3: Reread what you have inserted in the form fields and then click on the "Done" button. Obtain the dd form 2789 the instant you register at FormsPal for a free trial. Instantly gain access to the document in your personal account page, along with any edits and adjustments being all synced! If you use FormsPal, it is simple to complete documents without worrying about personal data leaks or entries being distributed. Our secure software makes sure that your personal information is maintained safely.