To cancel an appointment, click the cancel appointment button. Dd form 11722, application for identification carddeers enrollment. The instructions for completing the dd form 1172 2 should be closely followed to ensure accurate data collection and to preclude overcollection of information. Application for department of defense commonaccess carddeers enrollment keywords. The dd form 1172 2 form is used by the department of defense in the united states. Appropriate agency of the service concerned include zip code from. Instructions for completion of dd form 11722, dated jan 2014, application for identification carddeers enrollment section i sponsoremployee information block 1. You can print dd form 11722 for family members needing new id cards via milconnect. The sponsor must be present to sign the dd form 1172 or the spouse may bring. Form 1172 application for deers enrollment or the same form from another id card facility signed by the sponsor within a 90 day period. Click check box next to the name of the dependent for whom you want to request a form dd11722 and click proceed. Instructions for the dd form 11722 can be found at.
The air force aid society afas is the official charity of the united states air force. The instructions for completing the dd form 11722 should be closely followed to ensure accurate data collection and to preclude overcollection of information. S department of defense employee to enroll their spouse or child into the defense enrollment and eligibility reporting system, or deers. An activity that does not have this capability must complete the dd form 1172 and tell the member to deliver it to an appropriate id cardissuing activity, which will issue the member an id card. Dd form 1081, statement of agent officers account, may 1975 author. Laws calm legal forms guide a dd form 1172 is a department of defense form used for an application for an identification card and deers enrollment the form is required for obtaining the identification card. Where do i get formdd form 1173 so that i can get my. The new dd form 1172 2 requires to get personal information from both the government employee and. Aug 19, 2012 to download the da form 4187 in printable format and to know about the use of this form, who can use this da form 4187 and when one should use this da form 4187 form. Defense enrollment eligibility reporting system you must be registered in the defense enrollment eligibility reporting system deers a database of information on uniformed services members sponsors, u. Apr 26, 2017 the dd form 1172 is the application for uniformed services identification card and deers enrollment. If you are a dependent of a service member and the service member is called to active duty for 31 days or more, you and your sponsor should fill out a dd form 1172 2. Call the id card office first if you have any questions.
Sign, fax and printable from pc, ipad, tablet or mobile. Dd form 1172 2 march 2017 fill online, printable, fillable. Verify the configuration of your system and click proceed. Are you sure it expired, hes still at ait so you can go to the deers office and get a 30 day temp. Application for uniformed services identification card omb no. Sign, fax and printable from pc, ipad, tablet or mobile with pdffiller. The dd form 11722 shall also be used to enroll eligible individuals in deers or to update an eligible individuals deers record by submitting the form to a verifying official vo at any realtime automated personnel identification system rapids site. Required documents remember to bring all required documents to your appointment to update deers andor recieve your id card. Fort belvoir is beginning plans to gradually open some. This form valid for issue of common access card for 90 days from date of verification. Sep 10, 2012 difference between form dd 1172 and dd 1172 2 form.
Enter the attacheemployees date of birth in fourdigit year, three alphacharacter month, and twodigit day format yyyymmmdd. The sponsor must make application using the dd form 1172 for initial. Dd form 75, dependency statement incapacitated child over age 21. Dd form 11722 common access card cac dd form 11722, jan 2014.
Dd form 1172 must be completed according to the guidelines set forth in bupersinst 1750. Jul 05, 2017 required documents remember to bring all required documents to your appointment to update deers andor recieve your id card. If you are a dependent of a service member and the service member is called to active duty for 31 days or more, you and your sponsor should fill out a dd form 11722. Feb 27, 2015 download instructions for completing dd form 1172 sep 2005. The dd form 11722 shall be used to apply for issuance of a dd form 2 reserve, retired, and reserve retired, a dd form 1173, a dd form 11731, a dd form 2764, a dd form 2765, and a common access card cac for eligible individuals who are not enrolled in the defense enrollment eligibility reporting system deers. Dd form 11722, feb 2011 this form valid for issue of dod id card for 90 days from date of verification. This form valid for issue of dod id card for 90 days dd form 11722, application for identification carddeers enrollment. Instructions for completion of dd form 11722, application for department of defense common access card deers enrollment, october 2002 version the dd form 11722 shall be used to apply for issuance of united states doduniformed services geneva conventions identification card for civilians accompanying the armed. If you are working in the id card section of a persuppdet that has access to deers, you will be able to prepare the dd form 1172 using the rapids computer and subsequently issue the dd form 1173 directly to the recipient.
Application for department of defense commonaccess card deers enrollment keywords. Deers enrollment required items grand forks air force base. Mar 02, 2017 instructions for the dd form 11722 can be found at. If you are working in the id card section of a persuppdet that has access to deers, you will be able to. This form doubles as an application for a military identification card and for deers enrollment. Defense enrollment eligibility reporting system tricare. To register family members in deers, sponsors must. Dd form 11722, application for identification carddeers enrollment pdf instructions for dd from 11722 pdf dod instruction 41. The dd form 1172 is a document of the department of defense in the united states known as the application for information card and deers enrollment. The society supports the air force mission by providing worldwide emergency financial assistance to airmen and their eligible family members, sponsoring educational assistance programs, and offering an array of base community enhancement programs that have a positive impact on the welfare of airmen and. Dd form 1172 2, application for department of defense common access card deers enrollment, may 2004 shipping your vehicle to the rok a guide designed to simplify the vehicle registration process the overall process. This form is known as an application for information card and deers enrollment. Deers stands for defense enrollment and eligibility reporting system.
