DD Form 1966 Record of Military Processing - Armed Forces of the Unit

CUI when filled

RECORD OF MILITARY PROCESSING - ARMED FORCES OF THE UNITED STATES
(Read Privacy Act Statement and Instructions on back before completing this form.)

OMB No. 0704-0173
OMB approval expires
20241130

The public reporting burden for this collection of information, 0704-0173, is estimated to average 21 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 DO NOT RETURN YOUR FORM TO THE ABOVE ORGANIZATION.

A. SERVICE
PROCESSING FOR

B. PRIOR SERVICE
YES

C. SELECTIVE SERVICE CLASSIFICATION

D. SELECTIVE SERVICE REGISTRATION NO.

NO

NUMBER OF DAYS

SECTION I - PERSONAL DATA
1. SOCIAL SECURITY NUMBER

2.A. NAME (Last, First, Middle Initial (and Maiden, if any), Jr., Sr., etc.))

2.B. DoD ID NUMBER

2.C. PHONE NUMBER

-

3. CURRENT ADDRESS
(Street, City, County,
State, Country, ZIP Code)

2.D. EMAIL ADDRESS

4. HOME OF RECORD ADDRESS
(Street, City, County, State, Country, ZIP
Code)

-

5. CITIZENSHIP (X one)

6. SEX
(X one)

A. U.S. AT BIRTH (If this box is marked, also X (1) or (2))
(1) NATIVE BORN

(2) BORN ABROAD OF U.S. PARENT(S)
ALIEN REGISTRATION NUMBER
(If issued)

B. U.S. NATURALIZED

A. MALE
B. FEMALE

C. U.S. NON-CITIZEN NATIONAL
D. IMMIGRANT ALIEN (Specify)
E. NON-IMMIGRANT FOREIGN NATIONAL (Specify)

7. RACE AND ETHNICITY (Select all that apply and enter additional details in the spaces below.)
(1) AMERICAN INDIAN OR ALASKA NATIVE - Enter, for example, Navajo Nation, Blackfeet Tribe of the Blackfeet Indian Reservation of Montana, Native Village of
Barrow Inupiat Traditional Government, Nome Eskimo Community, Aztec, Maya, etc.
(2) ASIAN - Provide details below.
Chinese

Asian Indian

Filipino

Vietnamese

Korean

Japanese

Nigerian

Ethiopian

Somali

Cuban

Dominican

Guatemalan

Syrian

Iraqi

Israeli

Chamorro

Tongan

Fijian

Marshallese

Irish

Italian

Polish

Scottish

Enter, for example, Pakistani, Hmong, Afghan, etc.

(3) BLACK OR AFRICAN AMERICAN - Provide details below.
African American

Jamaican

Haitian

Enter, for example, Trinidadian and Tobagonian, Ghanaian, Congolese, etc.

(4) HISPANIC OR LATINO - Provide details below.
Mexican

Puerto Rican

Salvadoran

Enter, for example, Colombian, Honduran, Spaniard, etc.

(5) MIDDLE EASTERN OR NORTH AFRICAN - Provide details below.
Lebanese

Iranian

Egyptian

Enter, for example, Moroccan, Yemeni, Kurdish, etc.

(6) NATIVE HAWAIIAN OR PACIFIC ISLANDER - Provide details below.
Native Hawaiian

Samoan

Enter, for example, Chuukese, Palauan, Tahitian, etc.

(7) WHITE - Provide details below.
English

German

Enter, for example, French, Swedish, Norwegian, etc.

9. NUMBER OF DEPENDENTS

8. MARITAL STATUS (Specify)
10. DATE OF BIRTH
(YYYYMMDD)

11. RELIGIOUS
PREFERENCE
(Optional)

DD FORM 1966, DEC 2021
PREVIOUS EDITION IS OBSOLETE.

