DD Form 2656-7, "VERIFICATION FOR SURVIVOR ANNUITY"

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(Updated YYYYMMDD)
OMB No. 0704 - 0569
Expires 08/31/2026

VERIFICATION FOR SURVIVOR ANNUITY

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 War, 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.

PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. Chapter 71, Computation of Retired Pay; 10 U.S.C. 73, Annuities Based on Retired or Retainer Pay; DoD Instruction 1332.42, Survivor Benefit Plan; and DoD
Financial Management Regulation, 7000.14-R, Volume 7B; and E.O. 9397 (SSN), as amended.
PRINCIPAL PURPOSE(S): To provide for surviving spouse, dependent child(ren), surviving former spouse(s), and/or natural persons with an insurable interest (as defined in the
Glossary, DoDI 1332.42) to verify eligibility for an annuity under the Retired Serviceman's Family Protection Plan (RSFPP), Survivor Benefit Plan (SBP), and/or Reserve Component
Survivor Benefit Plan (RCSBP).
ROUTINE USE(S): Disclosure of records are generally permitted under 5 U.S.C. 552a(b) of the Privacy Act of 1974, as amended. Pursuant to 5 U.S.C. 552a(b)(3), records may be
disclosed as a routine use to the Department of Veterans Affairs (DVA) regarding establishments, changes and discontinuing of DVA compensation to retirees and annuitants. To former
spouses for purposes of providing information, consistent with the requirements of 10 U.S.C. 1450(f)(3), regarding Survivor Benefit Plan coverage. To spouses for purposes of providing
information, consistent with the requirements of 10 U.S.C. 1448(a), regarding Survivor Benefit Plan coverage. A complete list of routine uses may be found in the applicable System of
Records Notice, T7347b, Defense Military Retiree and Annuity Pay System Records at: http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/
Article/570196/t7347b/ and DoD-0020, Military Human Resource Records at: https://www.federalregister.gov/documents/2024/05/15/2024-09967/privacy-act-of-1974-system-ofrecords.
DISCLOSURE: Voluntary; however, failure to provide identifying information may delay the verification process and any subsequent payment.

INSTRUCTIONS
Read all instructions and Privacy Act Statement carefully before completing this form. Please verify that the information provided below is correct.

1. DECEASED MEMBER DATA VERIFICATION
a. DECEASED MEMBER'S NAME (Last, First, Middle Initial)

c. DATE OF BIRTH (YYYYMMDD)

b. SOCIAL SECURITY NUMBER

d. DATE OF DEATH (YYYYMMDD)

e. BRANCH OF SERVICE

NEEDS DD67

2. CLAIMANT VERIFICATION
a. CLAIMANT'S NAME (Last, First, Middle Initial)

c. DATE OF BIRTH
(YYYYMMDD)

d. TELEPHONE
(Include Area Code)

b. SOCIAL SECURITY NUMBER

e. CITIZEN OF (Country)

f. COUNTRY OF RESIDENCY

0

0

g. IF YOU ARE A NONRESIDENT ALIEN, X HERE
h. TYPE OF BENEFIT
CLAIMED

f. RANK/RATE

(See note in instructions for ALIEN TAX WITHHELD.)
j. CORRESPONDENCE ADDRESS (Street, Apartment Number, City, State and
ZIP Code)

i. RELATIONSHIP TO DECEASED (X One)
SPOUSE

SBP

CHILD

RCSBP

FORMER SPOUSE

RSFPP
INSURABLE INTEREST
k. INTERNATIONAL ADDRESS AND PHONE NUMBER (if applicable)

3. THE FOLLOWING SECTION APPLIES TO SPOUSE APPLICANTS ONLY
a. I CERTIFY THAT I WAS LEGALLY MARRIED TO THE MEMBER ON THE DATE OF DEATH:
YES
(1) If YES, please verify date of marriage to member:
(2) If NO, please provide the date of divorce: (YYYYMMDD)
(If blank or incorrect, please provide correct marriage date)

b. HAVE YOU REMARRIED SINCE MEMBER'S DEATH? (If yes, specify date of the marriage)

YES

NO

c. ARE THERE CHILDREN UNDER AGE 23 OR INCAPACITATED OF THE DECEASED MEMBER?
(If YES, please provide the following for all dependent children to include those outside of your household:)
(1) NAME (Last, First Middle Initial)

DD FORM 2656-7, DRAFT 20260713
PREVIOUS EDITION IS OBSOLETE.

