⇨

Blank DD 93 PDF Form

The DD 93 form, also known as the Record of Emergency Data, is a crucial document for military personnel. It provides vital information regarding an individual's emergency contacts and beneficiaries, ensuring that the right people are notified in case of an emergency. To ensure your information is up to date, please fill out the form by clicking the button below.

Article Guide

The DD 93 form, also known as the Record of Emergency Data, plays a crucial role in the lives of military personnel and their families. This document is designed to ensure that service members can provide essential information about their loved ones in case of an emergency. It captures vital details such as the names and contact information of beneficiaries, medical preferences, and the designation of individuals who should be notified in the event of a crisis. Completing the DD 93 form accurately is imperative, as it directly impacts the support and benefits available to family members during challenging times. Moreover, service members are encouraged to update this form regularly, especially after significant life changes, to guarantee that the information remains current and relevant. Understanding the importance of the DD 93 form is essential for both service members and their families, as it fosters communication and preparedness in moments of uncertainty.

Document Preview

RECORD OF EMERGENCY DATA

PRIVACY ACT STATEMENT

AUTHORITY: 5 USC 552, 10 USC 655, 1475 to 1480 and 2771, 38 USC 1970, 44 USC 3101, and EO 9397 (SSN).

PRINCIPAL PURPOSES: This form is used by military personnel and Department of Defense civilian and contractor personnel, collectively referred to as civilians, when applicable. For military personnel, it is used to designate beneficiaries for certain benefits in the event of the Service member's death. It is also a guide for disposition of that member's pay and allowances if captured, missing or interned. It also shows names and addresses of the person(s) the Service member desires to be notified in case of emergency or death. For civilian personnel, it is used to expedite the notification process in the event of an emergency and/or the death of the member. The purpose of soliciting the SSN is to provide positive identification. All items may not be applicable.

ROUTINE USES: None.

DISCLOSURE: Voluntary; however, failure to provide accurate personal identifier information and other solicited information will delay notification and the processing of benefits to designated beneficiaries if applicable.

INSTRUCTIONS TO SERVICE MEMBER

This extremely important form is to be used by you to show the names and addresses of your spouse, children, parents, and any other person(s) you would like notified if you become a casualty (other family members or fiance), and, to designate beneficiaries for certain benefits if you die. IT IS YOUR RESPONSIBILITY to keep your Record of Emergency Data up to date to show your desires as to beneficiaries to receive certain death payments, and to show changes in your family or other personnel listed, for example, as a result of marriage, civil court action, death, or address change.

INSTRUCTIONS TO CIVILIANS

This extremely important form is to be used by you to show the names and addresses of your spouse, children, parents, and any other person(s) you would like notified if you become a casualty.

Not every item on this form is applicable to you. This form is used by the Department of Defense (DoD) to expedite notification in the case of emergencies or death. It does not have a legal impact on other forms you may have completed with the DoD or your employer.

IMPORTANT: This form is divided into two sections: Section 1 - Emergency Contact Information and Section 2 - Benefits Related Information. READ THE INSTRUCTIONS ON PAGES 3 AND 4 BEFORE COMPLETING THIS FORM.

	SECTION 1 - EMERGENCY CONTACT INFORMATION

1. NAME (Last, First, Middle Initial)		2. SSN

3a. SERVICE/CIVILIAN CATEGORY

ARMY

NAVY

MARINE CORPS

AIR FORCE

DoD

CIVILIAN

CONTRACTOR

b. REPORTING UNIT CODE/DUTY STATION

4a. SPOUSE NAME (If applicable) (Last, First, Middle Initial)			b. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER

SINGLE	DIVORCED	WIDOWED

5. CHILDREN		b. RELATIONSHIP	c. DATE OF BIRTH	d. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER
a. NAME (Last, First, Middle Initial)		b. RELATIONSHIP	(YYYYMMDD)	d. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER
a. NAME (Last, First, Middle Initial)			(YYYYMMDD)

6a. FATHER NAME (Last, First, Middle Initial)	b. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER

7a. MOTHER NAME (Last, First, Middle Initial)	b. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER

8a. DO NOT NOTIFY DUE TO ILL HEALTH	b. NOTIFY INSTEAD

9a. DESIGNATED PERSON(S) (Military only)		b. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER

10. CONTRACTING AGENCY AND TELEPHONE NUMBER (Contractors only)

DD FORM 93, JAN 2008

PREVIOUS EDITION IS OBSOLETE.

