OMB control number

Application for Discharge of Member or Survivor of Group Certified to Have Performed Active Duty with the Armed Forces of the United States

OMB 0704-0100 · DOW/DODDEP.

OMB 0704-0100

38 USC 106 note(PL 95-202, Sec 401) directs Secretary of Defense to determine if civilian employment or contractual service rendered by groups to the Armed Forces of the United States shall be considered active duty. Using DD Form 2168, information that is compatible with that of a corresponding approved group and the applicant can provide supporting evidence to receive veteran’s status in accordance with the provisions of DoD Directive 1000.20, as established by 38 U.S.C.§ 106. This information collection is necessary to assist each of the Military Departments in determining if an applicant was a member of a group which has been found to have performed active military service and to assist in issuing an appropriate certificate of service.

The latest form for Application for Discharge of Member or Survivor of Group Certified to Have Performed Active Duty with the Armed Forces of the United States expires 2026-10-31 and is listed under ICR 202308-0704-002.

View the official OMB control history on Reginfo.gov.

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202607-0704-002 Extension without change of a currently approved collection 2026-09-22
202308-0704-002 Extension without change of a currently approved collection 2023-09-19 Approved without change
202007-0704-005 Reinstatement without change of a previously approved collection 2020-08-31 Approved without change
200801-0704-002 Extension without change of a currently approved collection 2008-01-31 Approved without change
200408-0704-001 Extension without change of a currently approved collection 2004-08-24 Approved without change
200108-0704-003 Extension without change of a currently approved collection 2001-08-30 Approved without change
199806-0704-005 Reinstatement with change of a previously approved collection 1998-06-15 Approved without change
199502-0704-003 Reinstatement without change of a previously approved collection 1995-02-22 Approved without change
199110-0704-001 Revision of a currently approved collection 1991-10-23 Approved without change
198904-0704-034 No material or nonsubstantive change to a currently approved collection 1989-04-24 Approved with change
198812-0704-001 Revision of a currently approved collection 1988-12-05 Approved without change
198510-0704-002 Extension without change of a currently approved collection 1985-10-22 Approved without change
198212-0704-002 Revision of a currently approved collection 1982-12-03 Approved without change
197809-0704-006 New collection (Request for a new OMB Control Number) 1978-09-29 Approved without change