DD Form 3 Application for Gold Star Lapel Button

DD Form 3 - also known as the "Application For Gold Star Lapel Button" - is a United States Military form issued by the Department of Defense.

The form - often incorrectly referred to as the DA form 3 - was last revised on February 1, 2000. Download an up-to-date fillable PDF version of the DD 3 below or request a copy through the chain of command.

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APPLICATION FOR GOLD STAR LAPEL BUTTON
(Please read Privacy Act Statement, Instructions, and Information on back before completing.
Use a different form for each applicant.)
1. I HEREBY MAKE APPLICATION FOR THE STYLE GOLD STAR LAPEL BUTTON INDICATED BELOW (X one)
PIN JOINT AND SAFETY CATCH
CLUTCH TYPE
(Front View)
(Back View)
2. DECEASED WAS A MEMBER OF (X applicable block and mail this application to the appropriate address.)
a. ARMY (If Regular Army)
(If Army Reserve)
(1) MAIL TO:
(2) MAIL TO:
National Personnel Records Center, NARA
Commander
(Military Personnel Records)
US Army Reserve Personnel Center
9700 Page Boulevard
Attention: DARPPAS-EAW
St. Louis, MO 63132-5199
9700 Page Boulevard
St. Louis, MO 63132-5200
b. NAVY (If application is made within one year from
(If application is made after one year from date of death)
date of death)
(2) MAIL TO:
(1) MAIL TO:
National Personnel Records Center, NARA
(Military Personnel Records)
Chief of Naval Personnel (Pers-E)
9700 Page Boulevard
Washington, DC 20370-2000
St. Louis, MO 63132-5199
c. MARINE CORPS (If application is made within one year
(If application is made after one year from date of death)
from date of death)
(2) MAIL TO:
(1) MAIL TO:
National Personnel Records Center, NARA
Commandant of the Marine Corps
(Military Personnel Records)
(Code MMDM)
9700 Page Boulevard
Washington, DC 20380-0001
St. Louis, MO 63132-5199
d. AIR FORCE
e. COAST GUARD
MAIL TO:
MAIL TO:
National Personnel Records Center, NARA
Commandant (G-PS)
(Military Personnel Records)
United States Coast Guard
9700 Page Boulevard
2100 2nd Street, SW
St. Louis, MO 63132-5199
Washington, DC 20593-0001
3. APPLICANT'S RELATIONSHIP TO DECEASED SERVICEMEMBER (X one)
WIDOW
STEPFATHER
SON
DAUGHTER BY ADOPTION
WIDOWER
MOTHER THROUGH ADOPTION
DAUGHTER
BROTHER
MOTHER
FATHER THROUGH ADOPTION
STEPSON
SISTER
FATHER
FOSTER MOTHER IN LOCO PARENTIS
STEPDAUGHTER
HALF BROTHER
STEPMOTHER
FOSTER FATHER IN LOCO PARENTIS
SON BY ADOPTION
HALF SISTER
4. SERVICEMEMBER DATA
a. NAME (Last, First, Middle Initial)
b. PAY GRADE OR RANK
c. SOCIAL SECURITY NUMBER OR
SERVICE SERIAL NUMBER
d. DATE OF DEATH (YYYYMMDD)
e. BRANCH OF SERVICE
f. GEOGRAPHICAL AREA OF SERVICE
5. SEND GOLD STAR TO: (Type or print name and address as this information is needed for record and shipping purposes)
a. NAME (Last, First, Middle Initial)
b. NUMBER, STREET, AND APARTMENT NUMBER (If applicable)
c. CITY, STATE, AND ZIP CODE
6. SIGNATURE OF APPLICANT
DD FORM 3, FEB 2000
PREVIOUS EDITION IS OBSOLETE.
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APPLICATION FOR GOLD STAR LAPEL BUTTON
(Please read Privacy Act Statement, Instructions, and Information on back before completing.
Use a different form for each applicant.)
1. I HEREBY MAKE APPLICATION FOR THE STYLE GOLD STAR LAPEL BUTTON INDICATED BELOW (X one)
PIN JOINT AND SAFETY CATCH
CLUTCH TYPE
(Front View)
(Back View)
2. DECEASED WAS A MEMBER OF (X applicable block and mail this application to the appropriate address.)
a. ARMY (If Regular Army)
(If Army Reserve)
(1) MAIL TO:
(2) MAIL TO:
National Personnel Records Center, NARA
Commander
(Military Personnel Records)
US Army Reserve Personnel Center
9700 Page Boulevard
Attention: DARPPAS-EAW
St. Louis, MO 63132-5199
9700 Page Boulevard
St. Louis, MO 63132-5200
b. NAVY (If application is made within one year from
(If application is made after one year from date of death)
date of death)
(2) MAIL TO:
(1) MAIL TO:
National Personnel Records Center, NARA
(Military Personnel Records)
Chief of Naval Personnel (Pers-E)
9700 Page Boulevard
Washington, DC 20370-2000
St. Louis, MO 63132-5199
c. MARINE CORPS (If application is made within one year
(If application is made after one year from date of death)
from date of death)
(2) MAIL TO:
(1) MAIL TO:
National Personnel Records Center, NARA
Commandant of the Marine Corps
(Military Personnel Records)
(Code MMDM)
9700 Page Boulevard
Washington, DC 20380-0001
St. Louis, MO 63132-5199
d. AIR FORCE
e. COAST GUARD
MAIL TO:
MAIL TO:
National Personnel Records Center, NARA
Commandant (G-PS)
(Military Personnel Records)
United States Coast Guard
9700 Page Boulevard
2100 2nd Street, SW
St. Louis, MO 63132-5199
Washington, DC 20593-0001
3. APPLICANT'S RELATIONSHIP TO DECEASED SERVICEMEMBER (X one)
WIDOW
STEPFATHER
SON
DAUGHTER BY ADOPTION
WIDOWER
MOTHER THROUGH ADOPTION
DAUGHTER
BROTHER
MOTHER
FATHER THROUGH ADOPTION
STEPSON