Adobe Professional X

SECTION 2 - BENEFITS RELATED INFORMATION

11a. BENEFICIARY(IES) FOR DEATH GRATUITY	b. RELATIONSHIP	c. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER	d. PERCENTAGE
(Military only)

12a. BENEFICIARY(IES) FOR UNPAID PAY/ALLOWANCES		b. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER	c. PERCENTAGE
(Military only) NAME AND RELATIONSHIP

13a. PERSON AUTHORIZED TO DIRECT DISPOSITION (PADD)		b. ADDRESS (Include ZIP Code) AND TELEPHONE NUMBER
(Military only) NAME AND RELATIONSHIP

14. CONTINUATION/REMARKS

15.SIGNATURE OF SERVICE MEMBER/CIVILIAN (Include rank, rate, or grade if applicable)

16.SIGNATURE OF WITNESS (Include rank, rate, or grade as appropriate)

17.DATE SIGNED

(YYYYMMDD)

DD FORM 93 (BACK), JAN 2008

INSTRUCTIONS FOR PREPARING DD FORM 93

(See appropriate Service Directives for supplemental instructions for completion of this form at other than MEPS)

All entries explained below are for electronic or typewriter completion, except those specifically noted. If a computer or typewriter is not available, print in black or blue-black ink insuring a legible image on all copies. Include "Jr.," "Sr.," "III" or similar designation for each name, if applicable. When an address is entered, include the appropriate ZIP Code. If the member cannot provide a current address, indicate "unknown" in the appropriate item. Addresses shown as P.O. Box Numbers or RFD numbers should indicate in Item 14, "Continuations/Remarks", a street address or general guidance to reach the place of residence. In addition, the notation "See Item 14" should be included in the item pertaining to the particular next of kin or when the space for a particular item is insufficient. If the address for the person in the item has been shown in a preceding item, it is unnecessary to repeat the address; however, the name must be entered. Those items that are considered not applicable to civilians will be left blank.

ITEM 1. Enter full last name, first name, and middle initial.

ITEM 2. Enter social security number (SSN).

ITEM 3a. Service. Military: Mark X in appropriate block.

Civilian: Mark two blocks as appropriate. Examples: an Army civilian would mark Army and either Civilian or Contractor; a DoD civilian, without affiliation to one of the Military Services, would mark DoD and then either Civilian or Contractor as appropriate.

ITEM 3b. Reporting Unit Code/Duty Station. See Service Directives.

ITEM 4a. Spouse Name. Enter last name (if different from Item 1), first name and middle initial on the line provided. If single, divorced, or widowed, mark appropriate block.

ITEM 4b. Address and Telephone Number. Enter the "actual" address and telephone number, not the mailing address. Include civilian title or military rank and service if applicable. If one of the blocks in 4a is marked, leave blank.

ITEM 5a-d. Children. Enter last name (only if different from Item 1) first name and middle initial, relationship, and date of birth of all children. If none, so state. Include illegitimate children if acknowledged by member or paternity/maternity has been judicially decreed. Relationship examples: son, daughter, stepson or daughter, adopted son or daughter or ward. Date of birth example: 19950704. For children not living with the member's current spouse, include address and name and relationship of person with whom residing in item 5d.

ITEM 6a. Father Name. Last name, first name and middle initial.

