DD Form 2767 JROTC Instructor Annual Certification of Pay and Data Form

What Is DD Form 2767?

DD Form 2767, JROTC Instructor Annual Certification of Pay and Data Form is used for defining the inclusive work dates of each Junior Reserve Officers' Training Corps (JROTC) instructor for the period of their duties. All JROTC instructors and district personnel should renew their contract annually through filing the form.

A DD Form 2767 fillable version released by the Department of Defense (DoD) is available for digital filing and download below or can be found through the Executive Services Directorate website.

The December 2017 edition of the DD 2767 - sometimes incorrectly referred to as the DA Form 2767 - is provided for reference only. The actual filing process is fully automated and performed digitally via the Joint Combat ID Marking System (JCIMS) through a Defense Manpower Data Center (DMDC) Defense Self Service Logon account.

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How to Fill out DD Form 2767?

The form is made up of a single page without any filing guidelines provided within the file. DD Form 2767 instructions are as follows.

  1. Each instructor has to log in to their DS Logon account and generate a copy of the form in the JCIMS;
  2. All information in Blocks 1 through 9 will be automatically imported from the JCIMS account. Any incorrect data must be corrected before continuing;
  3. Block 10 is completed with the beginning and end dates of the next employment period in YYYY/MM/DD format;
  4. Block 11 should contain the name of school official that is authorized to sign the annual contract along with their title, and contact information;
  5. The date the school official signs the DD 2767 is entered in Block 12 in proper data format.

The completed form should be printed, signed by the school official and the instructor, scanned and submitted to the Brigade via the JCIMS. The Brigade will validate the form. After that, the JROTC HQ will verify the form, thus completing the process.

