1. 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

2. 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 chapter

3. DD AR table 11-1
Block 1, Members full last name, first name and middle name
Block 2a, Members Social Security Number (SSN)
Smith, Timothy Greg

4. DD AR 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

5. DD AR 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

6. 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 Adopted son
Jane A. 04
Bobby J. Donald 13

7. DD AR 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

8. DD AR 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)

9. DD AR 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

10. DD AR 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%

11. DD AR 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

12. DD AR 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

13. 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

14. 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.

15. 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)

16. DD AR 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)

17. 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

18. DD 93
Reference
Army Casualty Operations/Assistance/ Insurance AR Chapter 11
DD 93 (back page) instructions

19. DD 93
QUESTIONS ?