Form Information

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FORM NUMBER:

DD2656-4(PHS)

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TITLE:

VERIFICATION FOR ANNUITY (U.S. PUBLIC HEALTH SERVICE)

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EDITION DATE:

20021001

CANCELLATION DATE:

20090820

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AVAILABLE FILE FORMATS:

PLEASE NOTE:

Fillable Adobe:

If no hyperlink appears next to a format, the form is not available electronically.

Perform Pro:

To obtain hard copies of current forms not available in electronic format, please

Form Flow 2.0:

contact your own Military Service or DoD Component Forms Management

Form Flow 99:

Officer. Cancelled forms are not available. Click on link for a list of Forms

Other:

Management POCs.

Forms Management POCs

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REMARKS:

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ISSUANCES:

DoDI 1332.42

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SPONSOR / POC:

P&R

SUB-SPONSOR:

OPDUSD(MPP)COMP

NUMBER OF PAGES:

2

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USERS*:

PHS

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PRESCRIBED OR ADOPTED?:

P

DISPOSITION:

FUNCTION CODE:

1352

FORM CONTROLLED:

N

MANDATORY PRINT SPECIFICATIONS:

N

RCS:

IRCN:

OMB:

PRIVACY ACT IMPLICATIONS:

Y

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* All revisions and/or cancellations must be coordinated through these USERS.

DISPOSITION: S = Do NOT use previous edition. U = Use previous edition until supply is depleted.