DD Form 884 "Application for Transportation of Dependents"

What Is DD Form 884?

This is a form that was released by the U.S. Department of Defense (DoD) on November 1, 2010. The form, often mistakenly referred to as the DA Form 884, is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DoD.

Form Details:

  • A 1-page document available for download in PDF;
  • The latest version available from the Executive Services Directorate;
  • Editable, printable, and free to use;
  • Fill out the form in our online filing application.

Download an up-to-date fillable DD Form 884 down below in PDF format or browse hundreds of other DoD Forms compiled in our online library.

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1. DOD COMPONENT
APPLICATION FOR TRANSPORTATION FOR DEPENDENTS
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 136; 37 U.S.C. 406 (Military); DTR 4500.9-R, Chapter 102.
PRINCIPAL PURPOSE(S): The completed form is used for transportation-in-kind of dependents within CONUS used as an authority to issue
transportation requests in the absence of dependent travel orders.
ROUTINE USE(S): The DoD "Blanket Routine Uses" found at http://privacy.defense.gov/blanket_uses.shtml apply to this collection.
DISCLOSURE: Voluntary; however, if requested information is not furnished, transportation may not be provided.
2.a. NAME OF APPLICANT
b. RANK
c. GRADE
(Last, First, Middle Initial)
3. SHIP OR STATION
4. DEPENDENTS FOR WHOM TRANSPORTATION IS REQUESTED
(Continue on blank page if necessary)
b. RELATIONSHIP*
c. DATE OF BIRTH
d. LOCATION AT TIME OF
a. NAME
(Last, First, Middle Initial)
RECEIPT OF ORDERS**
(Adopted son, stepdaughter, etc.)
(Children) (YYYYMMDD)
(City, State)
*If other than a lawful spouse or unmarried legitimate child under 21 years of age of a member, complete applicable certificates below.
**If travel is from other than vicinity of old station or to other than vicinity of new station, state reasons; if orders were received during temporary
absence of dependents from old duty station, explain necessity for their return thereto prior to proceeding to new station.
5. PRESENT ADDRESS OF DEPENDENTS
(Street Address, City, State and ZIP Code)
6. OLD PERMANENT STATION
7. NEW PERMANENT STATION
8. DATE OF ORDERS
(YYYYMMDD)
9. TRANSPORTATION REQUESTED a. FROM
b. TO
c. VIA
(Route) (City, State)
(City, State)
(City, State)
10. DATE OF DEPARTURE
11. BY
(Air, Rail, etc.)
(YYYYMMDD)
12. CERTIFICATION OF INTENT
I certify that transportation for persons listed above, who were my dependents on the effective date of applicable orders, is being requested with
the intent of establishing a bona fide residence. I further certify that I have not made application or submitted claim for transportation of my
dependents on this change of station except as follows:
13. CERTIFICATE OF PROOF OF DEPENDENCY (Required for dependent parents, adopted children, stepchildren and for mentally or physically
incapacitated children over 21 years of age.)
I certify that my dependent(s)
, named above,
(Relationship)
is/are in fact dependent upon me and that a certificate of dependency was approved by the appropriate agency. I further certify that there has been
no change in the conditions of dependency since the certificate was approved.
(NOTE: In the case of a dependent parent, the certificate of dependency must be approved annually.)
14. CERTIFICATE OF RESIDENCE OF PARENT (Required for a dependent parent in addition to block 13.)
I certify that my dependent(s)
(Relationship)
is/are residing as a member of my household and will reside as a member of my household established incident to this change of station.
15. CERTIFICATE FOR STEPCHILD (Required for a stepchild in addition to block 13.)
I certify that
,
(Name of child's other parent)
the mother/father of the stepchild(ren) named above, was my legal spouse on the effective date of applicable orders.
16.a. SIGNATURE OF APPLICANT
b. DATE
(YYYYMMDD)
DD FORM 884, NOV 2010
PREVIOUS EDITION IS OBSOLETE.
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1. DOD COMPONENT
APPLICATION FOR TRANSPORTATION FOR DEPENDENTS
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 136; 37 U.S.C. 406 (Military); DTR 4500.9-R, Chapter 102.
PRINCIPAL PURPOSE(S): The completed form is used for transportation-in-kind of dependents within CONUS used as an authority to issue
transportation requests in the absence of dependent travel orders.
ROUTINE USE(S): The DoD "Blanket Routine Uses" found at http://privacy.defense.gov/blanket_uses.shtml apply to this collection.
DISCLOSURE: Voluntary; however, if requested information is not furnished, transportation may not be provided.
2.a. NAME OF APPLICANT
b. RANK
c. GRADE
(Last, First, Middle Initial)
3. SHIP OR STATION
4. DEPENDENTS FOR WHOM TRANSPORTATION IS REQUESTED
(Continue on blank page if necessary)
b. RELATIONSHIP*
c. DATE OF BIRTH
d. LOCATION AT TIME OF
a. NAME
(Last, First, Middle Initial)
RECEIPT OF ORDERS**
(Adopted son, stepdaughter, etc.)
(Children) (YYYYMMDD)
(City, State)
*If other than a lawful spouse or unmarried legitimate child under 21 years of age of a member, complete applicable certificates below.
**If travel is from other than vicinity of old station or to other than vicinity of new station, state reasons; if orders were received during temporary
absence of dependents from old duty station, explain necessity for their return thereto prior to proceeding to new station.
5. PRESENT ADDRESS OF DEPENDENTS
(Street Address, City, State and ZIP Code)
6. OLD PERMANENT STATION
7. NEW PERMANENT STATION
8. DATE OF ORDERS
(YYYYMMDD)
9. TRANSPORTATION REQUESTED a. FROM
b. TO
c. VIA
(Route) (City, State)
(City, State)
(City, State)
10. DATE OF DEPARTURE
11. BY
(Air, Rail, etc.)
(YYYYMMDD)
12. CERTIFICATION OF INTENT
I certify that transportation for persons listed above, who were my dependents on the effective date of applicable orders, is being requested with
the intent of establishing a bona fide residence. I further certify that I have not made application or submitted claim for transportation of my
dependents on this change of station except as follows:
13. CERTIFICATE OF PROOF OF DEPENDENCY (Required for dependent parents, adopted children, stepchildren and for mentally or physically
incapacitated children over 21 years of age.)
I certify that my dependent(s)
, named above,
(Relationship)
is/are in fact dependent upon me and that a certificate of dependency was approved by the appropriate agency. I further certify that there has been
no change in the conditions of dependency since the certificate was approved.
(NOTE: In the case of a dependent parent, the certificate of dependency must be approved annually.)
14. CERTIFICATE OF RESIDENCE OF PARENT (Required for a dependent parent in addition to block 13.)
I certify that my dependent(s)
(Relationship)
is/are residing as a member of my household and will reside as a member of my household established incident to this change of station.
15. CERTIFICATE FOR STEPCHILD (Required for a stepchild in addition to block 13.)
I certify that
,
(Name of child's other parent)
the mother/father of the stepchild(ren) named above, was my legal spouse on the effective date of applicable orders.
16.a. SIGNATURE OF APPLICANT
b. DATE
(YYYYMMDD)
DD FORM 884, NOV 2010
PREVIOUS EDITION IS OBSOLETE.
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