DD Form 1966 Record of Military Processing - Armed Forces of the United States

What Is a DD Form 1966?

DD Form 1966, Record of Military Processing - Armed Forces of the United States is used for collecting information about individuals enlisting in the U.S. Army to determine if they meet recruitment standards. The DD 1966 also contains a section that provides written consent to allow medical providers to release personal medical records to the DoD.

The latest version of the form - sometimes incorrectly referred to as the DA Form 1966 - was released by the Department of Defense (DoD) in September 2014 with the August 2011 edition being obsolete.

Additional information is also gathered from employers and schools so that the Department of Defense can determine eligibility for joining the Army and to verify the identity of the enlistees. If all standards are met, the information provided on this form starts the soldier's Official Military Personnel File.

How Do I Get My DD Form 1966?

An up-to-date DD Form 1966 fillable version is available for download and digital filing below or can be found on the Executive Services Directorate website.

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RECORD OF MILITARY PROCESSING - ARMED FORCES OF THE UNITED STATES
OMB No. 0704-0173
OMB approval expires
(Read Privacy Act Statement and Instructions on back before completing this form.)
March 31, 2018
The public reporting burden for this collection of information, 0704-0173, is estimated to average 20 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-information-
collections@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.
PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ORGANIZATION.
A. SERVICE
C. SELECTIVE SERVICE CLASSIFICATION D. SELECTIVE SERVICE REGISTRATION NO.
B. PRIOR SERVICE:
PROCESSING FOR
YES
NO
NUMBER OF DAYS:
SECTION I - PERSONAL DATA
2. NAME
1. SOCIAL SECURITY NUMBER
(Last, First, Middle Name (and Maiden, if any), Jr., Sr., etc.)
3. CURRENT ADDRESS
4. HOME OF RECORD ADDRESS
(Street, City, County,
(Street, City, County, State,
State, Country, ZIP Code)
Country, ZIP Code)
7.b. RACIAL CATEGORY
5. CITIZENSHIP
6. SEX
7.a. ETHNIC
(X one or more)
(X one)
(X one)
CATEGORY
(1) AMERICAN INDIAN/
a. U.S. AT BIRTH (If this box is marked, also X (1) or (2))
a. MALE
(4)
NATIVE HAWAIIAN
ALASKA NATIVE
OR OTHER PACIFIC
(1) HISPANIC OR
(2) BORN ABROAD OF U.S.
(1) NATIVE BORN
b. FEMALE
ISLANDER
LATINO
PARENT(S)
(2) ASIAN
b. U.S. NATURALIZED
ALIEN REGISTRATION NUMBER
(2) NOT HISPANIC
(3) BLACK OR AFRICAN
(5) WHITE
c. U.S. NON-CITIZEN
(If issued)
OR LATINO
AMERICAN
NATIONAL
8. MARITAL STATUS
9. NUMBER OF DEPENDENTS
d. IMMIGRANT ALIEN (Specify)
(Specify)
e. NON-IMMIGRANT FOREIGN
NATIONAL (Specify)
13.
10. DATE OF BIRTH
PROFICIENT IN FOREIGN
1st
2nd
11. RELIGIOUS
12. EDUCATION
LANGUAGE (If Yes, specify.
PREFERENCE
(YYYYMMDD)
(Yrs/Highest Ed
If No, enter NONE.)
(Optional)
Gr Completed)
15. PLACE OF BIRTH
14. VALID DRIVER'S LICENSE
YES
NO
(City, State and Country)
(X one)
(If Yes, list State, number, and expiration date)
SECTION II - EXAMINATION AND ENTRANCE DATA PROCESSING CODES
