DD Form 2656-5 Reserve Component Survivor Benefit Plan (Rcsbp) Election Certificate

What Is DD Form 2656-5?

DD Form 2656-5 or the RCSBP Election Certificate is used by Reserve Component Members to make an election for the Reserve Component Survivor Benefit Plan during the 90-day period after receiving notification of eligibility to claim Reserve retired pay.

An up-to-date fillable version of the DD Form 2656-5 is available for download or digital filing below or can be found on the Executive Services Directorate website. The DD 2656-5 is a part of a series of related documents used for actions related to the SBP, the RSFPP, and the RCSBP. The form was last released by the Department of Defense (DoD) in August 2011 with all previous editions being obsolete.

Filing and disclosing personal information within the form is voluntary. However, failure to provide the information requested may result in an incorrect election of the SBP or a delay of payments in the event of the servicemember's death.

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DD Form 2656-5 Reserve Component Survivor Benefit Plan (Rcsbp) Election Certificate
DD Form 2656-5 Reserve Component Survivor Benefit Plan (Rcsbp) Election Certificate
DD Form 2656-5 Reserve Component Survivor Benefit Plan (Rcsbp) Election Certificate
DD Form 2656-5 Reserve Component Survivor Benefit Plan (Rcsbp) Election Certificate

Download DD Form 2656-5 Reserve Component Survivor Benefit Plan (Rcsbp) Election Certificate

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DD Form 2656-5 Instructions

  1. The form consists of nine sections with most being self-explanatory. Section I is for providing member information. Boxes 1 through 5 are for the servicemember's full name, social security number, date of birth, mailing address, phone number, and email address.
  2. Section II describes the servicemember's marital and dependency status. Boxes 7 and 8 ask the applicant whether they are married and have children, respectively.
  3. Section III is for providing information about the spouse and any dependent children the retiree may have. Boxes 9 and 10 require the name of the spouse, their social security number, date of birth and the date of marriage. The lines in Box 11 are for listing unmarried dependent children under the age of 18, children under the age of 22 receiving education full-time or children of any age incapable of self-support or disabled.
  4. Section IV is the main part of the form. Boxes 12 and 13 are for electing coverage (none, deferred annuity or immediate annuity) and selecting the type of coverage. Selecting deferred annuity or immediate annuity means choosing to participate in the program/ This decision is permanent and cannot be changed unless authorized by law. The final decision must be made within the 90-day period after receiving notification of eligibility for retired pay at the age of 60.
  5. Section V specifies the level of coverage. Applicants must enter the monthly amount of retired pay that they wish to have the survivor annuity to be based on. This can either be the full amount of retired pay or a reduced amount of retired pay which - as of August 2011 - cannot be less than $300.
  6. Section VI is for electing an insurable interest beneficiary. Box 15 is for providing their full name, SSN, date of birth, mailing address and relationship to the member.
  7. Section VII is for providing additional comments or remarks.
  8. Sections VIII and IX are for certification by the member, the spouse, and a notary witness. The witness must sign and date Box 21 to certify the spouse's consent and signature.

Where to Mail DD Form 2656-5?

  • Army Reserve and Army National Guard mail forms to HRC-Ft. Knox (ATTN: AHRC-PDR-RC), 1600 Spearhead Division Ave., Ft. Knox, KY 40122
  • Navy Reserve personnel mail forms to Navy Personnel Command (PERS-912), 5720 Integrity Drive, Millington, TN 38055-9120
  • Air Force Reserve/Air National Guard mail forms to HQ ARPC/DPTTB, 18420 E. Silvercreek Ave. Dldg 390 MS68, Buckley AFB, CO 80011
  • Marine Corps Reserve mail forms to Headquarters U.S. Marine Corps, Manpower and Reserve Affairs (MMSR-5), 3280 Russel Road, Quantico, VA 22134-5103

DD 2656-5 Related Forms

  1. DD Form 2656, Data for Payment of Retired Personnel is a form used for electing an SBP and designate beneficiaries for retired pay.
  2. DD Form 2656-1, SBP Election Statement for Former Spouse Coverage is used by spouses in order to provide information regarding SBP benefits.
  3. DD Form 2656-2, SBP Termination Request is used for discontinuing Army Survivor Benefit Plan participation.
  4. DD Form 2656-6, SBP Election Change Certificate is a form used by retired service members to change an SBP election.
  5. DD Form 2656-7, Verification for Survivor Annuity is used by a surviving or former spouse to verify eligibility for an annuity under the SBP.
  6. DD Form 2656-8, SBP Automatic Coverage Fact Sheet is used for determining marital and dependency status in order to maintain a retired pay account.
  7. DD Form 2656-10, SBP/RC SBP Request for Deemed Election is used by former spouses to provide information related to SBP coverage.
  8. DD Form 2656-11, Statement Certifying Number of Months of SBP Premiums Paid is used if the individual disagrees with the number of months credited toward Paid-up SBP by the Defense Finance and Accounting Service.
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