Forms and Worksheets

Collection of Information

Forms accessed through this web page are a collection of information (COI) targeted only to USCG personnel, retired USCG members, and dependents. If you are not a member of one of the targeted groups, please do not submit information to the Coast Guard through these forms. The Coast Guard will immediately delete any submissions that it receives from persons who do not fit into one of these categories.

Instructions:

This page lists PPC Forms and Worksheets referenced in the Personnel and Pay Procedures Manual. These forms and worksheets are now published independently of the manual. This allows us to effect needed changes and updates without waiting for a published change to the manual.

This page also provides links to some frequently used forms from Other Government Agencies (like the VA for insurance forms) and to Coast Guard (CG) forms.

Click on the form number. The form will open in Adobe Acrobat, fill in fields and print the form.

Adobe Acrobat (.pdf) forms: You need Adobe's free reader program to open Acrobat forms, visit the Adobe web site http://get.adobe.com/reader/ to download the program.

PPC Forms and Worksheets

Printing Forms: If you experience any printing problems, please be sure you are using the printer icon (picture of a printer) in the Adobe Acrobat Reader tool bar and not the printer icon in the Internet Explorer tool bar.

Number, CG  Title Notes
PPC-1570Individual Monthly IDT Tracking Worksheet(1)
PPC-1884Application For Annuity Under The Survivor Benefit Plan (SBP), Reserve Component Survivor Benefit Plan (RCSPB), Retired Serviceman's Family Protection Plan (RSFPP) And/Or Final Retired Pay Due(1)
PPC-2000PCS Departing Worksheet(1), (12)
PPC-2001Departing TDY or PCS/TEMDUINS to "A" School Worksheet(1)
PPC-2002e-Resume Worksheet(1)
PPC-2003PCS Entitlements Advance Travel Worksheet(1), (4), (13)
PPC-2005PCS Reporting Worksheet(1), (5), (9)
PPC-2010Advances Worksheet(1)
PPC-2015Pay Delivery Worksheet(1)
PPC-2020Dependency Worksheet(1)
PPC-2020ASupport Statement(1)
PPC-2020BFull-Time Student Statement(1)
PPC-2020CFormer Spouse Statement(1)
PPC-2020D
(W/O Spouse
notification
memo)		Designation of Beneficiaries(1), (6)
PPC-2020D
With Spouse
notification
memo)		Designation of Beneficiaries(1), (6)
PPC-2025BAH/Housing Worksheet(1)
PPC-2025AHousing Allowance (BAH/OHA) Protection Worksheet(1), (11)
PPC-2025BMember-Married-to-Member BAH Worksheet(1)
PPC-2030Career Development Worksheet(1)
PPC-2035Family Separation Allowance (FSA) Worksheet(1)
PPC-2040Allotment Worksheet(1)
PPC-2045Career Intentions Worksheet(1), (14), (16), (18)
PPC-2046Application to Sell Special Leave Accrual (SLA)(1)
PPC-2050Nonreceipt Worksheet(1)
PPC-2055AReserve Retirement Transfer Request(1), (7)
PPC-2060Bond Worksheet(1)
PPC-2070TDY Travel Request/Authorization Worksheet(1)
PPC-2075Family Subsistence Supplemental Allowance (FSSA) Application(1)
PPC-2426Career Status Bonus (CSB) Election(1), (19)
PPC-3600Designation Of Beneficiary For Payment Of Unpaid Retired Pay(1)
PPC-3799RReserve Annual Screening Questionnaire (ASQ)(1), (10)
PPC-3867Claim for Final Retired Pay(1)
PPC-4700Retired (Active or Reserve) Pay Account Worksheet and Survivor Benefit Election(1)
PPC-5007Modalls Transmittal Sheet(1)
PPC-5100Officer Uniform Allowance Claim Worksheet(1), 15
PPC-5150Civilian Clothing Monetary Allowance Worksheet(1)
PPC-5155Enlisted Supplementary Clothing Allowance Worksheet(1)
PPC-5200Ethnicity and Race Self-Reporting Worksheet(1)
PPC-5238Modall Documentation Sheet(1)
PPC-7201Waiver Application for Retiree(1)
PPC-7202Waiver Application for Annuitant(1)
PPC-7221Retired Allotment Authorization Form(1)
PPC-7270COLA - Unique Expenses Reimbursement Worksheet(1)
PPC-7421T-PAX/WINIATS User Access Authorization & Approving Official (AO) Designation (1),(8)
PPC-7421/2Direct Access User Authorization/Revocation(1)
PPC-7421/3JUMPS User Access Authorization(1)
PPC-7421/4ImageNow User Access Authorization(1)
PPC-7421/5Direct-Access PHS User Access Authorization/Revocation(1)
PPC-7421/6Direct Access II (Global Payroll) User Access Authorization/Revocation (1), 17
PPC-7543Statement of Financial Status Submitted for Consideration In Connection with Indebtedness to the United States(1)
PPC-11221Reserve Component Survivor Benefit Plan (RCSBP) Option - Election Certificate(1)
PPC-FITWFederal Tax Withholding Worksheet(2)
PPC-W2RERequest for Duplicate or Replacement IRS Form W-2(1), (3)