12. EDUCATION
(Yrs/Highest Ed Gr
Completed)
CUI when filled

13. PROFICIENT IN FOREIGN LANGUAGE
(If Yes, specify.
If No, enter NONE.)
Controlled by: OUSD(P&R)
CUI Category: HLTH, PRVCY
LDC: FEDCON
POC: 703-695-5527

1st

2nd

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14. VALID DRIVER'S LICENSE (X one)

YES

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

NO

(If Yes, list State, number, and expiration date)

SECTION II - EXAMINATION AND ENTRANCE DATA PROCESSING CODES
(FOR OFFICE USE ONLY - DO NOT WRITE IN THIS SECTION - Go on to Page 2, Question 20.)
16. APTITUDE TEST RESULTS
A. TEST ID B. TEST SCORES

GS

AFQT
PERCENTILE

17. DEP ENLISTMENT DATA
A. DATE OF ENLISTMENT-DEP

B. PROJ ACTIVE DUTY DATE

(YYYYMMDD)

AR

C. ES

WK

PC

MK

EI

AS

D. RECRUITER IDENTIFICATION

MC

AO

E. STN ID

VE

F. PEF

(YYYYMMDD)

G. T-E MOS/AFS

H. WAIVER (2)
(1)

18. ACCESSION DATA
A. DATE OF ENLISTMENT

(3)

(4)

(5)

B. ACTIVE DUTY SERVICE

(YYYYMMDD)

(3)

(4)

J. SVC ANNEX
CODES

K. MSO

(6)

D. MSO (YYWW)

E. AD/RC OBLIGATION
(YYYYMMDD)

G. PAY
GRADE

M. PEF

L. AD OBLIGATION (YYWW)

(YYWW)

(YYYYMMDD)

(5)

L. STN ID

K. RECRUITER IDENTIFICATION

I. PAY
GRADE

C. PAY ENTRY DATE

DATE (YYYYMMDD)

F. WAIVER (1) (2)

(6)

H. DATE OF GRADE

I. ES

J. YRS/HIGHEST ED
GR COMPLETED

(YYYYMMDD)

N. T-E MOS/AFS

O. PMOS/AFS

P. YOUTH

Q. OA

R. STATE GUARD S. SVC ANNEX CODES T. REPLACES ANNEXES U. TRANSFER TO (UIC)
19. SERVICE
REQUIRED
CODES

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PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 136, Under Secretary of Defense for Personnel and Readiness; 10 U.S.C. Subtitle A, General Military Law, Part II, Personnel (Chapter 31, Enlistments and
Chapter 33, Original Appointments of Regular Officers in Grades Above Warrant Officer Grades); 10 U.S.C. 3013, Secretary of the Army; 10 U.S.C. 5013, Secretary of the Navy; 10
U.S.C. 8013, Secretary of the Air Force; DoD Directive (DoDD) 1145.02E, United States Military Entrance Processing Command (USMEPCOM); DoD Instruction (DoDI) 1304.02,
Accession Processing Data Collection Forms; DoDI 1304.12E, DoD Military Personnel Accession Testing Programs; DoDI 1304.26, Qualification Standards for Enlistment,
Appointment and Induction; DoDI 6130.03, Medical Standards for Appointment, Enlistment, or Induction in the Military Services; DoD Manual 1145.02, Military Entrance Processing
Station (MEPS); USMEPCOM Regulation 680-3, Entrance Processing and Reporting System Management; and E.O. 9397 (SSN), as amended.
PURPOSE(S): Military recruiters use the information provided on this form to aid in determining if you meet recruitment standards for the Armed Forces of the United States related to
aptitude testing, medical examination, identity verification, background screening, and administrative processing. If you meet the standards and enlist, the information you provide on
this form will also be used to initiate your Official Military Personnel File.
ROUTINE USES: Disclosure of records are generally permitted under 5 U.S.C. 522a(b) of the Privacy Act of 1974, as amended. Pursuant to 5 U.S.C. 522a(b)(3), records may be
disclosed as a routine use to the Selective Service System (SSS) to report processing of inductees in support of a military draft, and for the purpose of updating the SSS registrant
database as required by 50 U.S.C. 3802 and to Federal, State and local health departments for compliance with public health communicable disease reporting laws in accordance
with 42 U.S.C. 264. A complete list of routine uses may be found in the applicable System of Records Notice, United States Military Entrance Processing Command (USMEPCOM)
Integrated Resource System (USMIRS), A0601-270 at: https://www.federalregister.gov/documents/2021/04/21/2021-08286/privacy-act-of-1974-system-of-records.
DISCLOSURE: Voluntary; however, failure to provide the requested information may result in an inability to process your application for enlistment or appointment in the Armed
Forces.
Additional system of records notices:
Official Military Personnel Files
Army: https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570051/a0600-8-104b-ahrc/; https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wideSORN-Article-View/Article/570052/a0600-8-104b-ngb/
Navy: https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570310/n01070-3/
Marine Corp: https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570626/m01070-6/
Air Force: https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-Component-Article-View/Article/569821/f036-af-pc-c/
Coast Guard: https://www.federalregister.gov/documents/2008/12/19/E8-29793/privacy-act-of-1974-united-states-coast-guard-014-military-pay-and-personnel-system-of-records

