1. DETERMINE ENTITLEMENT TO PAY AND ALLOWANCES
UNITED STATES ARMY
FINANCIAL MANAGEMENT SCHOOL
U.S ARMY SOLDIER SUPPORT INSTITUTE
DETERMINE ENTITLEMENT
TO PAY AND ALLOWANCES
PRACTICAL EXERCISE # 4
Supplement
OTHER ALLOWANCES
AAA6B103

2. STUDENT NOTE: If you receive an error message while coding disregard and continue with input.

3. FOR INSTRUCTIONAL PURPOSES ONLY
For problems , review the documents and the DSIS Printout, then complete the appropriate DMO screen found in the Student Answer Booklet. Once you have finished, code the appropriate input on the DMO computer terminal.
PROBLEM #11
CERTIFICATE OF MARRIAGE
STATE OF GEORGIA
COUNTY OF CHATAM
GROOM:
TOBY K. HALL
BRIDE:
CYNTHIA A. PARAWHEN
THE ABOVE NAMED INDIVIDUALS WERE UNITED BY ME IN HOLY MATRIMONY ON THE 1ST DAY OF AUGUST 20**.
Gerald L. Pittman
GERALD L. PITTMAN
JUSTICE OF THE PEACE
FOR INSTRUCTIONAL PURPOSES ONLY
STUDENT NOTE: CYNTHIA PARAWHEN IS NOT A MEMBER OF THE ARMED FORCES. 1

4. Toby Hall W.C. Cory, MAJ, CMD PROBLEM #11 (con’t) HALL, TOBY
2LT/O-1 XX
1ST FWD SPT BN
FT STEWART, GA 31314 X
**0801 X X
CIV
**0801
CYNTHIA A. HALL
5764 BRENDONWAY DR.
WIFE
N/A
PEMBROKE, GA 31321 TH TH
Toby Hall
20 AUG **
W.C. Cory, MAJ, CMD
20 AUG ** 2

5. FOR INSTRUCTIONAL PURPOSES ONLY
PROBLEM #12
CERTIFICATE OF BIRTH
STATE OF GEORGIA
COUNTY OF LIBERTY
DATE OF BIRTH: 17 AUGUST 20**
NAME OF CHILD: ADAM STEVEN FASANO
SEX OF CHILD: MALE
NAME OF MOTHER: SALLY ANN FASANO
NAME OF FATHER: NONE LISTED
Allen C. Webster
County Recorder
Joyce J Owens
Joyce J. Owens DO
Physician attending
FOR INSTRUCTIONAL PURPOSES ONLY 3

6. Sally Fasano W.C. Cory, MAJ, CMD PROBLEM #12 (con’t) X X X X X 2
Fasano, Sally
CPT/O-3 X
23rd Sustainment Brigade
FT STEWART, GA 31314 X
**0817 X X X
**0801 X
Adam S. Fasano
2414 W. 3rd ST.
SON
17 Aug **
Hinesville, GA 31313 SF SF
Sally Fasano
20 AUG **
W.C. Cory, MAJ, CMD
20 AUG ** 2