Notes:

  1. All PSC Worksheets, Rev. 02/2009: Changed from PSC to PPC.
  2. PPC-FITW, Federal Tax Withholding Worksheet, Rev. 01/2009: Added 2009 FITW rates
  3. PPC-W2RE, Request for Duplicate or Replacement IRS Form W-2, Rev. 02/2009: Added 2008 to the list of prior year W-2s
  4. PPC-2003, PCS Entitlements Advance Travel Worksheet, Rev. 01/2009: PCS mileage rate changed
  5. PPC-2005, PCS Reporting Worksheet, Rev. 01/2009: Added blocks for recording entitlement to Family Separation-Housing (FSH). SPOs will complete block 10.k on the reverse of the worksheet and forward to PSC (mas) for payment.

  6. PPC-2020D, Designation of Beneficiaries and Record of Emergency Data.

    Revisions: Form PPC-2020D, Designation of Beneficiaries and Record of Emergency Data (July 2008), has been revised. In the October 2008 revision we completely removed the original Death Gratuity beneficiary section, leaving only the new Beneficiary to Receive a Portion of Death Gratuity section. We also added a form letter for commands to use to notify the spouse of a marred member in the event the member designates someone (other than their spouse) to receive a portion or all of the Death Gratuity. The letter will print as page 6 of the form. It will be removed from the form when it is published in the next change to the Personnel and Pay Procedures Manual. In the November 2008 edition of the form we revised the format for entering names. All names should now be entered as "last name, first name, middle initial". In February 2009 the form ID was changed to "PPC" because of the unit name change. In August 2009 we added guidance for recording annual validation/certificaiton in Block 15 (Remarks). The form's revision date was not changed because the annual validation certification can be handwritten.

    Q & A:

    1. Q. With the adding of emergency contacts to the CG PPC-2020D are we doing away with verification of the emergency contact sheet and or including it in the PDR?

      A. No. We would like to continue the use of Direct Access to record emergency contacts in addition to the form. Per ALCOAST 427/08 (para 4.f), the software will be modified to add the new PADD designation. After the software is changed, we can look at removing the duplicate fields from the form or reorganizing it so the DA printout will actually print the form.

    2. Q. There have been many changes, clarifications, and form revisions, do you expect all members to complete a new form every time there's a change to the form version?

      A. No. A member's elections/designations, made on previous editions of CG Form PPC-2020D, remain valid and will be honored until the member executes a new CG Form PPC-2020D. The phrase "PREVIOUS EDITION IS OBSOLETE", which appears at the bottom of the form on page 1, means "do not use an older edition of the form from this point forward".

    3. Q. The last page of the form is a letter. What are we supposed to do with it?

      A. The letter is a template you can use to comply with the requirement to notify a married member's spouse if the member designated a beneficiary to receive a portion or of all of the death gratuity. This letter isn't required for single members or members who choose not to complete the optional election. Here's a version of file without the letter, use it if you want to save a little paper. The letter template will be removed from the form when we publish the next change to the Personnel and Pay Procedures Manual.

    4. Q: Does the form have to be witnesses when the person signs the form?

      A: Yes. (To meet the definition of "witness")

    5. Q: Does not following the format for dates invalidate the form requiring the member to do a new one?

      A. No. The YYYYMMMDD is preferred because there's little room for misinterpretation, unlike the dd/mm/yy or mm/dd/yy format.

    6. Q: The old form had an Annual Validation section where the member could sign and date to certify the information was up to date. How do we record annual validation on the new version?