WARNING
Information provided by you on this form is FOR OFFICIAL USE ONLY and will be maintained and used in strict compliance with Federal laws and
regulations. The information provided by you becomes the property of the United States Government, and it may be consulted throughout your military
service career, particularly whenever either favorable or adverse administrative or disciplinary actions related to you are involved.
YOU CAN BE PUNISHED BY FINE, IMPRISONMENT OR BOTH IF YOU ARE FOUND GUILTY OF MAKING KNOWING AND WILLFUL FALSE
STATEMENT ON THIS DOCUMENT.

INSTRUCTIONS
(Read carefully BEFORE filling out this form.)
1. Read Privacy Act Statement above before completing form.
2. Type or print LEGIBLY all answers. If the answer is “None” or “Not Applicable”, so state. “Optional” questions may be left blank.
3. Unless otherwise specified, write all dates as 8 digits (with no spaces or marks) in YYYYMMDD fashion. June 1, 2014 is written 20140601.

DD FORM 1966, DEC 2021
PREVIOUS EDITION IS OBSOLETE.

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21. SOCIAL SECURITY NUMBER

20. NAME (Last, First, Middle Initial)

SECTION III - OTHER PERSONAL DATA
22. EDUCATION
A. LIST ALL HIGH SCHOOLS AND COLLEGES ATTENDED. (List dates in YYYYMM format.)
(1) FROM

