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This version of the form is not currently in use and is provided for reference only. Download this version of
DD Form 2168
for the current year.
DD Form 2168 Application for Discharge of Member or Survivor of Member of Group Certified to Have Performed Active Duty With the Armed Forces of the United States
What Is DD Form 2168?
DD Form 2168, Application for Discharge of Member or Survivor of Member of Group Certified to Have Performed Armed Forces of the United States, is used to assist the Secretaries of the Armed Forces in determining if the applicant has ever performed active military service and in issuing a certificate of service after an affirmative finding.
The form was last released by the Department of Defense (DoD) on April 1, 2010 . The most recent DD Form 2168 fillable version can be downloaded through the link below.
Information on the DD 2168 can be released to the applicant's civilian employer, contractual group, or the Department of Homeland Security to obtain support for a claim. The provided information may be disclosed to the Department of Veterans Affairs (VA) for purposes of determining eligibility for benefits.
Use the information below to determine where to send the DD Form 2168 if using it as proof of service when claiming benefits:
- If the applicant was employed at the U.S. Army Transport Service (ATS) they must send their paperwork to the Commander at the U.S. Army Human Resources Command Department 420 Ft. Knox, KY 40122-5402 ATTN: AHRC-PDR;
- If the alleged service was employment for the Naval Transportation Service the applicant must send their forms to the Commander at the U.S. Navy Personnel Command (PERS-312) 5720 Integrity Drive Millington, TN 38054-5045;
- If the applicant was allegedly employed at the War Shipping Administration or the Office of Defense Transportation they must send their paperwork to the National Maritime Center (ATTN: Records Management Branch (NMC-41) 100 Forbes Drive Martinsburg, WV 25404 Phone: (888) 427-5662).
How to Fill Out DD Form 2168?
Procedural guidelines and additional information can be found in the Army Regulation 15-34, Department of the Army Individual Service Review Board. DD Form 2168 instructions are as follows:
- The applicant has to provide their full name - including their maiden name, if any - in Box 1. This section of the form also requires listing all aliases, the applicant's Social Security number, date of birth, current address (including ZIP code) and an apartment number;
- The second section requires information of the group the applicant served with. The applicant has to enter the name of the group and their identification number in Boxes 5 and 6. Box 7 requires their highest position in the group; the highest or actual pay grade within the group is indicated in Box 8;
- The date and place the applicant entered the military forces should be stated in Box 9. The employing departments and the time period of actual military service before the service period claimed should be indicated in Box 10;
- The applicant's home of record at the time of entry should be provided in Box 11. Their grade, rank or rating at the time of entry is entered in Box 12;
- The location of the military installation for reporting is given in Box 13. The specialty job titles are listed in Box 14. Any received awards should be specified in Box 15. Box 16 requires the date of group service termination. This includes the type and reason for termination, station base or location, service command affiliation, and the date when service was terminated;
- The third section should contain the applicant's full name, social security number, phone number, date of completion of the form, and signature. If the applicant is unable to sign the form due to any valid reason, the form can be signed by an authorized representative. In this case, the relationship between the person signing the form and the applicant should be specified in Box 17;
- The application should be submitted with as much supporting documentation as possible. The evidence might include identification cards, contracts, employment records or anything else proving the applicant's service.
Download DD Form 2168 Application for Discharge of Member or Survivor of Member of Group Certified to Have Performed Active Duty With the Armed Forces of the United States
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