Form DD Form 2585 DD Form 2585 Repatriation Processing Center Processing Sheet

SECTION I - TO BE COMPLETED BY THE "RESPONSIBLE PERSON"
ARE YOU ESCORTING UNACCOMPANIED MINOR CHILD(REN)? (X one)

YES

NO

The designated escort is responsible for completing (to the best of their ability) a separate form for each family
group they are escorting. If there is more than one child from the same family group, enter the information in Items
6 through 20 for the eldest child being escorted. Then, complete the family group information for each younger
child in Items 23(a) through (d), as applicable.
ADDITIONALLY, ESCORTS WILL FILL OUT A SEPARATE FORM FOR THEIR OWN FAMILY GROUP.
SECTION II - TO BE COMPLETED BY THE "RESPONSIBLE PERSON"
1. AIRLINE AND FLIGHT NUMBER

3. REPATRIATION CENTER

2. DATE OF ARRIVAL (YYYYMMDD)

D R A F T

4. PROCESSING DATE (YYYYMMDD)

5. PROCESSING TIME (Military)

SECTION III - EVACUEE IDENTIFYING INFORMATION - TO BE COMPLETED BY THE "RESPONSIBLE PERSON"
6. NAME OF EVACUEE (Last, First, Middle Initial)

7. COUNTRY EVACUATED FROM

8. DATE OF BIRTH (YYYYMMDD)

9. PLACE OF BIRTH (City, State, and Country)

10. COUNTRY OF CITIZENSHIP

11. GENDER (X one)
MALE

12. SOCIAL SECURITY NUMBER
FEMALE

13. MARITAL STATUS (X one)
SINGLE

MARRIED

WIDOWED

14.a. PASSPORT NUMBER

b. COUNTRY OF ISSUE

15.a. ALIEN NUMBER

b. COUNTRY OF ISSUE

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SEPARATED

DIVORCED

Page 5 of 10 Pages

SECTION III - EVACUEE IDENTIFYING INFORMATION (Continued) (Read before completing Items 16 and 23)
(Use these tables to complete Item 16 and Item 23 (Page 7.) Choose all that apply.)
TABLE 1a - U.S. CITIZEN

TABLE 1b - FOREIGN NATIONAL

CLASSIFICATION NUMBER
1a DoD: Service Member
b DoD: Service Member Dependent and/or Family Member
(Command Sponsored Dependent)
c DoD: Service Member Dependent and/or Family Member
(Non-Command Sponsored Dependent)
2a DoD: Civilian Employee WITH Transportation Agreement
b DoD: Dependent of Civilian Employee WITH
Transportation Agreement
c DoD: Civilian Employee WITHOUT Transportation
Agreement
d DoD: Dependent of Civilian Employee WITHOUT
Transportation Agreement
3a Non-DoD U.S. Government (USG): Employee
b Non-DoD USG: Employee Dependent and/or Family
Member
4
Citizen Residing Abroad (Child, Student, Private Business)
5
Tourist
6
Citizen on Business-Related Travel
7
U.S. Government Contractor

16. CLASSIFICATION NUMBER(S) AND AGENCY CODE(S) (Enter all
appropriate classification numbers and agency codes from Table 1
and Table 2 that are applicable to the person named in Item 6.)
a. CLASSIFICATION NUMBER

b. AGENCY CODE

c. CLASSIFICATION NUMBER

d. AGENCY CODE

e. CLASSIFICATION NUMBER

f. AGENCY CODE

TABLE 2

CLASSIFICATION NUMBER
8 Adult Dependent of Repatriated U.S. Citizen
(Foreign spouse or other adult dependent;
not U.S. citizen)
9 Minor Dependent of Repatriated U.S. Citizen
(Child born in foreign country, not U.S.
citizen to date)
10 Non-Dependent of Repatriated U.S. Citizen
(Extended family member, i.e. mother-inlaw, cousin, etc.)
11 Non-U.S. Civilian Employee (Works for U.S.
Government)
12 Citizen of Country Other Than U.S.
13 Other, None of the Above (Specify)

