Department of Defense INSTRUCTION ASD(P&R) Certification of Public and Community Service Employment of Military Retirees

Similar documents
Department of Defense INSTRUCTION. SUBJECT: Program to Encourage Public and Community Service Employment

Department of Defense INSTRUCTION. SUBJECT: Procedures for Transfer of Members Between Reserve and Regular Components of the Military Services

Department of Defense INSTRUCTION

OPNAVINST B N1/PERS-9 24 Oct 2013

Department of Defense DIRECTIVE

Department of Defense DIRECTIVE. SUBJECT: Management and Mobilization of Regular and Reserve Retired Military Members

DEPARTMENT OF THE NAVY OFFICE OF THE SECRETARY 1000 NAVY PENTAGON WASHINGTON, D.C

IIH UIII l I liii II INI! DIRECTIVE AD-A NUMBER Department of Defense. August 16, Prescribes procedures.

Department of Defense DIRECTIVE

Department of Defense INSTRUCTION

Department of Defense INSTRUCTION

Department of Defense INSTRUCTION

iiijuly 26, 1983 NUMBER

Department of Defense INSTRUCTION

DEPARTMENT OF THE NAVY OFFICE OF THE CHIEF OF NAVAL OPERATIONS 2000 NAVY PENTAGON WASHINGTON, DC

Department of Defense INSTRUCTION AD-A NUMBER

Department of Defense INSTRUCTION

Department of Defense. SUBJECT: Transfer of Members Between Reserve and Regular Components of the Military Services

Ref: (a) 10 U.S.C (b) OPNAVINST A (c) OPNAVINST B (d) DoD Instruction of 29 April 2008 (e) 10 U.S.C.

Department of Defense INSTRUCTION

mbirnoii m?:r t jpwed im. izsjjis ;rek«2«i i *.rr 5*3 ; fe^-k-' "^ ''"^TJS

Department of Defense INSTRUCTION. SUBJECT: Reporting of Personnel Tempo (PERSTEMPO) Events. References: See Enclosure 1

Department of Defense DIRECTIVE. SUBJECT: Management of the Individual Ready Reserve (IRR) and the Inactive National Guard (ING)

Department of Defense INSTRUCTION. SUBJECT: Eligibility of Regular and Reserve Personnel for Separation Pay

Department of Defense DIRECTIVE. SUBJECT: Emergency-Essential (E-E) DoD U.S. Citizen Civilian Employees

Department of Defense DIRECTIVE

MILPERSMAN DUAL COMPENSATION REGULATION APPLICABLE TO THE NAVY RESERVE

DEPARTMENT OF THE NAVY OFFICE OF THE CHIEF OF NAVAL OPERATIONS 2000 NAVY PENTAGON WASHINGTON, D,C,

Department of Defense INSTRUCTION. SUBJECT: Reserve Component Incapacitation System Management

Department of Defense INSTRUCTION

Department of Defense

\-111. t " 1. f- Department of Defense DIRECTIVE AD-A April 10, IIIIIlI11IlI11NUMBER. 1. Reissues reference (a).

APPRENTICESHIP PROGRAM FOR MOS OF CENTRAL OFFICE REPAIRER

PRIVACY IMPACT ASSESSMENT (PIA) For the- Performance Evaluation System (PES) Department of the Navy - United States Marine Corps (USMC)

Marine Corps Junior ROTC Program Instructor Application

The Prior Service Recruiting Pool for National Guard and Reserve Selected Reserve (SelRes) Enlisted Personnel

OPNAVINST G N13F 13 MAY 2011 OPNAV INSTRUCTION G. From: Chief of Naval Operations. Subj: FOREIGN LANGUAGE PROFICIENCY BONUS PROGRAM

Department of Defense DIRECTIVE. NUMBER July 16, SUBJECT: Management and Mobilization of Regular and Reserve Retired Military Members

Combat-Related Special Compensation

Department of Defense INSTRUCTION

Department of Defense DIRECTIVE

Department of Defense INSTRUCTION

Department of Defense INSTRUCTION

DOD INSTRUCTION MANAGEMENT OF REGULAR AND RESERVE RETIRED MILITARY MEMBERS

Department of Defense DIRECTIVE. SUBJECT: Fellowships, Scholarships, Training With Industry (TWI), and Grants for DoD Personnel

