DD Form 3048 Disposition of Organs Retained for Extended Examination

CUI (when filled in)
OMB No. 0704-0581
OMB approval expires
20250331

NOTIFICATION AND DISPOSITION ELECTION OF ORGANS RETAINED FOR
FORENSIC EXAMINATION

The public reporting burden for this collection of information is estimated to average 15 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, at [email protected]. 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 RETURN THIS FORM TO ODASD MC&FP; ATTN: CASUALTY; 4000 DEFENSE PENTAGON; WASHINGTON, DC 20301-4000.
PRIVACY ADVISORY
With this form, the Department of Defense asks you to acknowledge notification of the organ(s) retained for forensic examination. This process
includes providing your name and contact information, as well as your legal relationship to the decedent. This collection is authorized by Title 10 United
States Code Sections 1471 and 1481-1488. This form will be filed in the Defense Casualty Information Processing System as part of the decedent’s
casualty record, covered by the following Department of the Army System of Record Notice: (https://dpcid.defense.gov/Privacy/SORNsIndex/DODwide-SORN-Article-View/Article/570058/a0600-8-1c-ahrc-dod/).
Completing this form is voluntary; however, without completing this form, your choices regarding the decedent’s retained organ(s) may not be
documented or complied with.
1. NAME OF DECEASED (Last, First, Middle Initial)

2. DoD AFFILIATION

3. DCIPS CASE NUMBER

4. PERSON AUTHORIZED TO DIRECTION DISPOSITION (PADD) or PRIMARY NEXT OF KIN (PNOK)
a. NAME (Last, First, Middle Initial)

b. RELATIONSHIP TO DECEASED

c. TELEPHONE NUMBER (Include
Area Code)

d. CURRENT RESIDENCE ADDRESS (Street, Apartment Number, City, State and ZIP Code)

5. NOTIFICATION OF RETAINED ORGAN(S)
a. I, the undersigned, notified the PADD or PNOK above the specified organ(s) in 5.b. are being retained by the Armed Forces Medical Examiner System for the
purpose of forensic examination to determine the cause and manner of death.
b. SPECIFIED ORGAN(S):

c. NAME OF SERVICE REPRESENTATIVE

SIGNATURE OF SERVICE REPRESENTATIVE

DATE (YYYYMMDD)

d. I’ve been notified by the Service Representative above the specified organ(s) listed in 5.b. above was retained for the purpose of forensic examination to
determine the cause and manner of death. I understand this examination may take an extended period of time. The Armed Forces Medical Examiner is available
to discuss any issues and concerns and may be reached at (302) 346-8648.
e. NAME OF PADD OR PNOK

SIGNATURE OF PADD OR PNOK

DATE (YYYYMMDD)

AUTHORIZATION AND SIGNATURES
6. DISPOSITION OF RETAINED ORGAN(S)
Upon finalization of the forensic examination, I elect the following option by placing my initials beside the option of my choice. I understand the DoD will bear all
usual and customary expenses associated with the disposition of the organs. I further understand the Department of Defense will not provide or cover the costs
of an alternate burial place for a Service member or authorized family member, as a decedent is only authorized one burial location by the U.S. government.
Exhumation of buried remains or a funeral or memorial service will not be covered by the Department of Defense, as disposition of organs is considered an
administrative act.
I authorize the Armed Forces Medical Examiner System to effect disposition as a medical Specimen (skip item 7.).

I authorize disposition by placement in the Tomb of Remembrance at Arlington National Cemetery if eligible or by retirement at sea (skip item 7.).

Notify me when finalization of the forensic examination is complete.

DD FORM 3048, 20220819 DRAFT
PREVIOUS EDITION IS OBSOLETE.

CUI (when filled in)

Controlled by: OUSD(P&R)
Page 1 of
CUI Category: PRVCY
LDC: FEDCON
POC: [email protected]

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CUI (when filled in)
Request DoD cremate organ(s) at a DoD mortuary facility or DoD contracted facility and arrange transportation to the following
funeral home for disposition:
Request DoD cremate organ(s) at a DoD mortuary facility or DoD contracted facility and arrange disposition to the original
burial location at:
Request DoD prepare organ(s) and arrange transportation to the following funeral home for disposition (prepared organs are
required by law to be interred or inurned):
Request DoD prepare organ(s) and arrange disposition to the original burial location at:
7. Please indicate your choice of urn below by initialing the option. An urn is used for both cremated or whole organ(s). If you select a temporary urn, you may
purchase an urn of your choice and request reimbursement of no more than $
solid bronze urn
8.a. TYPED OR PRINTED NAME OF WITNESS

DD FORM 3048, 20220819 DRAFT
PREVIOUS EDITION IS OBSOLETE.

by submitting a DD Form 1375.
solid hardwood urn

b. SIGNATURE OF WITNESS

CUI (when filled in)

temporary urn
c. DATE (YYYYMMDD)

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