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Please read Privacy Act Statement and Agency Disclosure Notice prior to completing this form. APPLICATION FOR UNIFORMED SERVICES IDENTIFICATION CARD DEERS ENROLLMENT 1. NAME (Last, First, Middle).

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How to fill out the DD1172 online

Filling out the DD1172 form online can streamline the application process for a Uniformed Services Identification Card and facilitate DEERS enrollment. This guide will provide you with clear, step-by-step instructions to ensure you complete the form accurately and efficiently.

Follow the steps to complete the DD1172 form online.

  1. Click ‘Get Form’ button to access the DD1172 form electronically and open it in the appropriate editor.
  2. Enter your name in the designated fields (Last, First, Middle). Ensure the spelling is correct as it should match your identification documents.
  3. Select your sex from the options provided.
  4. Input your Social Security Number (or Service Number) accurately in the specified field.
  5. Indicate your current status (e.g., active duty, retired) and branch of service.
  6. Provide your pay grade and rank, ensuring the entries are in line with your current military record.
  7. Fill in your general category and the type of card you are requesting.
  8. Complete the current residence address section thoroughly, including any supplemental address information as needed.
  9. Provide your home telephone number, including the area code.
  10. Enter your date of birth in the specified format (YYYYMMMDD).
  11. Provide additional details such as blood type, color of eyes, and hair, height, and weight as required.
  12. Fill in the marital status and include any pertinent eligibility start and end dates.
  13. Describe the privileges authorized for the card you are requesting.
  14. If applicable, include details of dependents in the subsequent sections, repeating the necessary fields for each.
  15. Sign and date the form where indicated, certifying that the provided information is true and accurate.
  16. After all fields are completed, save your changes, download a copy, and print the form for your records or to share as necessary.

Start filling out the DD1172 form online today to ensure a smooth application process.

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MilConnect Guide for DD1172 Select “Family ID Cards” Ensure you have a DS Login if you no longer have a CAC for access to the site. Once logged in, select “Print Family List” Select the box marked “Select All Family Members” and proceed. Read and acknowledge the statement and select “I agree”

DD1172-2 for Dependents: If you have a Common Access Card (CAC), you may sign, view or print this form online at https://.dmdc.osd.mil/self_service/. If a sponsor is unable to sign the DD1172-2 online, they may come to the ID card office to sign one in person.

Should I neglect to report changes, I and/or my dependent(s) may be held responsible for recoupment for any accrued healthcare costs. (If not signed in the presence of the authorizing/verifying official, the signature must be notarized.)

Application for Identification Card/DEERS Enrollment (DD Form 1172-2) This form is used to register in the DEERS database and apply for a uniformed service identification card or Common Access Card.

What is a DD Form 1172 and what is its purpose? The DD Form 1172 is an application for uniformed services identification card/DEERS Enrollment. It is used for the application of military ID cards for military dependents. •

All potential cardholders must register in the Defense Enrollment Eligibility Reporting System (DEERS). To do this, you will need to complete a DD Form 1172-2. If you are a dependent, an active duty or retired Service member must take action to register you in DEERS with the required eligibility documents.

If you have a Common Access Card (CAC), you may sign, view or print this form online at https://.dmdc.osd.mil/self_service/. If a sponsor is unable to sign the DD1172-2 online, they may come to the ID card office to sign one in person.

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