PRIVACY IMPACT ASSESSMENT (PIA) For the

DOD INSTRUCTION AVIATION INCENTIVE PAYS AND BONUS PROGRAM

Department of Defense INSTRUCTION. Certificate of Release or Discharge from Active Duty (DD Form 214/5 Series)

2018 SCHOLARSHIP APPLICATION Military Spouse

Department of Defense DIRECTIVE

DoD Architecture Registry System (DARS) EA Conference 2012

2100 Second St., SW Washington, DC Staff Symbol: G-MEP Phone: (202) United States U.S. Coast Guard NOV /11

MILPERSMAN ACTIVE DUTY (ACDU) NAVY DEFINITE RECALL PROGRAM FOR RESERVE ENLISTED. OPNAV (N13) Phone: DSN COM FAX

(c) DoD Instruction of 11 March 2014 (d) SECNAVINST D (e) CNO WASHINGTON DC Z Apr 11 (NAVADMIN 124/11)

DOD INSTRUCTION GENERAL BONUS AUTHORITY FOR OFFICERS

PRIVACY IMPACT ASSESSMENT (PIA) For the

PRIVACY IMPACT ASSESSMENT (PIA) For the

Department of Defense DIRECTIVE

D E P A R T M E N T O F THE NAVY

PRIVACY IMPACT ASSESSMENT (PIA) For the

OFFICE OF THE SECRETARY OF DEFENSE 1950 Defense Pentagon Washington, DC

PRIVACY IMPACT ASSESSMENT (PIA) For the. RAPIDGate Information System (RAPIDGATE) Department of the Navy - United States Marine Corps (USMC)

Department of Defense INSTRUCTION

PRIVACY IMPACT ASSESSMENT (PIA) For the

Religious Ministry Support REFERENCE / AUTHORITYSOURCE DOCUMENT Information Sheet APPOINTMENT OF CHAPLAINS FOR THE MILITARY SERVICES

Subj: ARMED FORCES HEALTH PROFESSIONS SCHOLARSHIP PROGRAM

Department of Defense INSTRUCTION

Transitional Compensation Questions and Answers APRIL 2010

TIC ODepartment of Defense

Department of Defense DIRECTIVE

CHAIRMAN OF THE JOINT CHIEFS OF STAFF INSTRUCTION

DOD INSTRUCTION INVOLUNTARY SEPARATION PAY (NON-DISABILITY)

DEPARTMENT OF THE NAVY HEADQUARTERS UNITED STATES MARINE CORPS WASHINGTON, DC MCO 1500R.35A C Jan 1995

Office of Performance Analysis Integrity Data and Information System. May 2002 Gulf War Veterans Information September 10, 2002

PRIVACY IMPACT ASSESSMENT (PIA) For the

PRIVACY IMPACT ASSESSMENT (PIA) For the

DEFENSE HEALTH AGENCY 7700 ARLINGTON BOULEVARD, SUITE 5101 FALLS CHURCH, VIRGINIA

MILPERSMAN OPNAV N130) Phone: DSN COM FAX

Department of Defense INSTRUCTION

Applicant Information Please type or print. (Read instructions on pages 6-8 before completing this form) 2. Job Title: City: State: ZIP:

Subj: CREDIT FOR PRIOR NON-FEDERAL WORK EXPERIENCE AND CERTAIN MILITARY SERVICE FOR DETERMINING LEAVE ACCRUAL RATE

Subj: MARINE CORPS RETIRED ACTIVITIES OFFICE (RAO)

Subj: POLICY AND PROCEDURES FOR RESERVE COMPONENT SAILORS SERVICE BEYOND 16 YEARS OF ACTIVE-DUTY SERVICE

Department of Defense DIRECTIVE. SUBJECT: Eligibility Requirements for Education of Minor Dependents in Overseas Areas

Department of Defense DIRECTIVE

Army Reserve Retirement Points Information Guide

Department of Defense INSTRUCTION. Data Submission Requirements for DoD Civilian Personnel: Workforce and Address Dynamic Records

Chief, National Guard Bureau, Attn: NGB-ARP-C, 111 South George Mason Drive, Arlington, VA

Department of Defense INSTRUCTION. SUBJECT: Guidance for the Appointment of Chaplains for the Military Departments