ITEM 6b. Address and Telephone Number of Father. If unknown or deceased, so state. Include civilian title or military rank and service if applicable. If other than natural father is listed, indicate relationship.

ITEM 7a. Mother Name. Last name, first name and middle initial.

ITEM 7b. Address and Telephone Number of Mother. If unknown or deceased, so state. Include civilian title or military rank and service if applicable. If other than natural mother is listed, indicate relationship.

ITEM 8. Persons Not to be Notified Due to Ill Health.

a.List relationship, e.g., "Mother," of person(s) listed in Items 4, 5, 6, or 7 who are not to be notified of a casualty due to ill health. If more than one child, specify, e.g., "daughter Susan." Otherwise, enter "None".

b.List relationship, e.g., "Father" or name and address of person(s) to be notified in lieu of person(s) listed in item 8a. If "None" is entered in Item 8a, leave blank.

ITEM 9a. This item will be used to record the name of the person or persons, if any, other than the member's primary next of kin or immediate family, to whom information on the whereabouts and status of the member shall be provided if the member is placed in a missing status. Reference 10 USC, Section 655. NOT APPLICABLE to civilians.

ITEM 9b. Address and telephone number of Designated Person(s). NOT APPLICABLE to civilians.

ITEM 10. Contracting Agency and Telephone Number

(Contractors only). NOT APPLICABLE to military personnel. Civilian contractors will provide the name of their contracting agency and its telephone number. Example: XYZ Electric, (703) 555-5689. The telephone number should be to the company or corporation's personnel or human resources office.

ITEM 11a. Beneficiary(ies) for Death Gratuity (Military only). Enter first name(s), middle initial, and last name(s) of the person(s) to receive death gratuity pay. A member may designate one or more persons to receive all or a portion of the death gratuity pay. The designation of a person to receive a portion of the amount shall indicate the percentage of the amount, to be specified only in 10 percent increments, that the person may receive. If the member does not wish to designate a beneficiary for the payment of death gratuity, enter "None," or if the full amount is not designated, the payment or balance will be paid as follows:

(1)To the surviving spouse of the person, if any;

(2)To any surviving children of the person and the descendants of any deceased children by representation;

(3)To the surviving parents or the survivor of them;

(4)To the duly appointed executor or administrator of the estate of the person;

(5)If there are none of the above, to other next of kin of the person entitled under the laws of domicile of the person at the time of the person's death.

The member should make specific designations, as it expedites payment.

DD FORM 93 (INSTRUCTIONS), JAN 2008

INSTRUCTIONS FOR PREPARING DD FORM 93

(Continued)

ITEM 11a. (Continued) Seek legal advice if naming a minor child as a beneficiary. If a member has a spouse but designates a person other than the spouse to receive all or a portion of the death gratuity pay, the Service concerned is required to provide notice of the designation to the spouse.

NOT APPLICABLE to civilians.

Item 11b. Relationship. NOT APPLICABLE to civilians.

ITEM 11c. Enter beneficiary(ies) full mailing address and telephone number to include the ZIP Code. NOT

APPLICABLE to civilians.

ITEM 11d. Show the percentage to be paid to each person. Enter 10%, 20%, 30%, up to 100% as appropriate. The sum shares must equal 100 percent. If no percent is indicated and more than one person is named, the money is paid in equal shares to the persons named. NOT APPLICABLE to

civilians.

ITEM 12a. Beneficiary(ies) for Unpaid Pay/Allowance (Military only). Enter first name(s), middle initial, last name(s) and relationship of person to receive unpaid pay and allowances at the time of death. The member may indicate anyone to receive this payment. If the member designated two or more beneficiaries, state the percentage to be paid each in item 10c. If the member does not wish to designate a beneficiary, enter "By Law." The member is urged to designate a beneficiary for unpaid pay and allowances as payment will be made to the person in order of precedence by law (10 USC 2771) in the absence of a designation. Seek legal advice if naming a minor child as beneficiary. NOT APPLICABLE to civilians.

