DD Form 2656-7 "Verification for Survivor Annuity"

What Is DD Form 2656-7?

DD Form 2656-7, Verification for Survivor Annuity is used by a surviving spouse or spouses and dependent children of deceased service members to verify eligibility for an annuity under the Survivor Benefit Plan (SBP), Reserve Component Survivor Benefit Plan (RSSBP) or the Retired Servicemen Family Protection Plan (RSFPP).

The latest fillable version of the DD Form 2656-7 is available for download or digital filing below or can be found on the Executive Services Directorate website.

The DD 2656-7 is a part of a series of related documents used for actions related to the SBP, RSFPP, and RCSBP. The form was last released by the Department of Defense (DoD) on July 1, 2020, with all previous editions being obsolete.

DD Form 2656-7 Instructions

All information provided in the DD 2656-7 must be factual and correct. Applicants must verify the provided information before signing and then return the form to the Defense Finance and Accounting Service (DFAS), U.S. Military Annuitant Pay, 8899 E. 56th Street, Indianapolis, IN 46249-1300 or fax it to the DFAS toll-free number at 1-800-962-8459.

The form consists of seven sections in total:

Section I, Deceased Member Data Verification contains the deceased service member's full name, social security number, date of birth, date of death, rank, and branch of service.
The second Section is for the claimant's verification. Boxes A through E provide the claimant's name, social security number, date of birth, phone number and citizenship information. Non-resident aliens are automatically taxed a rate of 30 percent. They may not be charged if the country has a tax treaty with the United States.
Section III applies only to spouse applicants. Box A is for certifying that the applicant was legally married to the service member on the date of death. Box B is for providing information on any incapacitated children or children under the age of 23 of the deceased service member. Box C asks if the applicant is receiving any other annuity from DFAS based on the military record of any other deceased retiree.

DD 2656-7 Related Forms

DD Form 2656, Data for Payment of Retired Personnel, is the main form of the series used to elect an SBP and designate one or several beneficiaries for retired pay.
DD Form 2656-1, SBP Election Statement for Former Spouse Coverage, is a form used by spouses and former spouses of service members for purposes of providing information regarding SBP benefits.
DD Form 2656-2, SBP Termination Request. The form is used to voluntarily discontinue participation in the Uniformed Services Survivor Benefit Plan because of tax disadvantages or any cost-related or personal reasons.
DD Form 2656-5, RCSBP Election Certificate, is used by Reserve Component service members to elect a Reserve Component Survivor Benefit Plan.
DD Form 2656-6, SBP Election Change Certificate, is used for making changes to a Survivor Benefit Plan election.
DD Form 2656-8, SBP Automatic Coverage Fact Sheet, is used to determine army members' marital and dependency status in order to make changes to an automatically established SBP election.
DD Form 2656-10, SBP/RCSBP Request for Deemed Election, is used to provide SBP coverage-related information by former spouses.
DD Form 2656-11, Statement Certifying Number of Months of SBP Premiums Paid, is sent to the DFAS if the individual disagrees with the number of months credited toward Paid-up SBP.

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OMB No. 0704 - 0569

VERIFICATION FOR SURVIVOR ANNUITY

OMB approval expires

20230731

PRIVACY ACT STATEMENT

AUTHORITY: 10 U.S.C. Chapter 73, subchapters II and III Survival Benefit Plan; DoD Instruction 1332.42, Survivor Annuity Program Administration; and E.O. 9397 (SSN), as amended.

PRINCIPAL PURPOSE(S): Used by the 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): The System of Record Notice (SORN) T7347b is published at:

https://www.federalregister.gov/documents/2009/01/07/E9-41/privacy-act-of-1974-systems-of-

records

DISCLOSURE: Voluntary; however, failure to provide identifying information may delay the verification process and any subsequent payment.

