Dd Form 2839 PDF Details

If you are a current or former military service member, you may be familiar with the DD Form 2839. This form is used to request military records from the Department of Defense (DoD), and it can be an important resource for veterans and their families. In this blog post, we'll provide an overview of the DD Form 2839 and explain how to submit a request. We'll also discuss some of the most common reasons why veterans and their families might need copies of their military records. If you have any questions about the DD Form 2839 or need help submitting a request, please don't hesitate to contact us!

QuestionAnswer
Form NameDd Form 2839
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namesSSN, DIEMS, ineligibility, 12a

Form Preview Example

CAREER STATUS BONUS (CSB) ELECTION

(Read Instructions before completing form.)

PRIVACY ACT STATEMENT

AUTHORITY: 37 U.S.C. 322; E.O. 9397; ASD(FMP) Memorandum dated February 2, 2001, Subject: Career Status Bonus Implementing Guidance.

PRINCIPAL PURPOSE: To record a member's eligibility and election to receive or not receive the Career Status Bonus with reduced retired pay (REDUX) and to adjust such retired pay according to the member's election.

ROUTINE USE(S): Information may be provided to the Internal Revenue Service to resolve matters relating to an individual's tax withholding; to the Federal Retirement Thrift Investment Board to establish eligibility for contributions to the Thrift Savings Plan for Uniformed Service personnel, and to the Department of Justice or state and local governments when a question of conflicting interest is raised concerning a member's declarations and election.

DISCLOSURE: Voluntary; however, failure to provide the requested information by the time instructed by the member's branch of Service could result in an irrevocable determination affecting the amount of retired pay the individual may later qualify to receive and disqualification for electing the Career Status Bonus.

SECTION I - PERSONAL IDENTIFICATION (To be completed by Service Officials)

1.

NAME (Last, First, Middle Initial)

 

2. SSN

3.

RANK/PAY GRADE/BRANCH OF SERVICE

 

 

 

 

 

 

4.

DIEMS (YYYYMMDD)

5. DATE FOR DETERMINATION OF ACTIVE

6.

DATE OF NOTIFICATION (YYYYMMDD)

 

 

DUTY SERVICE COMPLETED (YYYYMMDD)

 

 

 

 

 

 

 

 

SECTION II - DETERMINATION OF ELIGIBILITY (To be completed by Service Officials)

7.You may be eligible to elect a Career Status Bonus (CSB). To be eligible, you must:

(1)Be on active duty,

(2)Complete 15 years of active duty service,

(3)Have a DIEMS of August 1, 1986 or later, and

(4)Qualify under Service regulations for retention to 20 years of active duty service. Service records indicate that you are currently:

Eligible to elect the Career Status Bonus.

Not eligible to elect the Career Status Bonus.

REASON NOT ELIGIBLE:

8.DATE OF DETERMINATION

(YYYYMMDD)

9. SERVICE AUTHENTICATING REPRESENTATIVE

a. PRINTED NAME (Last, First, Middle Initial)

b. SIGNATURE

 

 

SECTIONS III, IV, or V (To be completed by Member and Witness as directed by Service)

NOTE: Complete only one of these sections and then return it as instructed by your Service.

If not eligible, complete Section III only.

If eligible and you want to elect to receive the bonus, complete Section IV only.

If eligible and you do not want to receive the bonus, complete Section V only.

SECTION III - NOT CURRENTLY ELIGIBLE FOR CAREER STATUS BONUS

Complete this section only if you are not currently eligible to elect the Career Status Bonus and return the form as instructed by your Service.

10.I understand that I am not eligible for the Career Status Bonus at this time and that my ineligibility does not preclude my continued service to retirement if my Service so permits. I understand that I will not receive a bonus and I remain under the High-3 retirement system. I understand that my Service will notify me if I later become eligible to elect the bonus.

a. SIGNATURE

b. DATE SIGNED (YYYYMMDD)

11. WITNESS

a.PRINTED NAME (Last, First, Middle Initial)

b. RANK/PAY GRADE

c. POSITION/DUTY TITLE

d. ORGANIZATION

e. ORGANIZATIONAL ADDRESS

f. SIGNATURE

g. DATE SIGNED (YYYYMMDD)

DD FORM 2839, SEP 2002

PREVIOUS EDITION IS OBSOLETE.

Page 1 of 3 Pages

SECTION IV - ELIGIBLE AND ELECTING TO RECEIVE THE CAREER STATUS BONUS

Complete this section only if you are eligible and you desire to elect to receive the Career Status Bonus. Then return the form as instructed by your Service.