SISTER
FATHER
FOSTER MOTHER IN LOCO PARENTIS
STEPDAUGHTER
HALF BROTHER
STEPMOTHER
FOSTER FATHER IN LOCO PARENTIS
SON BY ADOPTION
HALF SISTER
4. SERVICEMEMBER DATA
a. NAME (Last, First, Middle Initial)
b. PAY GRADE OR RANK
c. SOCIAL SECURITY NUMBER OR
SERVICE SERIAL NUMBER
d. DATE OF DEATH (YYYYMMDD)
e. BRANCH OF SERVICE
f. GEOGRAPHICAL AREA OF SERVICE
5. SEND GOLD STAR TO: (Type or print name and address as this information is needed for record and shipping purposes)
a. NAME (Last, First, Middle Initial)
b. NUMBER, STREET, AND APARTMENT NUMBER (If applicable)
c. CITY, STATE, AND ZIP CODE
6. SIGNATURE OF APPLICANT
DD FORM 3, FEB 2000
PREVIOUS EDITION IS OBSOLETE.
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PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 1126
PRINCIPAL PURPOSE(S): To evaluate the applicant's eligibility to receive the Gold Star Lapel Button.
ROUTINE USE(S): To identify the applicant and establish a personnel record.
DISCLOSURE: Voluntary; however, if not provided, an eligible individual may not be issued the Gold Star Lapel Button.
INSTRUCTIONS
Application must be typewritten or completed legibly in ink, signed by applicant and forwarded to the appropriate address
listed in Item 2.
INFORMATION
Public Law 534 - 89th Congress, directs the design and
The law provides that one Gold Star Lapel Button will
distribution of a lapel button, to the known as the "Gold Star
be furnished, without cost, to the widow and to each of
Lapel Button," to identify widows, parents and next of kin of
the parents and the next of kin. The term "widow"
members of the Armed Forces of the United States who lost
includes widower; the term "parents" includes mother,
their lives:
father, stepmother, stepfather, mother through adoption,
(1) During World War I, April 6, 1917 to March 3, 1921;
father through adoption, and foster parents who stood in
(2) During World War II, September 8, 1939 to July 25,
loco parentis; the term "next of kin" includes only children,
1947;
brothers, sisters, half brothers, and half sisters; and the
(3) During any subsequent period of armed hostilities in
term "children" includes stepchildren and children through
which the United States was engaged before July 1, 1958
adoption.
(United Nations action in Korea, June 27, 1950 to July 27,
1954);
The law further provides that not more than one Gold
(4) After June 30, 1958
Star Lapel Button may be furnished to any one individual
(a) while engaged in an action against an enemy of
except that, when a Gold Star Lapel Button furnished
the United States;
under this section has been lost, destroyed, or rendered
(b) while engaged in military operations involving
unfit for use without fault or neglect on the part of the
conflict with an opposing foreign force;
person to whom it was furnished, the button may be
(c) while serving with friendly foreign forces engaged
replaced upon application and payment of an amount
in an armed conflict in which the United States is not a
sufficient to cover the cost of manufacture and
belligerent party against an opposing armed force.*
distribution.
* Operations subsequent to June 30, 1958 which are recognized by the Department of Defense in establishing eligibility for
the Gold Star Lapel Button include:
- Lebanon, July 1, 1958 to November 1, 1958
- Republic of Vietnam, July 1, 1958 to March 28, 1973
- Quemoy and Matsu Islands, August 23, 1958 to June 1, 1963
- Taiwan Straits, August 23, 1958 to January 1, 1959
- U.S. operations in direct support of the United Nations in the Congo, July 14, 1960 to September 1, 1962
- U.S. operations of assistance to the Republic of Laos, April 19, 1961 to October 7, 1962
- Berlin, August 14, 1961 to June 1, 1963
- Cuba, October 24, 1962 to June 1, 1963
- Congo, November 23, 1964 to November 27, 1964
- Dominican Republic, April 28, 1965 to September 21, 1966
- Korea, October 1, 1966 to June 30, 1974
- Cambodia, March 29, 1973 to August 15, 1973
- Thailand, March 29, 1973 to August 15, 1973
- Cambodia, April 11, 1975 to April 13, 1975
- Vietnam, April 29, 1975 to April 30, 1975
- Mayaguez Operation, May 15, 1975
- Lebanon, June 1983 to
- Grenadan Operation, October 23, 1983 to November 21, 1983
- Operation Eldorado Canyon, April 2, 1986 to April 17, 1986
- Panama, December 20, 1989 to January 31, 1990
- Desert Shield/Desert Storm, August 2, 1990 to November 30, 1995
- Haiti, September 16, 1994 to March 31, 1995
- Somalia, December 5, 1992 to March 31, 1995
- Operations in the Persian Gulf, November 30, 1995 to (to be determined)
- Operations in and around the Former Republic of Yugoslavia, December 20, 1996 to June 20, 1998
and any subsequent operations as may be announced by the Secretary of Defense.
DD FORM 3 (BACK), FEB 2000

Download DD Form 3 Application for Gold Star Lapel Button

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