INSTRUCTIONS

Please verify that the information provided below is correct. Please provide any missing information and line through and correct any errors. After verifying the information provided,

please sign the form below 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 needassistance completing this form, please contact DFAS toll-free at 1-800-321-1080.

1. DECEASED MEMBER DATA VERIFICATION

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

b. SOCIAL SECURITY NUMBER

c. DATE OF BIRTH (YYYYMMDD)

d. DATE OF DEATH (YYYYMMDD)

e. BRANCH OF SERVICE

f. RANK/RATE

2. CLAIMANT VERIFICATION

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

b. SOCIAL SECURITY NUMBER

c. DATE OF BIRTH (YYYYMMDD)

d. TELEPHONE (Include Area Code)

e. CITIZEN OF (Country)

United States of America

f. IF YOU ARE A NONRESIDENT ALIEN, X HERE, ENTER YOUR COUNTRY OF RESIDENCE, AND SEE NOTE.

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 (216) 522-5955. 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. RELATIONSHIP TO DECENDENT (X One)

i. CORRESPONDENCE ADDRESS (Street, Apartment Number, City, State and

g. TYPE OF BENEFIT

ZIP Code)

CLAIMED

SPOUSE

SBP

CHILD

RCSBP

FORMER SPOUSE

RSFPP

INSURABLE INTEREST

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. ARE THERE CHILDREN UNDER AGE 23 OR INCAPACITATED OF THE DECEASED MEMBER?

YES

(If YES, please provide the following for each child:)

(1) NAME (Last, First Middle Initial)

(2) SSN

(3) DATE OF BIRTH (YYYYMMDD)

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.

c. ARE YOU RECEIVING ANY OTHER ANNUITY FROM DFAS BASED ON THE MILITARY RECORD OF ANY OTHER DECEASED

YES

MILITARY RETIREE? (If YES, please provide the following:)

(3) Coverage Type

(4) Monthly Benefit

(1) Name of Deceased Retiree (Last, First, Middle Initial)

(2) SSN

Amount

SBP

RSFPP

DD FORM 2656-7, JULY 2020

Page 1 of 2

Reset Form

PREVIOUS EDITION IS OBSOLETE.

OMB No. 0704 - 0569

VERIFICATION FOR SURVIVOR ANNUITY

OMB approval expires

20230731

PRIVACY ACT STATEMENT

AUTHORITY: 10 U.S.C. Chapter 73, subchapters II and III Survival Benefit Plan; DoD Instruction 1332.42, Survivor Annuity Program Administration; and E.O. 9397 (SSN), as amended.

PRINCIPAL PURPOSE(S): Used by the 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): The System of Record Notice (SORN) T7347b is published at:

https://www.federalregister.gov/documents/2009/01/07/E9-41/privacy-act-of-1974-systems-of-

records

DISCLOSURE: Voluntary; however, failure to provide identifying information may delay the verification process and any subsequent payment.

INSTRUCTIONS

Please verify that the information provided below is correct. Please provide any missing information and line through and correct any errors. After verifying the information provided,

please sign the form below 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 needassistance completing this form, please contact DFAS toll-free at 1-800-321-1080.

1. DECEASED MEMBER DATA VERIFICATION

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

b. SOCIAL SECURITY NUMBER

c. DATE OF BIRTH (YYYYMMDD)

d. DATE OF DEATH (YYYYMMDD)

e. BRANCH OF SERVICE

f. RANK/RATE

2. CLAIMANT VERIFICATION

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

b. SOCIAL SECURITY NUMBER

c. DATE OF BIRTH (YYYYMMDD)

d. TELEPHONE (Include Area Code)

e. CITIZEN OF (Country)

United States of America

f. IF YOU ARE A NONRESIDENT ALIEN, X HERE, ENTER YOUR COUNTRY OF RESIDENCE, AND SEE NOTE.

