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DD Form 2168 is a Department of Defense form, not a service form: DD Form 2168, Application for Discharge of Member or Survivor of Member, April 2010 (Corrected for OMB expiration and Army address), used to Application for Discharge of Member or Survivor of Member of Group Certified to Have Performed Active Duty with the Armed Forces of the U.S.. The DD prefix is the operative fact. It means one blank serves every military department — Army, Navy, Air Force, Marine Corps, Space Force, Coast Guard under Defense jurisdiction — plus the defense agencies and combatant commands. No branch variant exists.
not stated is the prescribing publication and not stated the office responsible for the document. Deadlines belong to local implementing guidance, not to either of those, so a submission date is a question for the receiving office.
Edition not stated, status not stated. That comparison is the first thing worth making, because a DD form supersedes centrally and an old copy in a shared drive is out of date for every office, not just yours.
The set is PDF. Size: 2 pages, about 44 fields.
Free download, every format. Do not fill the form in a browser tab — browser pdf viewers handle interactive fields inconsistently and discard entries on close.
What the form asks for
- Section 1. Group member data. 1.a. Member's name: last, first, middle, and maiden, if any.
- 1.b. Alias(es).
- 2. Social Security Number. Do not include dashes.
- 3. Date of birth: 4 digit year, 2 digit month, 2 digit day, no spacers.
- 4.a. Present street address (include apartment number).
- 4.b. City.
- 4.c. County.
- 4.d. State.
- 4.e. ZIP code.
- Section 2 - Service group data to support claim. 5. Name of group served with.
- 6. Identification number.
- 7. Highest grade/rank/rating held.
- 8. Highest pay grade (or actual pay).
- 9. Entry into Service. a. Date (4 digit year, 2 digit month, 2 digit day).
- 9.b. Place (include city and state of military installation).
- 10.Actual military service before/after this service. a. Dates (4 digit year, 2 digit month, 2 digit day).
- 10.b. Department(s).
- 11. Home of record at time of entry. a. Street address (include apartment number).
- 11b. City.
- 11c. County.
- 11d. State.
- 11e. ZIP code.
- 12. Grade/rank/rating at time of entry.
- 13. Military installation where ordered to report (include city and state).
Start by matching the printed date to not stated. Old blanks accumulate in shared folders for years. Because the Department reissues to all services in one action, nobody is still accepting the previous layout by local custom.
For anything ambiguous in a specific field, the form's own instructions come first and not stated controls where the two differ.
Send it as not stated or local guidance specifies. Save a copy. Cross-service and cross-agency routing is normal for Department forms, and a lost original outside your own organization is harder to chase down.
A number is a complete address in the DD series. Because the sequence is Department-level and not duplicated per service, there is nothing further to specify.
Prefix before number. A DA citation and a DD citation in the same instruction point at separate systems — one Army, administered by an Army proponent, one Department-wide under not stated — and there is no correspondence between them at any number.
Editions change when the prescribing directive is reissued, when the data collected changes, or when notice language is amended. None of that reaches you. Checking not stated at download is the entire defence, and it is cheaper than repeating a submission.
This page publishes a Defense document and explains its contents. It does not advise, does not rule on applicability, and determines nothing about how a completed form will be treated. Direct such questions to not stated, to the servicing personnel office, or to the office designated in not stated.
Questions and answers
- What is DD Form 2168?
- DD Form 2168, Application for Discharge of Member or Survivor of Member, April 2010 (Corrected for OMB expiration and Army address)
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?