ITEM 12b. Enter beneficiary(ies) full mailing address and telephone number to include the ZIP Code. NOT

APPLICABLE to civilians.

ITEM 12c. If the member designated two or more beneficiaries, state the percentage to be paid each in this section. The sum shares must equal 100 percent. NOT

APPLICABLE to civilians.

ITEM 13a. Enter the name and relationship of the Person Authorized to Direct Disposition (PADD) of your remains should you become a casualty. Only the following persons may be named as a PADD: surviving spouse, blood relative of legal age, or adoptive relatives of the decedent. If neither of these three can be found, a person standing in loco parentis may be named. NOT APPLICABLE to civilians.

ITEM 13b. Address and telephone number of PADD. NOT

APPLICABLE to civilians.

ITEM 14. Continuations/Remarks. Use this item for remarks or continuation of other items, if necessary. Prefix entry with the number of the item being continued; for example, 5/John J./son/ 19851220/321 Pecan Drive, Schertz TX 78151. Also use this item to list name, address, and relationship of other persons the member desires to be notified. Other dependents may also be listed. This block offers the greatest amount of flexibility for the member to record other important information not otherwise requested but considered extremely useful in the casualty notification and assistance process. Besides continuing information from other blocks on this form, the member may desire to include additional information such as: NOK language barriers, location or existence of a Will, additional private insurance information, other family member contact numbers, etc. If additional space is required, attach a supplemental sheet of standard bond paper with the information.

ITEM 15. Signature of Service Member/Civilian. Check and verify all entries and sign all copies in ink as follows: First name, middle initial, last name. Include rank, rate, or grade if applicable. May be electronically signed (see DoD Instruction 1300.18 for guidelines).

ITEM 16. Signature of Witness. Have a witness (disinterested person) sign all copies in ink as follows: First name, middle initial, last name. Include rank, rate, or grade as appropriate. A witness signature is not required for electronic versions of the DD Form 93 (see DoD Instruction 1300.18).

ITEM 17. Date the member or civilian signs the form. This item is an ink entry and must be completed on all copies.

DD FORM 93 (INSTRUCTIONS) (BACK), JAN 2008

➤ PDF File

Form Specifications

Fact Name	Description
Purpose	The DD 93 form is used by military personnel to designate beneficiaries for various benefits, including life insurance and death benefits.
Eligibility	Active duty members of the Armed Forces, including Army, Navy, Air Force, Marine Corps, and Coast Guard, must complete this form.
Submission	This form must be submitted to the appropriate military personnel office or unit for processing.
Updates	Service members should update the DD 93 whenever there are changes in marital status, beneficiaries, or personal information.
Governing Law	The DD 93 is governed by Department of Defense regulations and policies, specifically under Title 10 of the United States Code.

DD 93: Usage Guidelines

Filling out the DD 93 form is an important step in ensuring that your personal information is accurately recorded. This form will help establish your preferences for beneficiaries and emergency contacts. After completing the form, you will need to submit it to the appropriate military personnel office.

Obtain a copy of the DD 93 form. This can usually be found online or at your unit's administrative office.
Begin by filling in your personal information in the designated sections. This includes your name, Social Security number, and date of birth.
Provide your current address and contact information. Make sure to include a phone number where you can be reached.
Designate your primary beneficiary. This is the person you wish to receive any benefits in the event of your death.
If applicable, list secondary beneficiaries. These individuals will receive benefits if the primary beneficiary is unable to do so.
Fill out the section for emergency contacts. Include names and phone numbers of people who can be contacted in case of an emergency.
Review all the information for accuracy. Double-check names, addresses, and phone numbers.
Sign and date the form at the bottom. Ensure that your signature matches the name provided on the form.
Submit the completed form to your unit's administrative office or designated personnel.

Your Questions, Answered

What is the DD 93 form?