PRIVACY IMPACT ASSESSMENT (PIA) For the

System of Records Notice (SORN) Checklist

Department of Defense DIRECTIVE

Department of Defense INSTRUCTION

Case 1:17-cv Document 1 Filed in TXSD on 03/02/17 Page 1 of 17 IN THE UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF TEXAS

MILPERSMAN RETROACTIVE STOP LOSS SPECIAL PAY COMPENSATION

SUBJECT: Department of Defense (DoD) Procedures for Settling Financial Accounts Under the Special Temporary Contract Closeout Authority

Naval Audit Service Audit Report Marine Corps Use of the Deployed Theater Accountability System

D (c) Executive Order 12656, "Assignment of Emergency

Appendix G. Immunization

Charter Department of Defense Military Family Readiness Council

Transcription:

TIC LLECTE N 051994 Department of Defense INSTRUCTION November 17, 1993 A NUMBER 1340.19 SUBJECT:.274562 ASD(P&R) Certification of Public and Community Service Employment of Military Retirees References: (a) Public Law 102-484, "National Defense Authorization Act for FY93," October 23, 1992 (b) Title 10, United States Code (c) DoD Instruction 7770.1, "Magnetic Tape Extracts of Retired Military Pay Records," March 6, 1987 (d) DoD 7000.14-R, "DoD Financial Management Regulation," Volume 7, Part B, November, 1992, authorized by DoD Instruction 7000.14, November 15, 1992 A. URPS This Instruction establishes policy, assigns responsibilities, and prescribes procedures to certify the public and community service employment of eligible retired members under Section 4464 of reference (a). Such certified employment may be used to recompute military retired pay and, where applicable, the Survivor Benefit Plan (SBP) base amount when the retired member attains or would have attained 62 years of age. -g B. APPLICABILITY AND SCOPE 0&.4 This Instruction applies to: 1. The Office of the Secretary of Defense and the Military - Departments. The term *military Services," as used herein, refers to the Army, the Navy, the Air Force, and the Marine Corps (including their National Guard and Reserve components). - r. 2. Any member of the Military Services who: a. Retires (other than for disability) under the temporary early retirement authority of Section 4403 of reference (a) before the completion of 20 years of creditable service (as computed under the applicable provision of law) (herein referred to as "retiree"). b. Is employed by a public or community service organization listed on the registry required by Section 1143a(c) 94-00106 S111111111, l 94 1 3 098

of 10 U.S.C. (reference (b)) as added by Section 4462 of Pub. L. No. 102-484 (1992) (reference (a)). c. Is employed within the period beginning on the date of retirement and ending on the date the retired member would have attained 20 years of creditable service for computing retired pay (herein referred to as "enhanced retirement qualification period"). C. EQLI= It is DoD policy that: 1. A retiree shall receive military service credit, as provided by reference (a), for all qualifying periods of employment during the enhanced retirement qualification period. A qualifying period of employment shall meet the following conditions: a. The employing organization is listed on the registry of public and community service organizations, maintained by the Department of Defense, reviewed by the Interagency Public and Community Service Working Group, and approved by the Assistant Secretary of Defense for Personnel and Readiness, as qualifying as an employer for additional military service credit. b. The employment is full-time, as defined by the employing organization. As a guideline, full-time is defined as a minimum of 33 hours per week or 143 hours per month, including paid holidays and paid periods of leave or vacation. c. The employee is paid. 2. The failure of the employing organization to have a listing on the registry of public and community service organizations before the beginning of a qualified period of employment shall not affect the computation of military service credit, if the organization has applied for a registry listing before the end of the qualifying period of employment or the end of the enhanced retirement qualification period, whichever is earlier. 3. For each qualifying period of employment, the amount of military service credit shall be computed by subtracting the date of the first day of employment or the first day of the enhanced retirement qualification period, whichever is later, from the date of the last day of employment or the last day of the enhanced retirement qualification period, whichever is earlier, and adding 1 day to account for inclusive dates. The arrangement 2