12.I elect to receive the Career Status Bonus payment, with payments as indicated in block 12a below. I make this election upon my attainment of 15 years of active duty service and having been determined eligible for the bonus by my Service. I understand that once the election is effective it may not be revoked. My election is effective once received and accepted at the 15th year of service, or if later, the date received and determined acceptable by my Service, but no later than the date that is six months after being notified of my eligibility. I understand that if I receive the CSB in error, I must repay the full, before-tax bonus amount. I agree to remain on continuous active duty, subject to Service regulations, until I attain a minimum of 20 years of such service. If I fail to complete such service, I understand that I will be required to repay a share of the total ($30,000) bonus payment in proportion to the amount of service I failed to complete compared to the additional service I agreed to serve. Any unpaid installments will be credited to my repayment. If I am separated prior to 20 years of service, I consent to withholding from current pay, final pay, or any other money due me to satisfy this indebtedness. I further consent to such withholding at a rate sufficient to satisfy this indebtedness no later than my separation, and understand that this could result in the withholding of 100% of any current pay, final pay, or other money due me. I further understand that if and when I do retire, it will be under the provisions of the 1986 Military Retirement Reform Act (1986 MRRA, known as REDUX), and that my future retired pay, if based on length of service, will be reduced under such provisions in the form of a reduced multiplier before age 62 and annual Cost-of-Living Adjustments (COLAs) that are 1 percentage point less than I would otherwise receive both before and after age 62, but with a one-time catch-up COLA adjustment at age 62.

I have received the Fact Sheet of Information for Eligible Career Status Bonus Members, explaining the details and effects of making this election.

a. I ELECT TO RECEIVE THE CAREER STATUS BONUS AS FOLLOWS (X the desired option):

(1)

A SINGLE LUMP SUM PAYMENT OF $30,000

 

(4)

FOUR ANNUAL PAYMENTS OF $7,500

(2)

TWO ANNUAL PAYMENTS OF $15,000

 

(5)

FIVE ANNUAL PAYMENTS OF $6,000

 

(3)

THREE ANNUAL PAYMENTS OF $10,000

 

 

 

 

 

 

NOTE: When multiple payments are to be made, the second and later payments are made in January of each succeeding year.

b. SIGNATURE

c. DATE SIGNED (YYYYMMDD)

13. WITNESS

a.PRINTED NAME (Last, First, Middle Initial)

b. RANK/PAY GRADE

c. POSITION/DUTY TITLE

d. ORGANIZATION

e. ORGANIZATIONAL ADDRESS

f. SIGNATURE

g. DATE SIGNED (YYYYMMDD)

SECTION V - ELIGIBLE AND ELECTING NOT TO RECEIVE THE CAREER STATUS BONUS

Complete this section only if you are eligible to receive the Career Status Bonus but you desire NOT to elect the bonus. Then return the form as instructed by your Service.

14.I elect not to receive the Career Status Bonus upon my attainment of 15 years of active duty service. I understand that once the election is effective it may not be revoked. My election is effective once received and accepted at the 15th year of service, or if later, the date received and determined acceptable by my Service, but no later than the date that is six months after being notified of my eligibility. I understand that I will not have any further opportunity to elect to receive this bonus. I understand that I will not receive a bonus payment and that I remain under the High-3 retirement system. I have received the Fact Sheet of Information for Eligible Career Status Bonus Members, explaining the details and effects of making this election not to receive this bonus.

a. SIGNATURE

b. DATE SIGNED (YYYYMMDD)

15. WITNESS

a.PRINTED NAME (Last, First, Middle Initial)

b. RANK/PAY GRADE

c. POSITION/DUTY TITLE

d. ORGANIZATION

e. ORGANIZATIONAL ADDRESS

f. SIGNATURE

g. DATE SIGNED (YYYYMMDD)

SECTION VI - SERVICE RECORDING OF ELECTION

(To be completed by Service Officials after member makes an election to receive the bonus)

16.CSB ELECTION EFFECTIVE DATE (YYYYMMDD)

17.RECORDING OFFICIAL

a.PRINTED NAME (Last, First, Middle Initial)

b. RANK/PAY GRADE

c. POSITION/DUTY TITLE

d. ORGANIZATION

e. ORGANIZATIONAL ADDRESS

f. SIGNATURE

g. DATE SIGNED (YYYYMMDD)

DD FORM 2839 (BACK), SEP 2002

Page 2 of 3 Pages

INSTRUCTIONS FOR COMPLETING DD FORM 2839, CAREER STATUS BONUS (CSB) ELECTION

GLOSSARY:

CSB Election Effective Date: This is the date the member's election to receive a Career Status Bonus becomes irrevocable. This is the date the election is received and accepted at the 15th year of service, or if later, the date received and determined acceptable by the Service concerned, but no later than the date that is six months after the member is notified of eligibility for the Career Status Bonus.

Date of CSB Notification: This is the date the Service processed the notification to the member. The Service should record this date in Section I, Item 6 of the form as this date may determine the effective date of an election.

Date for Determination of Active Duty Service Completed: This is the date used by the Service to compute the number of years of active duty service of a member. The terminology for this varies by Branch of Service.

Date of Initial Entry to Military Service (or Date of Initial Entry to Uniformed Service): This date is referred to as the DIEMS or the DIEUS. Other acronyms or terms may be used in other Branches of Service. This is the date someone first became a member of a Uniformed Service and pertains to the earliest date of enlistment, induction, or appointment in a regular or reserve component of a Uniformed Service as a commissioned officer, warrant officer, or enlisted member. Breaks in service shall not affect the date someone first became a member. Cadets and midshipmen of the Academies, cadets of the Reserve Officer Training Corps, and members of the Delayed Entry Program (DEP) are considered to have become members for the purposes of these provisions. All members should be informed of the implications of these provisions on their potential retired pay.

