Physician Certificate for Child Annuitant

OMB 0730-0011

OMB 0730-0011

DD Form 2828 is required and must be on file to support an incapacitation occurring prior to age 18. The form provides the authority for the Directorate of Retired and Annuitant Pay, Defense Finance and Accounting Service - Cleveland (DFAS-CL/PD) to establish and pay a Retired Service Member's Family Protection Plan (RSFPP) or Survivor Benefit Plan (SBP) annuity to the incapacitated individual. The form is completed by the child annuitant, and/or their guardian, custodian or legal representative and certified by the physician.

The latest form for Physician Certificate for Child Annuitant expires 2023-06-30 and can be found here.

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