Nov 17, 93 1340.19. below illustrates five possible date patterns when calculating military service credit. Q First and last day of enhanced retirement qualification period. E X First and last day of employment. Dates used to calculate military service credit. Pattern 1: ------- Q ---- E -------- E ---- Q------- ------ x --------x----------- Pattern 2: ------- Q ---- E ------------- Q E-- -- x----------- x------- Pattern 3: -- E ---- Q ------------- E ---- Q------- Sx ----------- x ---------- Pattern 4: -- E ---- Q ------------------ Q E-- ---- x-----------------x ------ Pattern 5: Q ---- E ---- E ---- E---Q ---- E-- - ------------- x----. x----x X x--- ------ 4. Periods of employment that occur before or after the enhanced retirement qualification period shall not be credited. 5. The calculated amount of military service credit for a creditable period of employment shall be reduced by the length of any overlapping period of active duty service. 6. Periods of creditable employment may not overlap. A retiree who is simultaneously employed in two jobs that both meet the conditions of employment specified in subsection C.1., above, shall not receive double military service credit. D. RESPONSIBILITIES. employment 1. The Assistant Secretary of Defense for Personnel and Readi e s shall: a. Establish policy and provide guidance on the reporting and certification of public and community service of eligible retirees.

b. Ensure that the Director, Defense Manpower Data Center (DMDC), establishes procedures for the receipt, certification, and auditing of information about public and community service employment and provides certified employment data to the Defense Finance and Accounting Service (DFAS). c. Establish, in coordination with other Federal Agencies, a registry of public and community service organizations. 2. The Com-troller of the Department of Defense shall ensure that the Director, DFAS, establishes procedures to maintain and report certified employment data and to recompute military retired pay and the SBP base amount. 3. The Secretaries of the Military Derartments shall ensure that the Military Services provide retirement processing, including instruction and informational materials on the certification of public or community service employment. E. PRCEURE 1. During retirement processing, the Military Services shall provide each retiree a copy of DD Form 2676, "Validation of Public or Community Service Employmenc,* (enclosure 1) and explain the reporting requirements and procedures for enhanced retirement credit as described in this Instruction. 2. Initial data reporting requirements. a. The Military Services shall provide to the DFAS the enhanced retirement qualification period beginning date (i.e., the date of retirement) and the creditable service for computing retired pay amount in years, months, and days for all retirees. b. The DFAS shall compute the enhanced retirement qualification period ending date. c. The DFAS shall uniquely identify these retirees and provide enhanced retirement qualification period beginning and ending dates and the creditable service for computing retired pay amount in years, months, and days to the DMDC on the retired pay master file records submitted under DoD Instruction 7770.1 (reference (c)). d. The DFAS o. report enhanced retirement qualification period begir"iing and ending dates with the first statement of account provided to the retiree. 40

djai Nov 17, 93 1340.19 3. Reporting of qualifying periods of employment. a. A retiree who becomes employed under the conditions specified in subsection C.1., above, shall obtain certification of employment from the employing organization and submit a completed DD Form 2676 as follows: (1) At the beginning of a qualifying period of employment, unless the expected period of employment is less than 3 months. (2) At the end of a qualifying period of employment or the end of the enhanced retirement qualification period, whichever comes first. (3) Annually during a qualifying period of employment on the anniversary of the date of retirement, unless this date is within 3 months of either of the dates defined by subparagraphs E.3.a.(1) and (2), above.. within b. In the event of the physical or mental incapacitation or death of the retiree, the completed DD Form 2676 may be submitted by anyone acting on behalf of the retiree. c. All reporting shall be completed by the retiree 1 year of the end of the enhanced retirement qualification period. 4. The DMDC shall receive and process the completed DD Form 2676, make a certification determination, and compute the amount of military service credit. If certification is denied, then the DMDC shall provide the retiree with a statement indicating the reasons for denial. 5. At the request of the DMDC, the Military Services shall provide the DMDC with the dates of any retiree's post retirement periods of active duty service. 6. The DMDC shall provide the retiree with a summary statement of certified employment within 2 months of the receipt of a completed DD Form 2676. 7. One year after the end of the enhanced retirement qualification period, the DMDC shall provide the DFAS with an automated record reporting the amount of military service credit earned by the retiree through creditable employment. Records shall be combined and submitted monthly via magnetic tape cartridge or electronic data transfer. 5

8. When the retiree attains or would have attained 62 years of age, the DFAS will recompute military retired pay and, where applicable, the SBP base amount consistent with the procedures in DoD 7000.14-R, Volume 7, Part B (reference (d)). F. INFORMATION REOUIREMENTS The reporting requirements contained in this Instruction have been assigned Report Control Symbol DD-FM&P(AR)1925 and OMB Control Number 0704-0357. G. EFFECTIVE DATE AND IMPLEMENTATION This Instruction is effective immediately. The Military Departments shall forward two copies of implementing documents to the Assistant Secretary of Defense for Personnel and Readiness within 120 days. Edwin Dorn Assistant Secretary of Defense Personnel and Readiness Enclosure DD Form 2676, Employment" "Validation of Public or Community Service Acceici NT!IS r'p~ A,, D ; ' 2 -, D'-ti. :' "' Li;" -- I,, 0 J.,,.-tQ IL, -,..

