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Get DD 2606 2020-2024

PLACEMENT TIME In months DD FORM 2606 MAY 2014 PREVIOUS EDITION IS OBSOLETE. Adobe Designer 9. 0 PRIVACY ACT STATEMENT AUTHORITY 10 U.S.C. DEPARTMENT OF DEFENSE CHILD DEVELOPMENT PROGRAM REQUEST FOR CARE RECORD OMB No* 0704-0515 OMB approval expires May 31 2017 Read Privacy Act Statement and Instructions on back before completing form* The public reporting burden for this collection of information is estimated to average 5 minutes 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 4800 Mark Center Drive Alexandria VA 22350-3100 0704-0515. 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* RETURN COMPLETED FORM TO OFFICE OF FAMILY POLICY/CHILDREN AND YOUTH 4800 MARK CENTER DRIVE SUITE 03G15 ALEXANDRIA VA 22350-1400 1. DATE OF REQUEST YYYYMMDD 2. EXPIRATION DATE YYYYMMDD To be completed by Facility 3. FAMILY INFORMATION a* SPONSOR S NAME Last First Middle Initial b. SPOUSE S NAME Last First Middle Initial c* CHILD S NAME Last First Middle Initial d. CHILD S DATE OF BIRTH YYYYMMDD f* HOME ADDRESS Street City State Zip Code g. SPONSOR S BRANCH OF SERVICE e. CHILD S AGE h. DUTY ORGANIZATION i. HOME TELEPHONE NUMBER Include Area Code j. DUTY TELEPHONE NUMBER Include Area Code k. SIBLING CARE 2 DATE OF BIRTH YYYYMMDD 1 NAME Last First Middle Initial 4. PROGRAM S DESIRED X as applicable 5. AGE GROUP X one a* FULL-DAY CARE d. FAMILY DAY CARE FDC a* INFANTS 0 - 12 months b. PART-DAY CARE e. PART-DAY ENRICHMENT b. TODDLERS 13 - 35 months c* SCHOOL-AGE f* PRE-SCHOOL c* PRESCHOOL 3 - 5 years d. SCHOOL AGE 5 years 6. SPONSOR STATUS X one a* SINGLE MILITARY e. SINGLE DOD CIVILIAN i. MILITARY/UNEMPLOYED SPOUSE b. DUAL MILITARY f* RETIRED MILITARY j. MILITARY/OTHER THAN DOD SPOUSE c* MILITARY/DOD SPOUSE g. MILITARY RESERVE k. OTHER Specify d. DUAL DOD CIVILIANS h. NATIONAL GUARD 7. PRESENT CHILD CARE ARRANGEMENTS X as applicable a* FCC ON-INSTALLATION d. CIVILIAN CDC g. IN-HOME CARE b. FCC OFF-INSTALLATION e. MILITARY ALTERNATE CARE h. NO PRESENT CARE c* OTHER MILITARY CHILD DEVELOPMENT CENTER CDC f* NON-MILITARY ALTERNATE CARE i. OTHER Specify 8. GENERAL INFORMATION X and complete as applicable NO a* IF CHILD IS NOT PRESENTLY IN CARE IS EMPLOYMENT OF SPOUSE IMPACTED If Yes estimate average annual income lost YES b. HAS CHILD BEEN IDENTIFIED FOR SPECIAL NEEDS CARE d. CURRENT COST OF CARE PER WEEK If child is currently in care c* IS CHILD ON OTHER MILITARY WAITING LIST If Yes name installation 9.

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