Niti Details

Are you familiar with the Form Cg 5267? If not, you should be. This form is important for business owners and individuals who have income from self-employment activities. The purpose of this form is to report certain information related to your income and your tax liability. Failure to file this form may result in penalties and interest charges. So, if you have any questions about the Form Cg 5267 or need help filling it out, be sure to contact a tax professional. They can help ensure that everything is done correctly and filed on time.

You will find info about the type of form you intend to prepare in the table. It can tell you the time you will need to complete form cg 5267, what parts you need to fill in and several further specific details.

QuestionAnswer
Form NameForm Cg 5267
Form Length2 pages
Fillable?Yes
Fillable fields73
Avg. time to fill out15 min 10 sec
Other namesCG-4170A, niti, 15b, ddle

Form Preview Example

 

U.S. DEPARTMENT OF

 

 

 

APPLICATION FOR ASSIGNMENT TO MILITARY HOUSING

 

HOMELAND SECURITY

 

 

 

 

U.S. COAST GUARD

 

 

 

 

 

(Instructions for preparation of this form are contained on page 2)

 

CG-5267 (01-09)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PRIVACY ACT STATEMENT

 

 

 

 

 

 

 

 

 

 

 

IN ACCORDANCE WITH 5 USC 552(E)(3), THE FOLLOWING INFORMATION IS PROVIDED TO YOU WHEN SUPPLYING PERSONAL INFORMATION TO THE U.S. COAST

 

GUARD.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1. AUTHORITY:

 

SECTION 515 P.L. 84-161, AS AMENDED (10 USC 2674) AUTHORIZED SOLICITATION OF THE INFORMATION.

 

2. PRINCIPAL

 

TO DETERMINE EACH APPLICANT'S ELIGIBILITY FOR ASSIGNMENT TO SUITABLE MILITARY HOUSING ACCOMMODATIONS.

 

 

PURPOSE(S):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. ROUTINE

 

THE INFORMATION IS USED BY CG HOUSING OFFICE TO EVALUATE THE ASSIGNMENT OF HOUSING ACCOMMODATIONS.

 

 

USES:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4. DISCLOSURE:

DISCLOSURE OF THE INFORMATION IS VOLUNTARY, BUT FAILURE TO PROVIDE THE INFORMATION MAY RESULT IN THE INABILITY

 

 

 

 

OF THE CG HOUSING OFFICE TO PROVIDE SUITABLE HOUSING TO THE APPLICANT AND AT THE MOST EXPEDITIOUS TIME.

 

 

 

 

DISCLOSURE OF THE INFORMATION HEREIN CONTAINED TO OTHER THAN THE AGENCY IS IN ACCORDANCE WITH THE FREEDOM

 

 

 

 

OF INFORMATION ACT.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION A - APPLICATION (To be completed by applicant)

 

 

 

 

 

 

 

1. APPLICANT'S NAME ( Last, first, middle initial)

 

 

2. EMPLOYEE IDENTIFICATION NUMBER

3. APPLICANT'S RANK/RATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4. CURRENT DUTY STATION AND PHONE NUMBER

 

 

5. NEW DUTY STATION AND PHONE NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6a. EST. DATE OF DEPARTURE

 

6b. EST. DATE OF ARRIVAL

 

7. ADDRESS AND PHONE NUMBER WHILE ON LEAVE ENROUTE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8. ENLISTMENT EXPIRES (Date)

 

9. ON LIST FOR PROMOTION

 

10a. ON CLASS "A" SCHOOL LIST

 

10b. IF SO, WHICH LIST

 

 

 

 

 

 

 

 

 

YES

NO

 

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SPONSOR INFORMATION

 

 

 

 

 

 

 

 

 

 

 

11a. NAME OF SPONSOR

 

 

 

11b. RANK/RATE

 

11c. SPONSOR'S DUTY STATION AND PHONE NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DEPENDENCY INFORMATION (Check appropriate box)

 

 

 

 

 

 

 

12. MARITAL STATUS

 

 

 

 

 

 

 

13. I AM SEPARATED FROM MY DEPENDENTS

 

 

MARRIED

 

 

SINGLE (CG-4170A not

applicable)

 

 

N/A

 

VOLUNTARILY

 

INVOLUNTARILY

 

 

 

 

 

 

 

 

DEPENDENTS RESIDING WITH ME (If more space is needed, continue on plain paper)

 

 

 

 

 

14a.