GENERAL

Service Personnel Officials: Complete Sections I, II, and VI as appropriate to member being notified.

Member: Complete only Section III, IV, or V, as appropriate to your situation.

1.Read these instructions carefully before completing the form.

2.This form will record your election to receive a Career Status Bonus. Your election will carry Service obligation requirements and affect your future retired pay.

3.If eligible to elect the Career Status Bonus, your Service must furnish you a copy of the fact sheet: Information for

Members Eligible to Receive a Career Status Bonus explaining the details and effects of making your election to receive or not to receive the bonus. You should read this fact sheet and consult other sources if desired.

SECTION I: To be completed by Service Officials.

Self-explanatory. Obtain from Service personnel records.

SECTION II: To be completed by Service Officials.

Item 7. This item is to be completed by Service officials and provided to the member on or about the time of completing 14 years and 6 months of active service.

Member: If this item is not completed, obtain a determination from your personnel office.

SECTIONS III, IV and V: To be completed by Member.

Complete only the one section appropriate for your situation. Sign and date the form in the appropriate blocks for the applicable section. Have your signature witnessed as instructed by your Service.

SECTION III: Not Currently Eligible for Career Status Bonus.

Complete Section III only if you have been determined currently not eligible to elect the bonus.

SECTION IV: Eligible and Electing to Receive the Career Status Bonus.

Complete Section IV only if you are eligible and desire to receive the bonus with associated reductions in future retired pay, and you agree to remain on active duty for a minimum of 20 years.

SECTION V: Eligible and Electing NOT to Receive the Career Status Bonus.

Complete Section V only if you are eligible but desire NOT to receive the bonus with associated reductions in retired pay.

SECTION VI: Service Recording of Election.

This section is to be completed by Service officials if the member elects to receive the CSB. If the member was not eligible for the bonus or was eligible but did not elect the bonus, leave this section blank.

DD FORM 2839 (INSTRUCTIONS), SEP 2002

Page 3 of 3 Pages

How to Edit Dd Form 2839 Online for Free

Working with PDF files online is certainly quite easy with our PDF tool. You can fill in SSN here painlessly. FormsPal team is devoted to providing you with the best possible experience with our editor by continuously presenting new features and enhancements. With these improvements, using our tool gets easier than ever! Getting underway is simple! All you should do is take the following simple steps directly below:

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For you to finalize this document, be sure you provide the required details in each and every blank field:

1. While submitting the SSN, make certain to incorporate all of the important blanks in its associated part. It will help to facilitate the process, which allows your information to be handled promptly and appropriately.

How you can fill in YYYYMMDD stage 1

2. The next stage would be to fill in all of the following blanks: I understand that I am not, a SIGNATURE, b DATE SIGNED YYYYMMDD, WITNESS a PRINTED NAME Last First, b RANKPAY GRADE, c POSITIONDUTY TITLE, d ORGANIZATION, e ORGANIZATIONAL ADDRESS, f SIGNATURE, g DATE SIGNED YYYYMMDD, DD FORM SEP, PREVIOUS EDITION IS OBSOLETE, and Page of Pages.

Writing part 2 of YYYYMMDD

3. This subsequent section should be relatively straightforward, a I ELECT TO RECEIVE THE CAREER, A SINGLE LUMP SUM PAYMENT OF, FOUR ANNUAL PAYMENTS OF FIVE, NOTE When multiple payments are to, c DATE SIGNED YYYYMMDD, WITNESS a PRINTED NAME Last First, b RANKPAY GRADE, c POSITIONDUTY TITLE, d ORGANIZATION, e ORGANIZATIONAL ADDRESS, f SIGNATURE, g DATE SIGNED YYYYMMDD, SECTION V ELIGIBLE AND ELECTING, and I elect not to receive the Career - all these fields will have to be completed here.

b RANKPAY GRADE, FOUR ANNUAL PAYMENTS OF FIVE, and A SINGLE LUMP SUM PAYMENT OF in YYYYMMDD

Always be really careful while filling out b RANKPAY GRADE and FOUR ANNUAL PAYMENTS OF FIVE, because this is the section in which many people make errors.

4. This section comes with these empty form fields to focus on: I elect not to receive the Career, b DATE SIGNED YYYYMMDD, WITNESS a PRINTED NAME Last First, b RANKPAY GRADE, c POSITIONDUTY TITLE, d ORGANIZATION, e ORGANIZATIONAL ADDRESS, f SIGNATURE, g DATE SIGNED YYYYMMDD, SECTION VI SERVICE RECORDING OF, CSB ELECTION EFFECTIVE DATE, RECORDING OFFICIAL a PRINTED NAME, b RANKPAY GRADE, c POSITIONDUTY TITLE, and d ORGANIZATION.

Filling in segment 4 in YYYYMMDD

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