The DD 93, also known as the Record of Emergency Data, is a form used by members of the U.S. Armed Forces to provide vital information about their emergency contacts and beneficiaries. This form is essential for ensuring that, in the event of an emergency, the right people are notified and that benefits are distributed according to the member's wishes. It includes details such as the member's marital status, children, and preferred contacts in case of an emergency.

Who needs to fill out the DD 93 form?

All active duty service members, reservists, and National Guard personnel are required to complete the DD 93 form. This ensures that the military has up-to-date information about whom to contact in case of an emergency or when a service member is injured or killed. Updating this form regularly is crucial, especially after significant life events like marriage, divorce, or the birth of a child.

How do I fill out the DD 93 form?

Filling out the DD 93 form involves providing personal information, including your name, Social Security number, and service details. You will also need to list your emergency contacts, including their relationship to you and their contact information. It's important to be thorough and accurate. After completing the form, review it carefully to ensure all information is correct before submitting it to your unit's personnel office.

Where do I submit the completed DD 93 form?

Once you have completed the DD 93 form, submit it to your unit's personnel office or administrative office. They will keep it on file and ensure that it is accessible in case of an emergency. It’s a good idea to keep a personal copy for your records as well.

Can I update my DD 93 form if my circumstances change?

Yes, you can and should update your DD 93 form whenever there are changes in your personal circumstances. This includes changes in marital status, the birth or adoption of a child, or if you want to change your emergency contacts. Keeping this information current is vital for ensuring that the right people are notified in case of an emergency.

What happens if I don’t fill out the DD 93 form?

If you do not complete the DD 93 form, it may lead to complications during emergencies. Without this critical information, the military may struggle to contact your loved ones or ensure that benefits are distributed according to your wishes. Therefore, it is essential to complete and maintain this form to ensure your preferences are honored.

Common mistakes

Failing to include all required personal information. This includes full name, Social Security number, and date of birth.
Not updating the form after major life changes. Changes such as marriage, divorce, or the birth of a child should be reflected.
Overlooking the designation of beneficiaries. Ensure that beneficiaries are clearly identified and their information is accurate.
Using incorrect or outdated contact information for beneficiaries. Always verify that phone numbers and addresses are current.
Neglecting to sign and date the form. A signature is required for the form to be valid.
Not providing enough information about the beneficiaries. Include details like relationship to the service member and percentage of benefits.
Submitting the form without reviewing it for errors. Double-check for typos or missing information before submission.
Failing to keep a copy of the completed form. It is important to retain a copy for personal records.
Ignoring the instructions provided with the form. Read all guidelines carefully to avoid mistakes.

Documents used along the form

The DD 93 form, also known as the Record of Emergency Data, is a crucial document for military personnel, serving to provide vital information in case of emergencies. Alongside this form, several other documents are often utilized to ensure comprehensive data collection and effective communication regarding a service member's personal and emergency contact details. Below are five important forms and documents commonly used with the DD 93.

DD Form 214: This form is issued upon a service member's separation from active duty. It provides a summary of the individual's military service, including dates of service, discharge status, and awards received.
SF 600: The Chronological Record of Medical Care is used to document a service member's medical history and treatment received while in service. This information is essential for continuity of care.
DA Form 4856: This form is known as the Developmental Counseling Form. It is used to document counseling sessions, which can address performance, behavior, or personal issues that may affect a service member's career.
DD Form 2656: The Data for Payment of Retired Personnel form is necessary for retired service members. It collects information needed for retirement pay, including beneficiary designations and tax withholding preferences.
DD Form 149: This form is used to apply for a correction of military records. It allows service members to request changes or updates to their official military records, ensuring accuracy and completeness.

Understanding these forms and their purposes can significantly impact the management of a service member's records and benefits. Properly completing and submitting these documents ensures that all necessary information is available when needed, particularly in emergencies.