AGENCY CODE
A
Army
N

Navy

F

Air Force

M

Marine Corps

G

Coast Guard

D

DoD Agency

O

Other U.S.
Government
Agency

X

Not Applicable

17. NUMBER OF FAMILY MEMBERS WITH YOU
ADULTS
(Include yourself)

CHILDREN
(Include all children)

18. NUMBER OF ANIMALS WITH YOU (If applicable)
DoD and SERVICE ANIMALS ONLY
DOGS

CATS

BIRDS

OTHER

19. EMERGENCY CONTACT IN U.S.
(For person named in Item 6 above)

a. NAME (Last, First, Middle Initial)

c. HOME TELEPHONE NO.
(Include Area Code)

D R A F T

b. ADDRESS (Street, City, State/Country, ZIP Code)

d. WORK TELEPHONE NO.
(Include Area Code)

e. CELL TELEPHONE NO.
(Include Area Code)

20. FINAL DESTINATION AND NAME OF POINT OF CONTACT (If applicable)
(If same as Item 19, enter "SAME")

a. NAME (Last, First, Middle Initial)

c. HOME TELEPHONE NO.
(Include Area Code)

b. ADDRESS (Street, City, State/Country, ZIP Code)

d. WORK TELEPHONE NO.
(Include Area Code)

e. CELL TELEPHONE NO.
(Include Area Code)

21. IF U.S. DEPARTMENT OF DEFENSE MILITARY AND CIVILIAN EMPLOYEE DEPENDENTS

(For escorted unaccompanied minor children enter the sponsor's (parent/guardian) information to the best of your ability.)

a. BRANCH OF SERVICE/DOD AGENCY (X one)
ARMY

NAVY

AIR FORCE

MARINE CORPS

b. NAME OF SPONSOR (Remaining in Country) (Last, First, Middle Initial)

COAST GUARD
c. SSN

DOD AGENCY
d. RANK/GRADE

e. ORGANIZATION/ADDRESS AND MAJOR COMMAND (Include APO#/FPO#)

22. FINAL DESTINATION AND NAME OF ESCORT FOR UNACCOMPANIED MINOR CHILD(REN)
(Complete if applicable)

a. NAME OF ESCORT (Last, First, Middle Initial)

c. HOME TELEPHONE NO.
(Final Destination of Escort)
(Include Area Code)

d. WORK TELEPHONE NO.
(Final Destination of Escort)
(Include Area Code)

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b. ADDRESS (Final Destination of Escort) (Street, City, State/Country,
ZIP Code)
e. CELL TELEPHONE NO.
(Final Destination of Escort)
(Include Area Code)

Page 6 of 10 Pages

SECTION III - EVACUEE IDENTIFYING INFORMATION (Continued)
23. ACCOMPANYING EVACUEES
(Fill out for each accompanying person.)

a.(1) NAME (Last, First, Middle Initial)
(4) GENDER (X one)
MALE

(2) SSN

(3) DATE OF BIRTH (YYYYMMDD)

(5) RELATIONSHIP TO PERSON COMPLETING FORM (X one)
FEMALE

SPOUSE

SON/DAUGHTER

PARENT

OTHER

(6) PLACE OF BIRTH (City, State, and Country)

(10) CLASSIFICATION NUMBER(S) AND AGENCY CODE(S)
(Enter all appropriate classification numbers and agency codes from
Table 1 and Table 2 (shown on Page 6) that are applicable to the person
named in Item a.(1).)

(7) COUNTRY OF CITIZENSHIP

(a) CLASSIFICATION NUMBER

(b) AGENCY CODE

(8) PASSPORT NUMBER

COUNTRY OF ISSUE

(c) CLASSIFICATION NUMBER

(d) AGENCY CODE

(9) ALIEN NUMBER

COUNTRY OF ISSUE

(e) CLASSIFICATION NUMBER

(f) AGENCY CODE

D R A F T

b.(1) NAME (Last, First, Middle Initial)
(4) GENDER (X one)
MALE

(2) SSN

(3) DATE OF BIRTH (YYYYMMDD)

(5) RELATIONSHIP TO PERSON COMPLETING FORM (X one)
FEMALE

SPOUSE

SON/DAUGHTER

PARENT

OTHER

(6) PLACE OF BIRTH (City, State, and Country)

(10) CLASSIFICATION NUMBER(S) AND AGENCY CODE(S)
(Enter all appropriate classification numbers and agency codes from
Table 1 and Table 2 (shown on Page 6) that are applicable to the person
named in Item b.(1).)