Dd form 1172 2 fill online, printable, fillable, blank. Dd form 1172 2, feb 2011 this form valid for issue of dod id card for 90 days from date of verification. To make a new appointment, click the make appointment button. Sponsoring office telephone number include area codedsn replaces previous edition and dd form 1172, which are obsolete. Fill dd form 1172 2 quantico instantly, edit online.
Dod publications, pdf forms fillable savable, pdf forms fillable, pdf forms saveable, pdf forms savable, eforms, eforms, pdf forms, adobe acrobat forms. Download and modify va letters, including civil service preferences, commissary and exchange privileges, service benefit verification and proof of service card. The phs deers project office requires the following forms. Instructions for completion of dd form 11722, application for department of defense common access card deers enrollment, october 2002 version the dd form 11722 shall. To lookup an appointment you have already made, click the find appointment button. The dd form 11722 form is used by the department of defense in the united states. Featured news belvoir prepares for first phase of reopening senior defense department leaders, health professionals key to transition. Retention and disposition of the dd form 11722 shall be in accordance with the uniformed services regulatory instructions. Dd form 1172 2 fill online, printable, fillable, blank pdffiller. Learn how to fill the da form 4187 personnel action youtube. Directorate of personnel and family readiness dpfr joint. Enter the attacheemployees last name first surname or family name, enter the first name, and then enter the middle initials, or the full middle name. The dd form 11722 shall be used to apply for issuance of a dd form 2 reserve, retired, and reserve retired, a dd form 1173, a dd form 11731, a dd form 2764, a dd form 2765, and a common access card cac for eligible individuals who are not enrolled in the defense enrollment eligibility reporting system. If that is the case, take your 1172, drivers license, marriage certificate, ssn card and go to the nearest base.
A dd 11722 form is used by the us department of defense dod to process identification card requests for someone who is considered a dependent of a. Each family members eligibility record must be updated separately. The dd form 11722 currently covers the rus that would include retirees and dependents. Phs16371, public health service commissioned officers request for dependency determination. Dd form 11722, application for department of defense common access card deers enrollment, may 2004 shipping your vehicle to the rok a guide designed to simplify the vehicle registration process the. Dd form 11722 application for identification carddeers enrollment a64 u. The sponsor must make application using the dd form 1172 for initial enrollment of hisher eligible dependents into deers and for all id card issuance to include renewals. To the department of health and human services, the department of veterans affairs. Deers collects and maintains information to ensure and facilitate the. Use the va blue button tool to view, print, and download. Laws calm legal forms guide a dd form 1172 is a department of defense form used for an application for an identification card and deers enrollment the form is required for obtaining the identification card and provides the adequate information for enrollment in benefits programs for the military member and their dependents the dd form 1172 is available on the department of defense. To the department of heath and human services, the department of veterans affairs, the social security administration, and to other federal, state, and ocal government agencies to identify individuals having benefit eligibility in.
Feb 17, 2010 the dd form 1172 is good for 90 days from the date of issue. Complete a dd form 1172 provide documentation see below if the sponsor is unavailable, family members can update deers with. The society supports the air force mission by providing worldwide emergency financial assistance to airmen and. The defense enrollment eligibility reporting system deers is a centralized person data repository pdr designed to provide timely and accurate information on those eligible for dod benefits and entitlements.
Dd form 1172 2, application for identification card deers enrollment pdf instructions for dd from 1172 2 pdf dod instruction 41. Dd 1172 2 fillable 2015, dd 1172 2 v 2014 fillable, dd 48 1a blank form, dd form 1173 pdf dependents, cac mil docs 1172 2, dd form 2861 pdf, dd form 1610 pdf, dod privacy act cover sheet, af form 53. Army foreign liaison directorate military attache guide september 20 block 9. The defense enrollment eligibility reporting system deers database contains information for each uniformed service member active duty, retired, or a member of a reserve component, ussponsored foreign military, dod and uniformed services civilians, other personnel as directed by the dod including the patient population serviced through the military health services system. To download the da form 4187 in printable format and to know about the use of this form, who can use this da form 4187 and when one should use this da form 4187 form. Section iv of this form should only be completed if benefits or sponsorship is being requested forby an eligible sponsor or their dependent. If this message is not eventually replaced by the proper contents of the document, your pdf viewer may not be able to display this type of document. Complete a dd form 1172 provide documentation see below if the sponsor. Any id cardissuing activity that can access deers through rapids can prepare dd form 1172 and eventually issue dd form 2n act directly to the member. The dd form 1172 is good for 90 days from the date of issue. The dd form 1172 is the application for uniformed services identification card and deers enrollment. To register a new child in deers, obtain a copy of.
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