      A. Block 15 (remarks) can be used to document annual validation. Suggested entry (pen & ink) for block 15 is:

      _________: reviewed, no changes. ____________________
      (date)                                              (member's signature)

  7. CG PPC-2055A,  Reserve Retirement Transfer Request, revised May 2009: Requests no longer need to be sent via the ISC(pf), send directly to CGPSC-rpm Arlington via email to ARL-PF-CGPC-rpm-Query@uscg.mil for approval.
  8. PPC-7421, T-PAX/WINIATS User Access Authorization & Approving Official (AO) Designation , revised March 2009: Added a note that Blocks 8 to 12 required only for Non-CG Employee requests.
  9. PPC-2005, PCS Reporting Worksheet, revised March 2009: Added reminder (Block 5.i) to update mailing address with Government Travel Charge Card contractor.
  10. PPC-3799R, Reserve Annual Screening Questionnaire (ASQ), revised March 2009: Added fields to record "First Responder" status.
  11. PPC-2025A, Housing Allowance (BAH/OHA) Protection Worksheet, revised March 2009: Added dependent(s) enrolled in the Special Needs Program as a possible reason for requesting housing allowance rate protection.
  12. PPC-2000, PCS Departing Worksheet, revised March 2009: Changed "Departure Date Requested" to "Departure Date (Last Day of Duty at current unit)". Added a new page on HHGs information. This page addresses Personally Procured Moves, what happens when certified weight tickets are not obtained or are lost/destroyed, and HHG's transportation and Non-Temporary Storage (NTS) upon separation from active duty.
  13. PPC-2003, PCS Entitlements Advance Travel Worksheet, Added note from JFTR U5105-B.1 (Change 268, 1 April 2009): "If more than one member/civilian employee travels as an authorized traveler in the same POC, only the authorized traveler incurring the expenses is authorized MALT for the official distance." The authorized traveler who is authorized MALT is also authorized to receive the reimbursable expenses.
  14. PPC-2045, Career Intentions Worksheet. Changed the label for block 8 from "Date of Reenlistment/Extension" to "Date of Reenlistment/Date to Sign Extension/Reextension".
  15. PPC-5100, Officer Uniform Allowance Claim. Changed the description for Claim Code "E"/ Additional Active Duty Uniform Allowance, to better match with Chapter 3.K of the Coast Guard Pay Manual.
  16. PPC-2045, Career Intentions Worksheet, revised July 2009: Added note in leave section that unused leave is carried over into new service obligation for members reenlisting or extending and that all leave must be used or sold for members who are separating.
  17. Direct Access II (Global Payroll) User Access Authorization/Revocation, revised August 2009: Changed description of user role "CG_RAS_TAX_PROC" to read "Tax Schedules and Internal Audit". Added the following user roles:
    • CG_RAS_PAY_FINALIZE - ability to finalize a payroll
    • CG_FINCEN_USER - view access to reconciliation pages
    • CG_SYSTEM_ADMIN - run interfaces, view system functions (workflow, integration, process)
    • CGDEVELOPER - access to migrate objects (IBM role)
    • CGDEVELOPER_VIEWONLY - access to view objects (architect role)
  18. PPC-2045, Career Intentions Worksheet, revised August 2009: Block 4, Question #2, changed to include Reserve bonuses - "Have you been advised on the subject of SRB eligibility and if separating, Reserve Enlistment/Affiliation Bonuses?". Block 6, added "enlist in the CG Reserve" option. Block 11, added fields for SELRES Enlistment and Affiliation bonuses. Blocks 14 and 15, added SELRES or IRR options for members affiliating with in the Reserve component upon release from active duty or discharge.
  19. PPC-2426, Career Status Bonus (CSB) Election revised August 2009, changed SSN (in block 2) to Employee ID.

Printing Forms: If you experience any printing problems, please be sure you are using the printer icon (picture of a printer) in the Adobe Acrobat Reader tool bar and not the printer icon in the Internet Explorer tool bar.

Other Government Agency Forms

Department of Defense:

Department of Homeland Security:

Standard Forms:

TRICARE:

IRS:

OPM:

VA/OSGLI:

More government agency forms (GSA, IRS, etc.) are available from the Federal Forms Program page http://www.fedforms.gov

Coast Guard (CG) Forms

Printing Forms: If you experience any printing problems, please be sure you are using the printer icon (picture of a printer) in the Adobe Acrobat Reader tool bar and not the printer icon in the Internet Explorer tool bar.

Last Modified 8/20/2009