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Get DD 2789 2019-2024

A. SIGNATURE DD FORM 2789 MAY 2008 b. JOB TITLE/CAREER FIELD PREVIOUS EDITION IS OBSOLETE. c. DATE SIGNED Reset Adobe Professional 7. OMB No* 0730-0009 OMB approval expires Nov 30 2008 WAIVER/REMISSION OF INDEBTEDNESS APPLICATION If more space is needed continue on separate sheet s. Identify each item by number. The public reporting burden for this collection of information is estimated to average 2 hours per response including the time for reviewing instructions searching existing data sources gathering and maintaining the data needed and completing and reviewing the collection of information* Send comments regarding this burden estimate or any other aspect of this collection of information including suggestions for reducing the burden to the Department of Defense Washington Headquarters Services Executive Services Directorate Information Management Division 1155 Defense Pentagon Washington DC 20301-1155 0730-0009. Respondents should be aware that notwithstanding any other provision of law no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ORGANIZATION* SEPARATED MILITARY OR FORMER CIVILIAN EMPLOYEES RETURN COMPLETED FORM TO DFAS-IN DEPT. 3300 WAIVER/REMISSION 8899 EAST 56TH STREET INDIANAPOLIS IN 46249-3300. ACTIVE DUTY MILITARY GUARD/RESERVE RETIRED OR ANNUITANT PAY RECIPIENTS CIVILIAN EMPLOYEES RETURN COMPLETED FORM TO THE ADDRESS LISTED ON THE DEBT NOTIFICATION LETTER FOR COMPLETION OF BACK SIDE* PRIVACY ACT STATEMENT AUTHORITY E*O. 9397 SSN. PRINCIPAL PURPOSE To be used by civilian employees current former or retired and military members active separated or retired and annuitants to request waiver of indebtedness collection for erroneous payments of salary or pay and allowances and expense reimbursement or allowances for travel transportation and relocation or in the case of enlisted members remission of these debts. ROUTINE USE S In addition to those disclosures generally permitted under 5 U*S*C. Section 552a of the PA this information may be disclosed to the Department of Justice or to commercial credit agencies whenever a financial status report is requested by the Department of Defense DoD for use in administering the Federal Claims Collection Act. It may also be disclosed for any of the blanket routine uses as published in the Federal Register at the beginning of the DFAS compilation of PA system notices. DISCLOSURE Disclosure is voluntary however failure to disclose the requested data including your Social Security Number may prevent consideration of the claim* 1. TYPE OF CLAIM X one WAIVER REMISSION Authority for granting waiver Active/Retired Military - 10 U*S*C. 2774 National Guard - 32 U*S*C. 716 Civilian - 5 U*S*C. 5584 Annuitant - 10 U*S*C. 1442/1453. Remission Army - 10 U*S*C. 4837 Navy - 10 U*S*C. 6161 Air Force - 10 U*S*C. 9837. Note Remission generally is applicable for active duty enlisted personnel only see DoDFMR Volume 7A.

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