Record of Emergency Data (DD 93) AR 600-8-1 chapter 11 Designate beneficiaries Guide for disposition of pay and allowances Names and address’s of emergency contacts SSN for Positive Identification

IMPORTANCE Official and legal document designating beneficiaries of certain benefits Provides the name and address of the person(s) to be notified in case of emergency, sickness or death AR 600-8-1 chapter 11 - 4

DD 93 AR 600-8-1 table 11-1 Block 1, Members full last name, first name and middle name Block 2a, Members Social Security Number (SSN) 123-45-6789 Smith, Timothy Greg

DD 93 AR 600-8-1 table 11-1 Block 2b,Members initials in ink to verify SSN Block 3a, Service A-Army, F-Air Force, N-Navy, M-Marine Corps Block 3b, Unit name or UIC WABC12 TGS A

DD 93 AR 600-8-1 table 11-1 Block 4a, Spouse First name, Middle initial, Maiden name (if applicable) If Service Member include Rank If no spouse use Single, Divorced or Widowed Once married never single even if divorced Block 4b, Complete address of Spouse Amber L, (Doe) 1234 N 5th St. Nowhere, Ia 12345

DD 93 AR 600-8-1 table 11-1 Jane A. 04 Bobby J. Donald 13 Block 5a, First name, Middle initial and Last name if different than Sponsor’s if none so state. If Service Member include Rank Block 5b, Relationship to sponsor (code) 03 Son / 04 Daughter / 13 Stepson 14 Stepdaughter / 33 Adopted daughter 34 Adopted son Jane A. 04 Bobby J. Donald 13

DD 93 AR 600-8-1 table 11-1 Block 5c, Date of Birth and Complete address Block 5d, If dependents live with current spouse no address is required Other than current spouse include Address, Name and Relationship of person with whom they reside 19950102 20030523

DD 93 AR 600-8-1 table 11-1 Block 6a.6b, First Name, Middle initial, Last name and Complete address of Father. If Service Member include Rank Block 7a. 7b, First Name, Middle initial, Last name, Maiden name and Complete address of Mother. If Parent(s) are deceased still list in blocks 6a, 7a and add “Deceased in address Block Other than natural parents state relationship (adopted) 123 First Ave, Middletown, Ne 54321 Gregory P. Smith 123 First Ave, Middletown, Ne 54321 Linda M. Smith (Thomas)

DD 93 AR 600-8-1 table 11-1 Block 8a, Persons not to be notified, list Name and Relationship (may be multiple people) Block 8b, List Persons to be notified instead list all Names, address’s and relationship

DD 93 AR 600-8-1 table 11-1 Block 9a, First Name, Last name, and Relationship to receive $12,000 gratuity pay if no surviving spouse or child. ONLY PARENTS (Person in Loco Parentis Status), BROTHER, SISTERS, HALF-BLOOD AND ADOPTED CHILDREN If Brothers or Sisters include Date of Birth Block 9b, Complete address for each Beneficiary Block 9c, Show percentage to be paid if more than one beneficiary is listed. Note: This is used in case of no surviving spouse or child Gregory P. Smith (father) 50% 123 First Ave, Middletown, Ne 54321 Linda M. Smith (mother) 50%

DD 93 AR 600-8-1 table 11-1 Block 10a, First Name, Middle initial Last name, and Relationship to receive unpaid pay and allowances if “None” so State Block 10b, Complete address of all beneficiaries Block 10c, If more than one beneficiary show percentage NONE

DD 93 AR 600-8-1 table 11-1 Block 11, First name, Middle initial, Last name, Relationship and Complete address of Dependents or Blood Relative Service Member designates. Receive allotment of pay if missing, captured or interned If more than one person use percentages for amount of allotment Percentages not left to a beneficiary are set aside for Service Member upon return Item may be left blank

All percentages in blocks 9c and10c must always Equal 100% DD 93 All percentages in blocks 9c and10c must always Equal 100% Percentages in block 11 do not have to equal 100% but cannot exceed

DD 93 AR 600-8-1 table 11-1 X Block 12, Insurance information Block 12a, X proper block and fill in amount in other if applicable Insurance Co. to be notified full name and policy numbers (Optional, helps expedite claims) X $100,000.

DD 93 AR 600-8-1 table 11-1 DR: Gregory P. Smith (father) Block 13, Disposition of Remains (DR) Family member to be responsible for the remains of Service Member First name, Middle initial, Last name, and Relationship Service member must initial DR. If address is Rural Route give specific directions Any further information that is deemed to be noted. DR: Gregory P. Smith (father)

DD 93 AR 600-8-1 table 11-1 Block 14. Service Member verify all information is correct and sign in ink include rank, or grade Block 15, Signature of witness include rank, or grade Block 16, Date service member signs form (YYYYMMDD)

DD 93 If family member is a Service member include Rank with name Cannot use P.O. Box for any address Phone numbers with area code written in PENCIL once per Address listed on each copy Print three copies for: Automated Records (Perm one copy) Individual Soldiers File (ISF) Soldiers Copy

DD 93 Reference Army Casualty Operations/Assistance/ Insurance AR 600-8-1 Chapter 11 DD 93 (back page) instructions

DD 93 QUESTIONS ?