Form DD-2088 STATEMENT OF ECCLESIASTICAL ENDORSEMENT

STATEMENT OF ECCLESIASTICAL ENDORSEMENT
This document contains information subject to the Privacy Act of 1974, as amended.

OMB Number 0704-0190
OMB approval expires

The public reporting burden for this collection of information is estimated to average 45 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, Executive Services Directorate (0704-0190). 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 COMPLETED FORM TO THE ABOVE ORGANIZATION. RETURN COMPLETED FORM TO CHIEF OF CHAPLAINS (ITEM 2).

1. FROM
a. TYPED OR PRINTED NAME OF RELIGIOUS ORGANIZATION GRANTING
RELIGIOUS MINISTRY PROFESSIONAL ENDORSEMENT

f. ADDRESS. (1) STREET (Include apartment or suite number)
g.

E-MAIL ADDRESS

c. EMPLOYER IDENTIFICATION
NUMBER (IRC)

d. TELEPHONE (Include Area Code)

e. FAX NUMBER (Include Area Code)

(2) CITY

(3) STATE

(4) ZIP CODE

NEEDS DD 67
h. WEB SITE

b. ADDRESS. (1) STREET (Include apartment or suite number)

2. TO
a. CHIEF OF CHAPLAINS
(X appropriate block)

b. DATE OF CURRENT INTERNAL
REVENUE CODE (IRC) 501(c)(3)
EXEMPT STATUS

(1) ARMY
(2) NAVY

(2) CITY

(3) STATE

(4) ZIP CODE

(3) AIR FORCE

3. PROSPECT INFORMATION. a. IS THIS AN INITIAL ENDORSEMENT? (X one)

c. TELEPHONE (Include Area Code)

d. ADDRESS. (1) STREET (Include apartment or suite number)
e.

E-MAIL ADDRESS

f.

NUMBER OF YEARS OF PROFESSIONAL MINISTRY EXPERIENCE
PROSPECT HAS COMPLETED

(2) CITY

(3) STATE

(4) ZIP CODE

g. NUMBER OF MONTHS OF PRIOR ACTIVE MILITARY SERVICE PROSPECT
HAS COMPLETED
(1) OFFICER

h. APPLICATION IS FOR
(X one)

NO

YES

b. TYPED OR PRINTED NAME (Last, First, Middle Initial)

(2) ENLISTED

(1) RESERVE (Non-Active Duty)

(4) EXTENDED ACTIVE DUTY (Indefinite)

(2) NATIONAL GUARD

(5) REGULAR COMMISSIONED OFFICER

(3) INITIAL ACTIVE DUTY (3 years)

(6) RESERVE (AGR)

4. ECCLESIASTICAL ENDORSING AGENT

,

a. AS THE ECCLESIASTICAL ENDORSING AGENT AUTHORIZED TO REPRESENT
(Name of religious organization) (Item 1)

I HEREBY VERIFY THE ABOVE PROSPECTIVE CANDIDATE TO BE PROFESSIONALLY QUALIFIED AS A RELIGIOUS MINISTRY
PROFESSIONAL FOR THE MILITARY CHAPLAINCY.
b. TYPED OR PRINTED NAME (Last, First, Middle Initial)

c. E-MAIL ADDRESS

d. ADDRESS. (1) STREET (Include apartment or suite number)

(2) CITY

e. TELEPHONE
(Include Area Code)

f. FAX NUMBER
(Include Area Code)

g. SIGNATURE

(3) STATE

(4) ZIP CODE

h. DATE SIGNED (YYYYMMDD)

5. COMMENTS

DD FORM 2088, 20090504 DRAFT

PREVIOUS EDITION IS OBSOLETE.

Reset

Adobe Professional 8.0