(2) TO

(3) NAME OF SCHOOL

(4) LOCATION

(5) GRADUATE
YES

NO

YES

NO

B. HAVE YOU EVER BEEN ENROLLED IN ROTC, JUNIOR ROTC, SEA CADET PROGRAM OR CIVIL AIR PATROL?

23. MARITAL/DEPENDENCY STATUS AND FAMILY DATA
(If "Yes," explain in Section VI, "Remarks.")
A. IS ANYONE DEPENDENT UPON YOU FOR SUPPORT?
B. IS THERE ANY COURT ORDER OR JUDGMENT IN EFFECT THAT DIRECTS YOU TO PROVIDE ALIMONY OR SUPPORT FOR
CHILDREN?
C. DO YOU HAVE AN IMMEDIATE RELATIVE (FATHER, MOTHER, BROTHER, OR SISTER) WHO: (1) IS NOW A PRISONER OF WAR
OR IS MISSING IN ACTION (MIA); OR (2) DIED OR BECAME 100% PERMANENTLY DISABLED WHILE SERVING IN THE ARMED
SERVICES?
D. ARE YOU THE ONLY LIVING CHILD IN YOUR IMMEDIATE FAMILY?
24. PREVIOUS MILITARY SERVICE OR EMPLOYMENT WITH THE U.S. GOVERNMENT
(If "Yes," explain in Section VI, "Remarks.")
A. ARE YOU NOW OR HAVE YOU EVER BEEN IN ANY REGULAR OR RESERVE BRANCH OF THE ARMED FORCES OR IN THE
ARMY NATIONAL GUARD OR AIR NATIONAL GUARD?
B. HAVE YOU EVER BEEN REJECTED FOR ENLISTMENT, REENLISTMENT, OR INDUCTION BY ANY BRANCH OF THE ARMED
FORCES OF THE UNITED STATES?
C. ARE YOU NOW OR HAVE YOU EVER BEEN A DESERTER FROM ANY BRANCH OF THE ARMED FORCES OF THE UNITED
STATES?
D. HAVE YOU EVER BEEN EMPLOYED BY THE UNITED STATES GOVERNMENT?
E. ARE YOU NOW DRAWING, OR DO YOU HAVE AN APPLICATION PENDING, OR APPROVAL FOR: RETIRED PAY, DISABILITY
ALLOWANCE, SEVERANCE PAY, OR A PENSION FROM ANY AGENCY OF THE GOVERNMENT OF THE UNITED STATES?
25. ABILITY TO PERFORM MILITARY DUTIES
(If "Yes," explain in Section VI, "Remarks.")
A. ARE YOU NOW OR HAVE YOU EVER BEEN A CONSCIENTIOUS OBJECTOR? (THAT IS, DO YOU HAVE, OR HAVE YOU EVER
HAD, A FIRM, FIXED, AND SINCERE OBJECTION TO PARTICIPATION IN WAR IN ANY FORM OR TO THE BEARING OF ARMS
BECAUSE OF RELIGIOUS BELIEF OR TRAINING?)
B. HAVE YOU EVER BEEN DISCHARGED BY ANY BRANCH OF THE ARMED FORCES OF THE UNITED STATES FOR REASONS
PERTAINING TO BEING A CONSCIENTIOUS OBJECTOR?
C. IS THERE ANYTHING WHICH WOULD PRECLUDE YOU FROM PERFORMING MILITARY DUTIES OR PARTICIPATING IN
MILITARY ACTIVITIES WHENEVER NECESSARY (I.E., DO YOU HAVE ANY PERSONAL RESTRICTIONS OR RELIGIOUS
PRACTICES WHICH WOULD RESTRICT YOUR AVAILABILITY)?
26. DRUG USE AND ABUSE (If "Yes," explain in Section VI, "Remarks.")
HAVE YOU EVER TRIED, USED, SOLD, SUPPLIED, OR POSSESSED ANY NARCOTIC (TO INCLUDE HEROIN OR COCAINE),
DEPRESSANT (TO INCLUDE QUAALUDES), STIMULANT, HALLUCINOGEN (TO INCLUDE LSD OR PCP), OR CANNABIS (TO
INCLUDE MARIJUANA OR HASHISH), OR ANY MIND-ALTERING SUBSTANCE (TO INCLUDE GLUE OR PAINT), OR ANABOLIC
STEROID, EXCEPT AS PRESCRIBED BY A LICENSED PHYSICIAN?

DD FORM 1966, DEC 2021
PREVIOUS EDITION IS OBSOLETE.

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28. SOCIAL SECURITY NUMBER

27. NAME (Last, First, Middle Initial)

SECTION IV - CERTIFICATION
29. CERTIFICATION OF APPLICANT (Your signature in this block must be witnessed by your recruiter.)
A. I certify that the information given by me in this document is true, complete, and correct to the best of my knowledge and belief.
I understand that I am being accepted for enlistment based on the information provided by me in this document; that if any of the information is knowingly
false or incorrect, I could be tried in a civilian or military court and could receive a less than honorable discharge which could affect my future employment
opportunities.
B. TYPED OR PRINTED NAME (Last, First, Middle Initial)