S* Nov 17, 93 1340.19 (Encl 1) 0Form Aoproved (Please read mns rucrions on back before completing this form.) Epires Sept 30, 1996 VALIDATION OF PUBLIC OR COMMUNITY SERVICE EMPLOYMENT. PqDIC rgan burdenf t ~ii.on of ~,formation is estimated to average 10 minutes Per ressonse. including the time for reviewing instructions. searcing existi data source-. gaihennq and inantah the dat l@h~~. and conipieting and reviewrnqk thep collection of,nformathon Send Comments reqardin thn Oird~fi ent~mate of 4fnt other aipec tinl Colle :t Ol Of Infmmaltido.mA, ing m~lugentiofi r reducing this burden, to Del~artment of Defenne. Waihn lon ieadqulrtern Wr'icen. i~re~torate for information' Operaiton$ and ftprtn. 121tS jafeandvin if~y eqat 1204. Alanqten. VA 22202-4302. and to the office Of Management an fluaget. Patierwork ReduCtion Pro/ect {0704-0357). Wanhingiofi DC 20503 Pt.PL ASE 00 NOT RETURN YOUR COMPLETED FORM TO EITHER OF THESE ADDRESSES. RETURN O tetei ORM TO: DMDC ATTN: OPERATION TRANSITION. TERA DESK, P.O. lox 100, FORT DAD. CA 93941-0100 AUTrubli Law 102-484. Section 4464, October 23, 1992 EO 9397 GOVERNMENT USE ONLY PRINCIPAL PURPOSE(S): To provide certification of full-time public and community service employment. Full-time employment is defined by the employing organization. Information on this form will be used to verify employment ROUTINE USE(S): None. DISCLOSURE: Voluntary; h er if information is not provided, no further action can be taken to bfic or community service for increased retirement benefit. SECTION I-TO ISE COMPLETED BY MILIT4Y RETI EJ,, 1. NAME (LAST, First, Middle Initial) 2. CURRENT HOME ADDRESS/APT. NUMBER (Include 9-digit ZIP Code) (Check box if new 3. TELEPHONE (include Area Code) a. Home Number address) Booth, David E. 7000 West Pine Street (001) 111-1110 Rural, Virginia 11110 b. Daytime Number (001) 110-0011 4. SOCIAL SECURITY NUMBER -,IA. SERVICE _BRA_,F DATE OF RETIREMENT.DT~~~il N O IR r,force d. MARINE CORPS 7. TYPE OF EMPLOYMENT REPORTED (Mark approp"ate box), H served on active duty since the beginning of this period of qualifying employment or since you last submitted a DO Form 2676. a. NEW b. END OF JOB whichever uate is later?. 14. c. ANNUAL d. FINAL. YES X Ib. NO SECTION N - TO BE COMPLETED BY EMPLOYER 9. INFORMATION ON EMPLOYING ORGANIZATION a. PUBICfCOMMUNITY SERVICE REGISTRY NUMBER b. NAME OF ORG TI 0.2 i0ieii 10 10 0 10 l 0 Rural Count i School c. ADDRESS (Include 9-digit ZIP Code) d. TELEPHONE (Include Area Code) 6000 East Branch Avenue (1) OfficeNumber Urban, Virginia 00011 (001) 110-1111 (2) Fax Number -01) 001-0111 10. DATES OF QUALIFYING PERIODS OF FULL-TIME EMPLOYMENT (YYMMDD) a. BEGINNING DATE (YYMMDD) b. ENDING DATE (YYMMDD) 931201 1 931202 I understand the intent of the certification of public and community service e military retirees as provided by Public Law 102-484, Section 4464, October 1992. I certify the full-time paid employment of the employee for the dates indicated, and that this organization is a registered public or community service organization. 11. TYPED/PRINITED NAME AND TITLE OF CERTIFIER 12. SIGNATURE OF CERTIFIER 13. DATfVYAdkl Stephanie S. Certifier 9h3 2 SECTION III - TO BE COMPLETED BY MILITARY RETIREE " CERTIFICATION OF MILITARY RETIREE: I certify that the information provided is true, accurate, and complete. I ack- ledge tt any falke statement may be punishable pursuant to Section 1001 of Title 1S. U.S.C. a. SIGNATURE b. DATE (YYMMDD) 931202 DD Form 2676. OCT 93 1-1