 

 

 

 

 

 

 

14b. DATE OF BIRTH

14c.

14d.

 

 

14e.

 

 

 

 

 

 

 

NAME (Last, First, Middle Initial)

 

 

 

(YYYY/MM/DD)

SEX

RELATIONSHIP

 

 

REMARKS, (handicap, health problems, expected

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

additions to family, etc.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YOU MUST ATTACH COPY OF CG-4170A WHICH INDICATES DATES OF APPROVAL OF THOSE DEPENDENTS WHO WILL RESIDE WITH YOU.

 

 

 

 

 

 

 

 

 

 

 

ADDITIONAL DEPENDENT INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15a. SPOUSE IN SERVICE

15b. IF SO, WHICH SERVICE

15c. CURRENT DUTY STATION AND PHONE NUMBER

 

15d. EXPECTED DATE HE/SHE WILL JOIN YOU

 

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16a. ARE YOU ENROLLED IN THE CG SPECIAL NEEDS

16b. IF SO, LIST DEPENDENTS WITH SPECIAL NEEDS.

 

 

 

 

 

 

 

 

PROGRAM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17a. DO YOU HAVE PETS

 

17b. IF SO, WHAT KIND

 

 

 

 

 

17c. AGE

 

17d. WEIGHT

 

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GENERAL

UPON ARRIVAL AT YOUR NEW DUTY STATION, IT IS MANDATORY THAT YOU REPORT TO THE HOUSING AUTHORITY SERVING THE AREA PRIOR TO MAKING ARRANGEMENTS FOR ANY TYPE HOUSING. YOU SHOULD HAVE DD-1747 (previously issued) READY FOR PRESENTATION.

IN THE EVENT ASSIGNMENT TO MILITARY HOUSING BECOMES MANDATORY, THIS IS TO CERTIFY THAT:

I DO

I DO NOT DESIRE A WAIVER TO RESIDE IN CIVILIAN HOUSING

I CERTIFY THAT THE INFORMATION ABOVE IS CORRECT. I HAVE ATTACHED A COPY OF MY ORDERS AND APPROVED CG-4170A HERETO. CG-4170A N/A FOR SINGLE MEMBERS.

DATE SUBMITTED

APPLICANT'S SIGNATURE

 

 

PREVIOUS EDITION IS OBSOLETE

PAGE 2 OF CG-5267 (01-09)

SECTION B - HOUSING AUTHORITY ACTION

1.

APPLICATION EFFECTIVE DATE

2.

DATE APPLICATION RECEIVED

3.

DATE DD-1747 SENT TO APPLICANT

 

 

 

 

 

 

4.

WAITING LIST PLACED ON

5.

EFFECTIVE DATE

6.

APPLICANT NOT PLACED ON WAITING LIST (Reason)

 

 

 

 

 

 

7.

APPLICANT ASSIGNED TO (Housing unit )

8.

DATE OF ASSIGNMENT

9.

BAH TERMINATION EMAIL COMPLETED ON (Date)

 

 

 

 

 

 

 

 

 

INSTRUCTIONS

 

 

 

 

 

SECTION A - APPLICATION

 

ALL BLOCKS ARE SELF EXPLANATORY.

THE APPLICATION MUST BE DATED AND SIGNED BY MEMBER.

SECTION B - HOUSING AUTHORITY ACTION

TO BE COMPLETED BY HOUSING AUTHORITY WHO WILL ACKNOWLEDGE RECEIPT OF APPLICATION, MAIL DD-1747, AND PLACE MEMBER ON WAITING LIST (if applicable)

OR ADVISE REASONS MEMBER NOT PLACED ON WAITING LIST.

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