C. SIGNATURE

D. DATE SIGNED (YYYYMMDD)

30. DATA VERIFICATION BY RECRUITER (Enter description of the actual documents used to verify the following items.)
B. AGE (X one)
C. CITIZENSHIP (X one)
A. NAME (X one)
(1) BIRTH CERTIFICATE

(1) BIRTH CERTIFICATE

(1) BIRTH CERTIFICATE

(2) OTHER (Explain)

(2) OTHER (Explain)
D. SOCIAL SECURITY NUMBER (SSN) (X one)

(2) OTHER (Explain)
F. OTHER DOCUMENTS USED

E. EDUCATION (X one)

(1) SSN CARD

(1) DIPLOMA

(2) OTHER (Explain)

(2) OTHER (Explain)

31. CERTIFICATION OF WITNESS
A. I certify that I have witnessed the applicant's signature above and that I have verified the data in the documents required as prescribed by my directives.
I further certify that I have not made any promises or guarantees other than those listed and signed by me. I understand my liability to trial by courts-martial
under the Uniform Code of Military Justice should I effect or cause to be effected the enlistment of anyone known by me to be ineligible for enlistment.
B. TYPED OR PRINTED NAME (Last, First, Middle Initial) C. PAY
D. RECRUITER I.D. E. SIGNATURE
GRADE

F. DATE SIGNED
(YYYYMMDD)

32. SPECIFIC OPTION/PROGRAM ENLISTED FOR, MILITARY SKILL, OR ASSIGNMENT TO A GEOGRAPHICAL AREA GUARANTEES
A. SPECIFIC OPTION/PROGRAM ENLISTED FOR (Completed by Guidance Counselor, MEPS Liaison NCO, etc., as specified by sponsoring service.) (Use clear text English.)

B. I FULLY UNDERSTAND THAT I WILL NOT BE GUARANTEED ANY SPECIFIC MILITARY SKILL OR ASSIGNMENT TO A
GEOGRAPHIC AREA EXCEPT AS SHOWN IN ITEM 32.A. ABOVE AND ANNEXES ATTACHED TO MY ENLISTMENT/
REENLISTMENT DOCUMENT (DD FORM 4).

C. APPLICANTS
INITIALS

33. CERTIFICATION OF RECRUITER OR ACCEPTOR
A. I certify that I have reviewed all information contained in this document and, to the best of my judgment and belief, the applicant fulfills all legal
policy requirements for enlistment. I accept him/her for enlistment on behalf of the United States (Enter Branch of Service)
and certify that I have not made any promises or guarantees other than those listed in Item 32.a.
above. I further certify that service regulations governing such enlistments have been strictly complied with and any waivers required to effect
applicant's enlistment have been secured and are attached to this document.
B. TYPED OR PRINTED NAME (Last, First, Middle Initial) C. PAY
D. RECRUITER I.D. E. SIGNATURE
GRADE

F. DATE SIGNED
(YYYYMMDD)

SECTION V - RECERTIFICATION
34. RECERTIFICATION BY APPLICANT AND CORRECTION OF DATA AT THE TIME OF ACTIVE DUTY ENTRY
A. I have reviewed all information contained in this document this date. That information is still correct and true to the best of my knowledge and
belief. If changes were required, the original entry has been marked "See Item 34" and the correct information is provided below.
B. ITEM NUMBER

C. CHANGE REQUIRED

D. APPLICANT
(1) SIGNATURE

E. WITNESS
(2) DATE SIGNED (1) TYPED OR PRINTED NAME (Last,
(YYYYMMDD)

DD FORM 1966, DEC 2021
PREVIOUS EDITION IS OBSOLETE.

First, Middle Initial)

CUI when filled

(2) RANK/
GRADE

(3) SIGNATURE

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36. SOCIAL SECURITY NUMBER

35. NAME (Last, First, Middle Initial)

SECTION VI - REMARKS
(Specify item(s) being continued by item number. Continue on separate pages if necessary.)