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 (216) 522-5955. 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. RELATIONSHIP TO DECENDENT (X One)

i. CORRESPONDENCE ADDRESS (Street, Apartment Number, City, State and

g. TYPE OF BENEFIT

ZIP Code)

CLAIMED

SPOUSE

SBP

CHILD

RCSBP

FORMER SPOUSE

RSFPP

INSURABLE INTEREST

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. ARE THERE CHILDREN UNDER AGE 23 OR INCAPACITATED OF THE DECEASED MEMBER?

YES

(If YES, please provide the following for each child:)

(1) NAME (Last, First Middle Initial)

(2) SSN

(3) DATE OF BIRTH (YYYYMMDD)

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.

c. ARE YOU RECEIVING ANY OTHER ANNUITY FROM DFAS BASED ON THE MILITARY RECORD OF ANY OTHER DECEASED

YES

MILITARY RETIREE? (If YES, please provide the following:)

(3) Coverage Type

(4) Monthly Benefit

(1) Name of Deceased Retiree (Last, First, Middle Initial)

(2) SSN

Amount

SBP

RSFPP

DD FORM 2656-7, JULY 2020

Page 1 of 2

Reset Form

PREVIOUS EDITION IS OBSOLETE.

DECEASED MEMBER'S NAME (Last, First, Middle Initial)

SOCIAL SECURITY NUMBER

4. THE FOLLOWING SECTION APPLIES TO CHILD APPLICANTS ONLY

a. ARE YOU MARRIED?

YES

b. IF YOU ARE 18 YEARS OF AGE OR OLDER, ARE YOU A FULL-TIME STUDENT?

YES

5. THE FOLLOWING SECTION APPLIES TO FORMER SPOUSE APPLICANTS ONLY

a. DATE OF DIVORCE FROM DECEASED MEMBER (YYYYMMDD)

b. DATE OF REMARRIAGE (YYYYMMDD)

6. STATEMENT OF UNDERSTANDING - DEPENDENCY AND INDEMNITY COMPENSATION (DIC)

(This applies to spouse applicants only.)

The surviving spouse of a deceased member may be eligible for DIC, payable by the Department of Veterans Affairs (VA) if the member dies

from a disease or injury incurred or aggravated in the line of duty while on active duty, active duty for training, or inactive duty for training. A

spouse receiving DIC may not receive the full amount of an annuity under SBP, or RCSBP. In order to eliminate problems resulting from an

annuity overpayment due to concurrent DIC payments, a statement of understanding is provided for your signature.

I UNDERSTAND THAT:

- I cannot receive both the full amounts of my annuity and DIC from the same deceased member.

- DFAS will establish my annuity in full if DIC or other survivor annuity payments data, as may be applicable, is not known at time of

establishment.

- I am only entitled to the amount of the annuity that exceeds the DIC payment that may be payable, or the DIC only if that payment is greater

than the annuity. Note: All SBP premiums paid will be refunded if the SBP annuity is not payable because the DIC payment is greater. In cases

where the annuity is greater than the DIC payment, the cost will be recalculated and the difference between the SBP premiums paid and the

recalculated cost will be refunded.

- If any overpayment of benefits occurs as the result of being awarded DIC, my signature on this statement authorizes the VA to repay DFAS

the amount of the overpayment from the DIC payments to which I am or may become eligible.

- In the event I apply to the VA for DIC, I agree to notify DFAS of that application to include the address of the VA Office applied to, VA Claim

number, and if applicable, the amount of award.

a. HAVE YOU APPLIED OR DO YOU INTEND TO APPLY TO THE VETERAN'S ADMINISTRATION

YES

(VA) FOR BENEFITS? (If YES, please provide the following:)

(3) Mailing Address of VA Office Handling Your Account (Street, City, State, ZIP

(1) VA Claim Number

(2) VA Monthly Award Amount

Code)

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)

b. DATE SIGNED (YYYYMMDD)

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 Defense,

Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-informationcollections@mail.mil. 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.

DD FORM 2656-7, JULY 2020

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PREVIOUS EDITION IS OBSOLETE.