JROTC INSTRUCTOR ANNUAL CERTIFICATION OF PAY AND DATA FORM
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 2031, as amended, Junior Reserve Officers' Training Corps, Reserve Officers' Training Corps Program for Secondary
Educational Institutions; DoDI 1205.13, Junior Reserve Officer Training Corps (JROTC) Program; and DoDFMR 7000.14-R, Vol. 10, Chapter 21,
JUNIOR RESERVE OFFICER TRAINING CORPS (JROTC) INSTRUCTOR PAY.
PRINCIPAL PURPOSE(S): To determine the inclusive work dates of each instructor for employment period of JROTC Instructor duties.
ROUTINE USE(S): To the school/school district to provide information regarding the instructor's computed minimum instructor pay, and the amount
being reimbursed by the applicable Military Service. To the Treasury Department to provide information on check issues and electronic funds
transfers. The remaining routine uses are available in the applicable system of records notice T1205, Junior Reserve Officer Training Corps Payment
Reimbursement System, available at: http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570153/t1205/
DISCLOSURE: Voluntary; however, failure to provide the requested information may impede or delay the reimbursement to the school.
2. DoD ID NUMBER
1. INSTRUCTOR NAME
(Last, First, Middle Initial)
3. SEX
4. STATUS
(X one)
(X one)
RETIRE/
FEMALE
NEW
RESIGN
MALE
RETURN
6. RETIRED GRADE
5. BRANCH OF SERVICE
(Retired from)
ARMY
AIR FORCE
NAVY
MARINE CORPS
COAST GUARD
7a. NAME AND ADDRESS OF SCHOOL
8a. NAME AND ADDRESS OF SCHOOL DISTRICT
(Include ZIP Code)
(Include ZIP Code)
NEW ADDRESS?
YES
NO
NEW ADDRESS?
YES
NO
b. SCHOOL/UNIT IDENTIFICATION NUMBER
b. DISTRICT IDENTIFICATION OR AREA NUMBER
9. CURRENT SCHOOL YEAR DATES OF WORK FOR JROTC
10. UPCOMING EMPLOYMENT PERIOD DATES OF WORK
(Not required for new hires)
(You MUST complete a separate sheet for any break in contract dates.)
a. FROM (YYYYMMDD)
b. TO (YYYYMMDD)
a. BEGINNING (YYYYMMDD)
b. ENDING (YYYYMMDD)
NOTE: Show the inclusive dates during which the individual will be performing DUTIES IN DIRECT SUPPORT OF JROTC, and for which the
minimum required salary will be due. Include only the period of time during which the instructor will ACTUALLY be working in support of JROTC.
These dates are subject to physical verification at any time by a representative from the applicable Military Service JROTC Headquarters. The
Military Service is authorized to reimburse the school for one-half the Minimum Instructor Pay unless other arrangements have been approved.
Reimbursement to the school/school district is only authorized for the period of time the instructor is covered by a valid contract, and is receiving a
salary equal to or greater than Minimum Instructor Pay as computed by the Military Service. This form is to be submitted to the appropriate Military
Service JROTC Instructor Reimbursement Office (JIRO) within 30 days of the instructor's employment, termination, and on a yearly basis when
requested by the JIRO (normally at the end of the school year). The school must immediately notify the appropriate JIRO of any changes to dates
indicated above.
11. SCHOOL OFFICIAL
a. TYPED NAME (Last, First, Middle Initial)
b. TITLE
c. TELEPHONE (Include Area Code)
d. SIGNATURE
e. DATE (YYYYMMDD)
12. INSTRUCTOR CERTIFICATION
I certify that I have been hired to instruct at the above school for the inclusive work period indicated and that the salary will be for JROTC duties.
a. INSTRUCTOR SIGNATURE
b. DATE (YYYYMMDD)
DD FORM 2767, DEC 2017
PREVIOUS EDITION IS OBSOLETE
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JROTC INSTRUCTOR ANNUAL CERTIFICATION OF PAY AND DATA FORM
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 2031, as amended, Junior Reserve Officers' Training Corps, Reserve Officers' Training Corps Program for Secondary
Educational Institutions; DoDI 1205.13, Junior Reserve Officer Training Corps (JROTC) Program; and DoDFMR 7000.14-R, Vol. 10, Chapter 21,
JUNIOR RESERVE OFFICER TRAINING CORPS (JROTC) INSTRUCTOR PAY.
PRINCIPAL PURPOSE(S): To determine the inclusive work dates of each instructor for employment period of JROTC Instructor duties.
ROUTINE USE(S): To the school/school district to provide information regarding the instructor's computed minimum instructor pay, and the amount
being reimbursed by the applicable Military Service. To the Treasury Department to provide information on check issues and electronic funds
transfers. The remaining routine uses are available in the applicable system of records notice T1205, Junior Reserve Officer Training Corps Payment
Reimbursement System, available at: http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570153/t1205/
DISCLOSURE: Voluntary; however, failure to provide the requested information may impede or delay the reimbursement to the school.
2. DoD ID NUMBER
1. INSTRUCTOR NAME
(Last, First, Middle Initial)
3. SEX
4. STATUS
(X one)
(X one)
RETIRE/
FEMALE
NEW
RESIGN
MALE
RETURN
6. RETIRED GRADE
5. BRANCH OF SERVICE
(Retired from)
ARMY
AIR FORCE
NAVY
MARINE CORPS
COAST GUARD
7a. NAME AND ADDRESS OF SCHOOL
8a. NAME AND ADDRESS OF SCHOOL DISTRICT
(Include ZIP Code)
(Include ZIP Code)
NEW ADDRESS?
YES
NO
NEW ADDRESS?
YES
NO
b. SCHOOL/UNIT IDENTIFICATION NUMBER
b. DISTRICT IDENTIFICATION OR AREA NUMBER
9. CURRENT SCHOOL YEAR DATES OF WORK FOR JROTC
10. UPCOMING EMPLOYMENT PERIOD DATES OF WORK
(Not required for new hires)
(You MUST complete a separate sheet for any break in contract dates.)
a. FROM (YYYYMMDD)
b. TO (YYYYMMDD)
a. BEGINNING (YYYYMMDD)
b. ENDING (YYYYMMDD)
NOTE: Show the inclusive dates during which the individual will be performing DUTIES IN DIRECT SUPPORT OF JROTC, and for which the
minimum required salary will be due. Include only the period of time during which the instructor will ACTUALLY be working in support of JROTC.
These dates are subject to physical verification at any time by a representative from the applicable Military Service JROTC Headquarters. The
Military Service is authorized to reimburse the school for one-half the Minimum Instructor Pay unless other arrangements have been approved.
Reimbursement to the school/school district is only authorized for the period of time the instructor is covered by a valid contract, and is receiving a
salary equal to or greater than Minimum Instructor Pay as computed by the Military Service. This form is to be submitted to the appropriate Military
Service JROTC Instructor Reimbursement Office (JIRO) within 30 days of the instructor's employment, termination, and on a yearly basis when
requested by the JIRO (normally at the end of the school year). The school must immediately notify the appropriate JIRO of any changes to dates
indicated above.
11. SCHOOL OFFICIAL
a. TYPED NAME (Last, First, Middle Initial)
b. TITLE
c. TELEPHONE (Include Area Code)
d. SIGNATURE
e. DATE (YYYYMMDD)
12. INSTRUCTOR CERTIFICATION
I certify that I have been hired to instruct at the above school for the inclusive work period indicated and that the salary will be for JROTC duties.
a. INSTRUCTOR SIGNATURE
b. DATE (YYYYMMDD)
DD FORM 2767, DEC 2017
PREVIOUS EDITION IS OBSOLETE
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