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  • Dd 2854 2018

Get Dd 2854 2018-2025

TRICARE PLUS DISENROLLMENT REQUEST (Read Agency Disclosure Notice, Privacy Act Statement, and Instructions before completing form.) OMB No. 0720-0028 OMB approval expires April 30, 2021 AGENCY DISCLOSURE.

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How to fill out the DD 2854 online

The DD 2854, also known as the TRICARE Plus Disenrollment Request form, is essential for individuals seeking to disenroll from the TRICARE Plus program. This guide will provide you with clear and supportive instructions on how to complete this form online, ensuring that your disenrollment is processed smoothly.

Follow the steps to fill out the DD 2854 online

  1. Use the ‘Get Form’ button to access the DD 2854 form in an editing interface.
  2. In Section I, input the sponsor information. This includes the sponsor’s Social Security Number (SSN) or DoD Benefits Number (DBN), their full name (last, first, and middle initial), and the date of birth in the format YYYYMMDD.
  3. Proceed to Section II, where you will fill in the names and dates of birth for the individuals requesting disenrollment. Indicate the reason for disenrollment by placing an 'X' in the appropriate box and, if applicable, provide a requested disenrollment date.
  4. In Section III, review the information you've entered for accuracy. Sign the form, confirming that the information is true, accurate, and complete. Include the date signed using the YYYYMMDD format.
  5. Finally, ensure that you save any changes made to the form. You can download, print, or share the completed DD 2854 form as required. Keep a copy for your records before submission.

Complete your DD 2854 form online today to manage your TRICARE Plus disenrollment efficiently.

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Related content

Untitled - RegInfo.gov
Jun 4, 2012 - Enrollment Application (DD Form 2853) and TRICARE Plus Disenrollment...
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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232