Similar forms

The DD 93 form, also known as the Record of Emergency Data, serves a specific purpose in the military context. Here are five documents that are similar to the DD 93 form, along with explanations of their similarities:

SF 86 - Questionnaire for National Security Positions: Like the DD 93, the SF 86 collects personal information. It is used to determine an individual's eligibility for security clearance and requires detailed data about family, finances, and history.
DD 214 - Certificate of Release or Discharge from Active Duty: The DD 214 provides essential information about a service member's military service. Both documents are crucial for administrative purposes and contain vital personal details.
DA Form 2823 - Sworn Statement: This form is used to collect statements from individuals involved in incidents. Similar to the DD 93, it gathers information that can be critical for military investigations or administrative actions.
VA Form 21-526EZ - Application for Disability Compensation and Related Compensation Benefits: This form is used by veterans to apply for benefits. It requires personal information and similar data about health and service, much like the DD 93.
SF 50 - Notification of Personnel Action: The SF 50 documents employment actions within federal service. It includes personal details and employment history, paralleling the DD 93's focus on personal data for emergency contacts.

Dos and Don'ts

When filling out the DD 93 form, it's important to ensure that the information provided is accurate and complete. Here are some key do's and don'ts to keep in mind:

Do read the instructions carefully before you begin.
Do provide accurate and up-to-date contact information for your emergency contacts.
Don't leave any sections blank unless instructed to do so.
Don't use abbreviations or nicknames for names and places; use full legal names.

Misconceptions

The DD 93 form, also known as the Record of Emergency Data, is an important document for military personnel. However, several misconceptions surround it. Here are eight common misunderstandings:

It is only for active-duty service members. Many believe that only active-duty personnel need to complete the DD 93. In reality, all members of the military, including reservists and National Guard members, should fill it out.
It only needs to be filled out once. Some think that completing the form is a one-time task. However, any changes in personal circumstances, such as marriage, divorce, or the birth of a child, require an update to the DD 93.
It is not important for benefits. There is a misconception that the DD 93 does not affect benefits. In fact, the information on this form can influence the distribution of benefits in case of injury or death.
It is only relevant during deployment. Some believe the DD 93 is only necessary when being deployed. However, it should be kept current at all times, regardless of deployment status.
Only the service member needs to fill it out. Many think that only the individual in the military needs to complete the DD 93. However, it often requires input from family members or designated beneficiaries.
It can be filled out casually. Some people assume that the DD 93 can be filled out without much thought. In reality, accuracy and thoroughness are crucial, as incorrect information can lead to serious issues.
It is not a legal document. There is a belief that the DD 93 is merely a formality. On the contrary, it is a legal document that carries significant weight in determining emergency contacts and beneficiary designations.
Once submitted, it cannot be changed. Some individuals think that after submitting the DD 93, they cannot make changes. This is incorrect; updates can and should be made whenever necessary.

Understanding these misconceptions can help ensure that service members and their families are adequately prepared and informed about the importance of the DD 93 form.

Key takeaways

The DD 93 form, also known as the Record of Emergency Data, is an essential document for military personnel. It helps ensure that vital information is available in case of emergencies. Here are some key takeaways about filling out and using the DD 93 form:

Accurate Information is Crucial: Ensure all details, such as your name, address, and emergency contacts, are accurate. This information is critical for notifying family members in case of an emergency.
Update Regularly: Review and update the form whenever there are significant life changes, such as marriage, divorce, or the birth of a child. Keeping this information current is essential.
Multiple Copies: Keep multiple copies of the DD 93 form. Distribute them to trusted family members and retain a copy in your personal records.
Privacy Considerations: Be mindful of the sensitive information included on the form. Ensure that it is stored securely to protect your privacy and that of your loved ones.
Filing with Personnel Records: Submit the completed form to your unit's personnel office. This ensures that the information is accessible in case of an emergency.
Understand the Importance: Recognize that the DD 93 form plays a critical role in emergency situations. It can facilitate timely communication with family members during crises.