7. PROBLEM #13 5

8. FOR INSTRUCTIONAL PURPOSES ONLY
PROBLEM # 13
STATEMENT TO SUBSTANTIATE PAYMENT OF FAMILY SEPARATION ALLOWANCE (FSA)
PRIVACY ACT STATEMENT
AUTHORITY: Title 37, U.S. Code, Section 427.
PRINCIPAL PURPOSE: To evaluate member’s application for FSA
ROUTINE USES: a. Serves as a substantiating document for FSA payments and input into the member’s pay account.
b. Provides an audit trail for validating propriety of payments and to assist in collecting erroneous payments.
c. Provides a record in service member’s pay account and for safekeeping.
DISCLOSURE: Disclosure of your social security number and other personal information is voluntary. However, if requested information is not provided, FSA will not be considered.
1. NAME OF MEMBER (Last, First, Middle Initial)
2. GRADE
3. SOCIAL SECURITY NUMBER
4. BRANCH AND ORGANIZATION
HACKMAN, LUTHER
CW4
U.S. Army
PART I – MEMBER COMPLETES THIS SECTION TO SUBSTANTIATE ENTITLEMENT TO FSA
5. TYPE II (X as applicable)
FSA-T (Temporary)
FSA-R (Restricted)
FSA-S (Ship)
6. COMPLETE CURRENT ADDRESS(ES) OF DEPENDENT(S) X
11500 PARRISH AVE, CLAXTON, GA 30417
7. DATE (DDMMYY) DEPARTED RESIDENCE TO UNIT HOME
STATION (Mobilized Members)
8. I CERTIFY TO THE FOLLOWING FACTS (X applicable box(es))
a. I am not divorced or legally separated from my spouse. X
b. My dependent child (children) was (were) not in the legal custody of another person when I received my military orders. X
c. My dependent (other than my spouse; see line f. below) is not a member of the military service on active duty. X
d. My sole dependent is not in an institution for a known period of over 1 year or a period expected to exceed 1 year. X
e. I am claiming FSA for my parent(s) for whom I have a current and approved dependency status and am residing with, and I maintain a residence(s) for my dependent(s). I have
assumed the liability and responsibilities thereof at the address(es) shown above, where I likely reside during periods of leave or such other times as my duty assignment may permit.
f. I am married to another military member currently serving on active duty and my spouse was was not residing with me immediately before being separated by execution
of military orders.
Spouse’s SSN: ____________________________ Branch and Component: _________________________________________________________________________
g. My last TDY or deployment, if any, was was not within the last 30 days from this TDY or deployment. X X
9. I understand that I must notify my commanding officer immediately upon any change in dependency status and if my sole dependent or all of my dependents move to or near this station or
If my dependent(s) visit at or near this station for more than 90 continuous days (more than 30 continuous days in the case of FSA-T (Temp) or FSA-S (Ship) while I am in receipt of FSA
a. DATE (DDMMYY)
b. SIGNATURE OF MEMBER
Luther Hackman
18 SEP 20**
PART II – CERTIFYING OFFICER COMPLETES THE APPROPRIATE SECTION(S) BELOW
10. TYPE II – FSA-T. Member has been ordered to and has performed temporary duty (TDY) at the location(s) shown below for more than 30 continuous days. This (these) locations(s) is (are)
outside a reasonable commuting distance from the member’s permanent duty station (PDS pertains to active component) or the home of residence (HOR pertains to reserve component).
A distance of 50 miles, one way, is normally considered to be within a reasonable commuting distance of a PDS or HOR. “Within a reasonable commuting distance” also may include
distances of less than 50 miles and the time required to travel, under unusual conditions, does not exceed 1-1/2 hours. (Attach a blank page for continuation if necessary.)
a. LOCATION
b. INCLUSIVE DATES OF TDY/T (From/To)
c. NO. OF DAYS
11. TYPE II - FSA-R. Member departed (PCS/detached) from ______________________________________________ on ____________________________________
1/50TH FA FT. STEWART, GA 31314
1208**
(Last permanent duty station) (DDMMYY)
was on leave en route ________________________________________ , proceed time ______________________________________________________
12 AUG ** - 14 SEP **
N/A
(Inclusive dates chargeable as leave) (inclusive dates)
1509**
and the member reported to __________________________________________________ on ____________________________ Transportation of
dependent(s) is not authorized at government expense to this station or to a place near this station.
GUGGENHEIM, GE
(Permanent duty station (PDS)) (DDMMYY)
12. TYPE II – FSA-S. Member was serving on orders, on board ship, away from homeport commencing (DDMMYY) ________________________________
a. NAME OF SHIP/UNIT
b. HOMEPORT
13. Travel performed under authority of orders _________________________________________________ , dated ___________________________________
ORDER
6 JUN **
14. Member claiming TYPE II FSA, is receiving basic allowance for housing (BAH) (or residing in government type quarters) as a member with
dependents or member married to a military member.
15. DATE (DDMMYY)
16. CERTIFYING OFFICER
a. TYPED NAME (Last, First, Middle Initial)
b. TITLE
MAJ, COMMANDER
1809**
CORY, W.C.
c. ORGANIZATION
d. SIGNATURE
W.C. Cory, MAJ, CMD
23RD FMSU
DD FORM 1561
FOR INSTRUCTIONAL PURPOSES ONLY 6

9. FOR INSTRUCTIONAL PURPOSES ONLY
PROBLEM # 14
CERTIFICATE OF MARRIAGE
STATE OF GEORGIA
COUNTY OF LIBERTY
GROOM: DARRIN FLETCHER
BRIDE: BARBARA A. LANSING
THE ABOVE NAMED INDIVIDUALS WERE MARRIED BY ME IN HOLY
MATRIMONY ON THE 11TH DAY OF SEPTEMBER 20**.
Gerald L. Pittman
GERALD PITTMAN
JUSTICE OF THE PEACE
STUDENT NOTE: BARBARA A. LANSING IS NOT A MEMBER OF THE ARMED FORCES.
FOR INSTRUCTIONAL PURPOSES ONLY 7

10. Darrin Fletcher W.C.CORY, MAJ, CMD PROBLEM #14 (con’t)
FOR INSTRUCTIONAL PURPOSES ONLY
FLETCHER, DARRIN
LTC/0-5 X
1/92 ND MECH INF
FT STEWART, GA 31314 X
**0911 X X
BARBARA A. FLETCHER
1254 MOTTEVILLE RD APT 34
WIFE
N/A
GLENNVILLE, GA DF DF
Darrin Fletcher
20 SEP **
W.C.CORY, MAJ, CMD
20 SEP ** 8

11. PROBLEM #17 9

12. Jody Gerut W.C.CORY, MAJ, CMD PROBLEM #11 (con’t) Gerut, Jody
MAJ/O4 X
1/14TH ARM
FT STEWART, GA 31314 X
**0912 X X X
**0912 X
Becky Gerut
13 Bird LN.
Daughter
29 Mar 2004
Hinesville, GA 31313 JG JG
Jody Gerut
18 Sep**
W.C.CORY, MAJ, CMD
18 Sep** 10

13. FOR INSTRUCTIONAL PURPOSES ONLY
PROBLEM #14 (con’t)
DIVORCE DECREE
STATE OF GEORGIA
COUNTY OF LIBERTY
PLAINTIFF DEFENDANT
Jody Gerut Michael Welch
13 Bird LN West ST
Hinesville, GA Los Angeles, CA 90001
Let it be known that on this 12th day of September in the year 20**, the marriage between the plaintiff and the defendant is hereby dissolved.
James N. Morales
Superior Court Judge
FOR INSTRUCTIONAL PURPOSES ONLY 11

14. FOR INSTRUCTIONAL PURPOSES ONLY
PROBLEM #14 (con’t)
CERTIFICATE OF BIRTH
STATE OF GEORGIA
COUNTY OF LIBERTY
NAME OF CHILD: BECKY GERUT DATE OF BIRTH: 29 Mar 2004
TIME OF BIRTH: 8:16 pm SEX OF CHILD: FEMALE
NAME OF MOTHER: JODY GERUT NAME OF FATHER: MICHAEL WELCH
A. C. Webster
A.C. Webster
County Recorder
J.J. Owens
J.J. Owens DO
Physician attending
FOR INSTRUCTIONAL PURPOSES ONLY 12