(2) SSN

(3) DATE OF BIRTH
(YYYYMMDD)

CUI (when filled in)

NO

YES
(4) CHILD WITH
FORMER SPOUSE

NO

(5) INCAPACITATED
(Yes/No)
YES

NO

YES

NO

YES

NO

YES

NO

YES

NO

YES

NO

YES

NO

YES

NO

Controlled by: OUSW(P&R)
CUI Category: PRVCY
LDC: FEDCON
POC: [email protected]

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SOCIAL SECURITY NUMBER

CLAIMANT'S NAME (Last, First, Middle Initial)

I understand that my annuity may be affected if I am receiving any other military survivor annuity of any kind from this deceased
member or any other deceased member. I also understand that I am obligated to notify DFAS of any other annuities that might affect
my entitlement.
d. ARE YOU RECEIVING ANY OTHER ANNUITY FROM DFAS BASED ON THE MILITARY RECORD OF ANY OTHER DECEASED
MILITARY RETIREE? (If YES, please provide the following:)
(1) Name of Deceased Retiree (Last, First, Middle Initial)

(2) SSN

YES

NO

(4) Monthly Benefit
Amount

(3) Coverage Type
SBP

$

RSFPP
4. THE FOLLOWING APPLIES TO CHILD APPLICANTS ONLY
a. ARE YOU MARRIED?

YES

NO

b. ARE YOU OVER THE AGE OF 18 BUT UNDER THE AGE OF 22 AND A FULL-TIME STUDENT?
c. ARE YOU THE CHILD OF THE FORMER SPOUSE OR THE CURRENT SPOUSE?

YES

FORMER SPOUSE

NO
CURRENT SPOUSE

5. THE FOLLOWING SECTION APPLIES TO FORMER SPOUSE APPLICANTS ONLY
a. DATE OF DIVORCE FROM DECEASED MEMBER (YYYYMMDD)
b. DATE OF REMARRIAGE (YYYYMMDD)

c. DID YOU SUBMIT SBP REQUEST FOR FORMER SPOUSE DEEMED ELECTION? (If Yes, provide date of Deemed Election)
YES

NO

6. DIRECT DEPOSIT INFORMATION
a. ACCOUNT INFORMATION

NEEDS DD67
(2) Routing Number (See Instructions)

(1) Account Type (Check one)
CHECKING

(3) Account Number (See Instructions)

SAVINGS

(4) Account Title (Account Holder's Name)

(5) Financial Institution
(a) Name

(b) Street (Include apartment number)

(c) City

(d) State

(e) Zip Code

(f) International Address (If applicable)

7. CLAIM CERTIFICATION AND SIGNATURE (To be completed by ALL applicants)

The claimant or authorized representative must sign. The signature must be that of: the applicant; or for the annuitant by: the
custodial natural parent or the legal representative; guardian; or custodian. Failure to sign will delay payment of the annuity.
a. SIGNATURE OF APPLICANT OR LEGAL REPRESENTATIVE (If applicable)

DD FORM 2656-7, DRAFT 20260713
PREVIOUS EDITION IS OBSOLETE.

CUI (when filled in)

b. DATE SIGNED (YYYYMMDD)

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INSTRUCTIONS
Read these instructions and Privacy Act Statement carefully before completing this form.
The DD Form 2656-7 is usually sent by Defense Finance and Accounting Service to the spouse (widow or widower), eligible former spouse, or child of a
deceased military member/retiree. It is used to establish the Survivor Benefit Plan after the passing of an active, reserve, or retired military service member.
Please verify that the information provided in this form is correct. Please provide any missing information and line through and correct any errors. After verifying
the information provided, please sign the form and return it to: Defense Finance and Accounting Service, U.S. Military Annuitant Pay, 8899 E. 56th Street,
Indianapolis, IN 46249-1300 or fax it to DFAS toll-free at 1-800-982-8459. If you have questions or need assistance completing this form, please contact DFAS
toll-free at 1-800-321-1080. Additional help in filling out the DD 2656-7, including a Form Wizard and a how-to video, is available on the Start an SBP Annuity
webpage at www.dfas.mil/retiredmilitary/survivors/ApplySBP. For USCG, NOAA, or USPHS accounts, e-mail the completed form to: [email protected] or mail to USCG/RAS, 444 SE Quincy Street, Topeka, KS 66683-3591 or call 1-866-772-8724 for questions.
1. DECEASED MEMBER DATA VERIFICATION - Enter the deceased military member’s/retiree’s information for a. through f.
a. Provide the name of deceased member.
b. Enter Social Security Number of deceased member.
c. Date of birth of deceased member (YYYYMMDD)
d. Date of death of deceased member (YYYYMMDD)
e. Enter the name of the branch of service of the deceased member: Army, Marine Corps, Navy, or Air Force
f. Enter the deceased member’s rank or rate.
2. CLAIMANT VERIFICATION - Enter the claimant’s information for 2.a. though 2.i.
a. Provide claimant's name.
b. Enter Social Security Number (SSN) of claimant. If claimant does not have an SSN enter Taxpayer Identification Number.
c. Date of birth of claimant (YYYMMDD)
d. Telephone number of claimant with area code
e. Provide country of citizenship of claimant
f. Enter country of residency.
g. Check the box if the claimant is a nonresident alien.
NOTE: ALIEN TAX WITHHELD: Nonresident aliens are automatically taxed at the rate of 30 percent, unless there is a tax treaty between the United States
and the foreign country permitting a lesser rate. If the country in which the annuitant lives has a tax treaty with the United States, then complete IRS Form
W-8BEN, Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding showing the country of residence. This Form may be obtained
from any United States Internal Revenue Service office, United States consulate office, on the Internet at www.irs.gov/pub/irs-pdf/fw8ben.pdf, or by
calling the Defense Finance and Accounting Service, toll free 1-800-321-1080 or from overseas +1(317)212-0551. The Defense Finance and Accounting
Service will mail foreign annuitants IRS Form 1042-S, Foreign Person's U.S. Source Income Subject to Withholding, at the end of each year for tax
reporting purposes.
h. Select/mark with an 'X' the type of benefit claimed: Survivor Benefit Plan (SBP), Reserve Component Survivor Benefit Plan (RCSBP), or Retired
Serviceman’s Family Protection Plan (RSFPP).
i. Select/mark with an 'X' the claimant’s relationship to the deceased member: spouse, child, former spouse, or insurable interest
j. Enter the claimant’s correspondence (mailing) address
k. Provide claimant's international address and phone number if applicable.