(7) COUNTRY OF CITIZENSHIP

(a) CLASSIFICATION NUMBER

(b) AGENCY CODE

(8) PASSPORT NUMBER

COUNTRY OF ISSUE

(c) CLASSIFICATION NUMBER

(d) AGENCY CODE

(9) ALIEN NUMBER

COUNTRY OF ISSUE

(e) CLASSIFICATION NUMBER

(f) AGENCY CODE

(2) SSN

(3) DATE OF BIRTH (YYYYMMDD)

c.(1) NAME (Last, First, Middle Initial)
(4) GENDER (X one)
MALE

(5) RELATIONSHIP TO PERSON COMPLETING FORM (X one)
FEMALE

SPOUSE

SON/DAUGHTER

PARENT

OTHER

(6) PLACE OF BIRTH (City, State, and Country)

(10) CLASSIFICATION NUMBER(S) AND AGENCY CODE(S)
(Enter all appropriate classification numbers and agency codes from
Table 1 and Table 2 (shown on Page 6) that are applicable to the person
named in Item c.(1).)

(7) COUNTRY OF CITIZENSHIP

(a) CLASSIFICATION NUMBER

(b) AGENCY CODE

(8) PASSPORT NUMBER

COUNTRY OF ISSUE

(c) CLASSIFICATION NUMBER

(d) AGENCY CODE

(9) ALIEN NUMBER

COUNTRY OF ISSUE

(e) CLASSIFICATION NUMBER

(f) AGENCY CODE

(2) SSN

(3) DATE OF BIRTH (YYYYMMDD)

d.(1) NAME (Last, First, Middle Initial)
(4) GENDER (X one)
MALE

(5) RELATIONSHIP TO PERSON COMPLETING FORM (X one)
FEMALE

SPOUSE

SON/DAUGHTER

PARENT

OTHER

(6) PLACE OF BIRTH (City, State, and Country)

(10) CLASSIFICATION NUMBER(S) AND AGENCY CODE(S)
(Enter all appropriate classification numbers and agency codes from
Table 1 and Table 2 (shown on Page 6) that are applicable to the person
named in Item d.(1).)

(7) COUNTRY OF CITIZENSHIP

(a) CLASSIFICATION NUMBER

(b) AGENCY CODE

(8) PASSPORT NUMBER

COUNTRY OF ISSUE

(c) CLASSIFICATION NUMBER

(d) AGENCY CODE

(9) ALIEN NUMBER

COUNTRY OF ISSUE

(e) CLASSIFICATION NUMBER

(f) AGENCY CODE

NOTE: If there are more than 4 accompanying family members, use additional copies of Page 7.
Page 7 of 10 Pages
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SECTION III - EVACUEE IDENTIFYING INFORMATION (SERVICES) (Continued)
24. IF NO SERVICES ARE NEEDED, X THIS BLOCK
25. SERVICES NEEDED (X all that apply)
CLOTHING
HOUSING

PERMANENT

TEMPORARY

MEDICAL
DOD INFORMATION
DOD LEGAL SERVICES
CHILD CARE

D R A F T

FEDERAL CIVILIAN PERSONNEL ASSISTANCE

LOCATOR ASSISTANCE FOR OTHER FAMILY MEMBERS
TRANSPORTATION TO ONWARD DESTINATION
FINANCIAL ASSISTANCE
MENTAL HEALTH
GENERAL INFORMATION
CHAPLAIN ASSISTANCE
FUNERAL ASSISTANCE
DOD RELOCATION INFORMATION
TRANSLATOR (Indicate language)
OTHER (Specify)

26. ADDITIONAL REMARKS

STOP HERE.
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Page 8 of 10 Pages