DD FORM 1966/5 ATTACHED? (X one)

YES

NO

SECTION VII - STATEMENT OF NAME FOR OFFICIAL MILITARY RECORDS
37. NAME CHANGE
If the preferred enlistment name (name given in Item 2) is not the same as on your birth certificate, and it has not been changed by legal procedure
prescribed by state law, and it is the same as on your social security number card, complete the following:
A. NAME AS SHOWN ON BIRTH CERTIFICATE

B. NAME AS SHOWN ON SOCIAL SECURITY NUMBER CARD

C. I hereby state that I have not changed my name through any court or other legal procedure; that I prefer to use the name of
by which I am known in the community as a matter of convenience
and with no criminal intent. I further state that I am the same person as the person whose name is shown in Item 2.
D. APPLICANT
(1) SIGNATURE

(2) DATE SIGNED
(YYYYMMDD)

E. WITNESS
(1) TYPED OR PRINTED NAME (Last, First, Middle Initial)

DD FORM 1966, DEC 2021
PREVIOUS EDITION IS OBSOLETE.

(2) PAY GRADE

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(3) SIGNATURE

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39. SOCIAL SECURITY NUMBER

38. NAME (Last, First, Middle Initial)

USE THIS DD FORM 1966 PAGE ONLY IF EITHER SECTION APPLIES TO THE APPLICANT'S RECORD OF MILITARY PROCESSING.

SECTION VIII - PARENTAL/GUARDIAN CONSENT FOR ENLISTMENT
40. PARENT/GUARDIAN STATEMENT(S) (Line out portions not applicable)
A. I/we certify that (Enter name of applicant)

has no other legal guardian other than me/us and I/we consent to his/her enlistment in the United States (Enter Branch of Service)

I/we acknowledge/understand that he/she may be required upon order to serve in combat or other hazardous situations. I/we certify that no
promises of any kind have been made to me/us concerning assignment to duty, training, or promotion during his/her enlistment as an
inducement to me/us to sign this consent. I/we hereby authorize the Armed Forces representatives concerned to perform medical
examinations, other examinations required, and to conduct records checks to determine his/her eligibility. I/we relinquish all claim to his/her
service and to any wage or compensation for such service. I/we authorize him/her to be transported unsupervised to/from the Military
Entrance Processing Station via public conveyance and to stay unsupervised at a government contracted hotel facility.

B. FOR ENLISTMENT IN A RESERVE COMPONENT.

I/we understand that, as a member of a reserve component, he/she must serve minimum periods of active duty for training unless
excused by competent authority. In the event he/she fails to fulfill the obligations of his/her reserve enlistment, he/she may be recalled to
active duty as prescribed by law. I/we further understand that while he/she is in the ready reserve, he/she may be ordered to extended
active duty in time of war or national emergency declared by the Congress or the President or when otherwise authorized by law, and may
be required upon order to serve in combat or other hazardous situations.

C. PARENT/GUARDIAN
(1) TYPED OR PRINTED NAME (Last, First, Middle Initial)

(2) SIGNATURE

(3) DATE SIGNED
(YYYYMMDD)

D. WITNESS
(1) TYPED OR PRINTED NAME (Last, First, Middle Initial)

(2) SIGNATURE

(3) DATE SIGNED
(YYYYMMDD)

E. PARENT/GUARDIAN
(1) TYPED OR PRINTED NAME (Last, First, Middle Initial)

(2) SIGNATURE

(3) DATE SIGNED
(YYYYMMDD)

F. WITNESS
(1) TYPED OR PRINTED NAME (Last, First, Middle Initial)

(2) SIGNATURE

(3) DATE SIGNED
(YYYYMMDD)

41. VERIFICATION OF SINGLE SIGNATURE CONSENT

DD FORM 1966, DEC 2021
PREVIOUS EDITION IS OBSOLETE.

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