NEEDS DD67

3. THE FOLLOWING SECTION APPLIES TO SPOUSE APPLICANTS ONLY - Fill out if claimant is the spouse (widow or widower) of the deceased member.
a. Answer question, mark with an 'X' Yes or No: Was the claimant legally married to the deceased member on the date of death?
(1) If yes, enter date of marriage to member. (YYYYMMDD) If blank or incorrect, please provide correct information. (2) If no, enter date of divorce.
(YYYYMMDD) If blank or incorrect, please provide correct information.
b. Answer question by marking with an 'X', Yes or No: Have you remarried since member's death? If yes, provide the date of marriage (YYYYMMDD)
c. Answer by marking with an 'X', Yes or No: Does the deceased member have children under age 23 or who are incapacitated? If yes, enter the children (1)
Name(s), (2) SSN(s), (3) Date(s) of Birth (YYYYMMDD), d. Relationship (Son, daughter, stepson, etc.), e. Child with Former Spouse, f. Incapacitated (Y or
N).
d. Answer, mark with and 'X' Yes or No: Is the claimant receiving any other annuity paid by DFAS based on the military record of any other deceased military
service member (for example, benefits from a former spouse)? If yes, enter the deceased military member’s information: (1) name, (2) SSN, (3) Type of
benefit: SBP or RSFPP, and (4) monthly benefit amount.
4. THE FOLLOWING APPLIES TO CHILD APPLICANTS ONLY - Fill out if claimant is the child of the deceased member.
a. Answer, mark with 'X' for Yes or No: Are you married?
b. Answer, mark with 'X' for Yes or No: Are you over the age of 18 but under the age of 22 and a full-time student?
c. Answer, mark with 'X' for Former Spouse or Current Spouse: Are you the child of the former spouse or the current spouse?
5. THE FOLLOWING SECTION APPLIES TO FORMER SPOUSE APPLICANTS ONLY - Fill out if claimant is the eligible former spouse of the deceased
member.
a. Enter the date of divorce from the deceased member
b. If you remarried this member after divorce, enter the date of remarriage
c. Answer, mark with 'X' for Yes or No: Did you submit SBP Request for Former Spouse Deemed Election? (If Yes, provide date of Deemed Election) Former
Spouse Deemed election must be requested within 1 year of being court ordered.
6. DIRECT DEPOSIT INFORMATION - Fill out claimant's account information.
a. ACCOUNT INFORMATION
(1) ACCOUNT TYPE, indicate with an 'X' whether your account is Checking or Savings.
(2) ROUTING NUMBER, provide the nine-digit Routing Transit Number (RTN) for your financial institution.
(3) ACCOUNT NUMBER, enter your account number.
(4) ACCOUNT TITLE, enter the account holder's name.
(5) Enter claimants Financial Institution information: (a) NAME, (b) STREET, (c) CITY, (d) STATE, (e) ZIP CODE, (f) INTERNATIONAL ADDRESS (If
applicable)
7. CLAIM CERTIFICATION AND SIGNATURE - (Must be completed by all applicants) - Important - Remember to sign and date your form! The claimant or their
authorized representative must SIGN in (a) and DATE in (b). If signed by a legal representative, legal documents must be included. Failure to sign will delay
payment of the annuity.

DD FORM 2656-7, DRAFT 20260713
PREVIOUS EDITION IS OBSOLETE.

CUI (when filled in)

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