SECTION IV (ITEMS 27 - 36) - TO BE COMPLETED BY REPATRIATION PROCESSING CENTER
DEPARTMENT OF HEALTH AND HUMAN SERVICES (DHHS) STAFF
27. IF NO SERVICES ARE REQUIRED/WERE PROVIDED, X THIS BLOCK
28. SERVICES PROVIDED BY DHHS
(1) SERVICES

(2) COSTS

(3) TOTAL

PERSONS

a. CASH ASSISTANCE

DOLLARS

X
PERSONS

X

b. ONWARD TRANSPORTATION

PERSONS

c. TEMPORARY LODGING AND PER DIEM
d. MISCELLANEOUS (Specify)

X

0.00

=

0.00

=

0.00

=

0.00

DOLLARS

X
PERSONS

=
DOLLARS

DAYS

DOLLARS

X

D R A F T

=
=
=
=

29. TOTAL COSTS
30. HAS EMERGENCY MEDICAL ASSISTANCE BEEN PROVIDED OFF-SITE? (X one)

=

0.00
YES

NO

31. ADDITIONAL REMARKS

SECTION V - CLOSING QUESTIONS - TO BE COMPLETED BY REPATRIATION PROCESSING CENTER
DEPARTMENT OF HEALTH AND HUMAN SERVICES (DHHS) STAFF
(X one)
YES

NO

32. HAS REPATRIATE BEEN GIVEN A HEALTH AND HUMAN SERVICES WELCOME BROCHURE?
33. DOES THIS PERSON/FAMILY NEED A LOAN FOR TEMPORARY ASSISTANCE BECAUSE HE/SHE/THEY ARE
WITHOUT RESOURCES IMMEDIATELY ACCESSIBLE TO MEET HIS/HER/THEIR NEEDS?
34. HAVE YOU EXPLAINED TO THE REPATRIATE THAT THE INFORMATION OBTAINED IS PROTECTED UNDER THE
PRIVACY ACT AND WILL BE USED SOLELY FOR THE PURPOSE OF ESTABLISHING ELIGIBILITY FOR AND
ADMINISTERING THE U.S. REPATRIATION PROGRAM?
35. HAS THE REPATRIATE SIGNED THE HHS REPAYMENT-LOAN AGREEMENT? (Agreement must be attached to file.)

36. HAS THE REPATRIATE BEEN GIVEN INFORMATION/REFERRAL FOR ASSISTANCE AT THE FINAL DESTINATION?
37. NAME OF INTERVIEWER (Last, First, Middle Initial)

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38. TELEPHONE NUMBER (Include Area Code)

Page 9 of 10 Pages

SECTION VI - ASSISTANCE PROVIDED DOD PERSONNEL TO BE COMPLETED BY REPATRIATION PROCESSING CENTER
39. IF NO SERVICES WERE PROVIDED, X THIS BLOCK
40. SERVICES PROVIDED (X as applicable)

41. COSTS

a. TRANSPORTATION

a. TRANSPORTATION

b. FINANCIAL (Advance per diem)

b. FINANCIAL (Amount paid)
VOUCHER NUMBER (for per diem)

c. AMERICAN RED CROSS (ARC)

c. AMERICAN RED CROSS (ARC)

42. TOTAL COST

d. HOUSING

0.00

D R A F T

e. MEDICAL/OTHER

f. LEGAL SERVICES

g. CHAPLAIN ASSISTANCE

h. FAMILY CENTER ASSISTANCE

SECTION VII - EXIT INFORMATION TO BE COMPLETED BY REPATRIATION PROCESSING CENTER
43. EXIT FROM PROCESSING CENTER
DATE (YYYYMMDD)

44. EXIT FROM PROCESSING 45. DESTINATION (City, State, Country)
CENTER TIME (Military)

46. TRANSPORTATION CARRIER(S)

47.a. ETA AT DESTINATION
(Military Time)

b. DATE OF ARRIVAL AT
DESTINATION (YYYYMMDD)

48. ADDITIONAL REMARKS

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Page 10 of 10 Pages