DD FORM 2676 COMPLETION INSTRUCTIONS This form collects information to be used to certify the public and SECTION I - TO BE COMPLETED BY MILITARY RETIREE (Continueod community service employment of eligible retired members under Section 4464 oj ~ 102-484(1992). Such certified employment b. END OF JOB - if this form reports end of job information may be ured mpu litar retired e pay and, where applicable, while still in the enhanced retirement qualification period. the Sutrvivor I (IP) base amount when the retired member attains or we ve a 'noed 62 years of age. c ANNUAL -if this form reports continuing employment A retiree" -"ml reeae)ilitary service credit for all qualifying d. FINAL - if this form reports completion of reporting periods of e a nlj dng the enhanced retirement qualification requirements and is the last report at the conclusion of enhanced period, which begins on the date of retirement and ends on the date the retirement qualification period. retired member would have attained 20 years of creditable service for retirement purposes. A qualifying period of employment shall meet the I. Check YES or NO to indicate if you were on active duty during the following conditions: A period covered in this report. (The Defense Manpower Data Center will authenticate dates of actwe duty sirruice from Military Service (1) The employing organization v es or coordinates the fi s.) provision of public or comn rvices and is listed on the Registry of Publi A and C mmunity Service SECTIONU-TOBECOMPLETEDBYEEMPLOYER Organizations maintain y the p ent of Defense. 9. Information on the Employing organization: (2) The employment is full-time, as defined by the employing organization. Typically. full-time is defined as a minimum a. Enter Public or Community Service Registry number. If you of 33 hours per week or 143 hours per month, including paid holidays and paid periods of leave or vacation, (3) The employee is paid. The intent of the form is to ensure that the retiree is ab validated proofof employment. Submission is requeired as h do not have a registry number, leave blank. To obtain a registry number, write to DMDC. ATTN: Operation Transition, TERA Desk. P.O. Box 100, FortOrd,CA 93941-0100,or call 1-800-727-3677. b. Enter the organization's name. c. Enter organization's address. (1) At the beginning of a qualifying period of e p y e it, d. Enter organization's telephone number (Fax number is unless the expected period of employment is -a t an 3 optional). months; 10. Enter dates ofqualifying periods of employmenti (2) At the end of a qualifying period of employment or the end of the enhanced retirement qualification period, whichever a. Beginning date. If NEW, ANNUAL, END OF JOB, or comes first; and FINAL, enter date employment began. (3) Annually during a qualifying period of employment on the E. If NEW or ANNUAL, enter date form is signed. anniversary of the date of retirementý unless this date is For 4EV, th ny only be a day's time; however, full creditable within 3 months oftither ofthe dates defined by (1) iand (2), time lished on subsequent reports. For END OF JOB, above. use W asw -,yiptbjment ended. For FINAL. enter date that ends repo~t requirement for creditable employment. In the event of the physical or mental incapacitation or death of the retiree, the completed DD Form 2676 may be submitted by anyone 11 r Print the name and title of the certifier of the form. siting on behalf of the retiree. The title of the signatory should be included in Section!II, Item 14s. 12. Signature of certifier. ALL ITEMS MUST BE COMPLETED SECTION I - TO BE COMPLETED BY MILITARY RETIREE 13. Enter the date the form is signed in year, month, day format. SECTION IU - TO BE COM LEtED BY MILITARY RETIREE 1. Printftype your name (LAST, Fiat, Middle 1 14. CERTIFICATION OF WITARY RETIREE. Sign and date your certification. Enter the cteas YYMMDD; i.e., 930726. 2. and 3. Current nddresslapartment number and home telephone number, as well ans daytime telephone number. 4. Enter your Social Security Number. 5. Branch of Service. Check applicable box. 6. Enter the date you retired (use year, month, day). 7 Type of employment being reported. Check the box that applies: a. NEW- if this form reports the beginning of a new period of qualifying employment. DD Form 2676. OCT 93 (BACK) 1-2