Fillable Form DD 93

What is DD Form 93?

DD Form is used by military personnel and Department of Defense civilian and contractor personnel, collectively referred to as civilians, when applicable. It should be updated whenever a life event occurs, such as marriage, divorce, the birth of a child, the death of a beneficiary, or a change in a beneficiary’s address.

DD Form 93 Form is used to designate beneficiaries for certain benefits and provide the military’s command with the names and addresses of the people the military desires to be notified in case of emergency or death. It is also a guide for the disposition of the service member's pay and allowances if captured, missing, or interned.

How to fill out DD Form 93?

IMPORTANT: This form is divided into two sections: Section 1 - Emergency Contact Information and Section 2 - Benefits Related Information.

SECTION 1

ITEM 1. Name

• Enter full last name, first name, and middle initial.

ITEM 2. SSN

• Enter social security number.

ITEM 3a. Service.

• Military: Mark X in appropriate block.
• Civilian: Mark two blocks 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.

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 do state.
• Include illegitimate children if acknowledged by a 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: YYYY MM DD.
• 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's 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.

1. 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.
2. 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. Designated Persons (Military Only)

• This item will be used to record the name of the person or persons to whom information on the whereabouts and status of the member shall be provided if the member is placed in a missing status.

ITEM 9b.

• Address and telephone number of Designated Person(s).

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.
  • The telephone number should be to the company or corporation's personnel or human resources office.

SECTION 2

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.

ITEM 11a.

• Seek legal advice if naming a minor child as a beneficiary.

Item 11b.

• Relationship.

ITEM 11c.

• Enter beneficiary(ies) full mailing address and telephone number to include the ZIP Code.

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.

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.

ITEM 12b.

• Enter beneficiary(ies) full mailing address and telephone number to include the ZIP Code.

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.

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.

ITEM 13b.

• Address and telephone number of PADD.

ITEM 14. Continuations/Remarks.

• Use this item for remarks or continuation of other items, if necessary.
• Also use this item to list the name, address, and relationship of other persons the member desires to be notified. Other dependents may also be listed. member contact numbers, etc.

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.

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.

ITEM 17. Date the member or civilian signs the form.

• This item is an ink entry and must be completed on all copies.

Where to file DD Form 93?

It should be filed within the Interactive Personnel Records Management System (iPERMS). It is from iPERMS that HRC’s Casualty and Mortuary Affairs Operation Division obtains the Soldier’s most current documentation in order to begin processing benefits following a reported death.