(FOR OFFICE USE ONLY - DO NOT WRITE IN THIS SECTION - Go on to Page 2, Question 20.)
16. APTITUDE TEST RESULTS
GS
AR
WK
PC
MK
EI
AS
MC
AO
VE
a. TEST ID b. TEST SCORES
AFQT
PERCENTILE
17. DEP ENLISTMENT DATA
a. DATE OF ENLISTMENT - DEP
b. PROJ ACTIVE DUTY DATE
c. ES d. RECRUITER IDENTIFICATION
e. STN ID
f. PEF
(YYYYMMDD)
(YYYYMMDD)
i. PAY
l. AD OBLIGA-
h. WAIVER
(2)
(3)
(4)
(5)
(6)
j. SVC ANNEX CODES
k. MSO
g. T-E MOS/AFS
(YYWW)
(1)
GRADE
TION
(YYWW)
18. ACCESSION DATA
e. AD/RC OBLIGATION
d. MSO
a. DATE OF ENLISTMENT
b. ACTIVE DUTY SERVICE DATE
c. PAY ENTRY DATE
(YYMMWWDD)
(YYWW)
(YYYYMMDD)
(YYYYMMDD)
(YYYYMMDD)
f. WAIVER
j.
(2)
(3)
(4)
(5)
(6)
g. PAY GRADE
h. DATE OF GRADE
YRS./HIGHEST
i. ES
(YYYYMMDD)
(1)
ED GR COMPL
r.
k. RECRUITER IDENTIFICATION
l. STN ID
m. PEF
n. T-E MOS/AFS
o. PMOS/AFS
p. YOUTH
q. OA
STATE
GUARD
s. SVC ANNEX CODES
t. REPLACES ANNEXES
u. TRANSFER TO (UIC)
19. SERVICE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
REQUIRED
CODES
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
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70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
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140
DD FORM 1966/1, SEP 2014
PREVIOUS EDITION IS OBSOLETE.
Adobe Professional X
RECORD OF MILITARY PROCESSING - ARMED FORCES OF THE UNITED STATES
OMB No. 0704-0173
OMB approval expires
(Read Privacy Act Statement and Instructions on back before completing this form.)
March 31, 2018
The public reporting burden for this collection of information, 0704-0173, is estimated to average 20 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-information-
collections@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.
PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ORGANIZATION.
A. SERVICE
C. SELECTIVE SERVICE CLASSIFICATION D. SELECTIVE SERVICE REGISTRATION NO.
B. PRIOR SERVICE:
PROCESSING FOR
YES
NO
NUMBER OF DAYS:
SECTION I - PERSONAL DATA
2. NAME
1. SOCIAL SECURITY NUMBER
(Last, First, Middle Name (and Maiden, if any), Jr., Sr., etc.)
3. CURRENT ADDRESS
4. HOME OF RECORD ADDRESS
(Street, City, County,
(Street, City, County, State,
State, Country, ZIP Code)
Country, ZIP Code)
7.b. RACIAL CATEGORY
5. CITIZENSHIP
6. SEX
7.a. ETHNIC
(X one or more)
(X one)
(X one)
CATEGORY
(1) AMERICAN INDIAN/
a. U.S. AT BIRTH (If this box is marked, also X (1) or (2))
a. MALE
(4)
NATIVE HAWAIIAN
ALASKA NATIVE
OR OTHER PACIFIC
(1) HISPANIC OR
(2) BORN ABROAD OF U.S.
(1) NATIVE BORN
b. FEMALE
ISLANDER
LATINO
PARENT(S)
(2) ASIAN
b. U.S. NATURALIZED
ALIEN REGISTRATION NUMBER
(2) NOT HISPANIC
(3) BLACK OR AFRICAN
(5) WHITE
c. U.S. NON-CITIZEN
(If issued)
OR LATINO
AMERICAN
NATIONAL
8. MARITAL STATUS
9. NUMBER OF DEPENDENTS
d. IMMIGRANT ALIEN (Specify)
(Specify)
e. NON-IMMIGRANT FOREIGN
NATIONAL (Specify)
13.
10. DATE OF BIRTH
PROFICIENT IN FOREIGN
1st
2nd
11. RELIGIOUS
12. EDUCATION
LANGUAGE (If Yes, specify.
PREFERENCE
(YYYYMMDD)
(Yrs/Highest Ed
If No, enter NONE.)
(Optional)
Gr Completed)
15. PLACE OF BIRTH
14. VALID DRIVER'S LICENSE
YES
NO
(City, State and Country)
(X one)
(If Yes, list State, number, and expiration date)
SECTION II - EXAMINATION AND ENTRANCE DATA PROCESSING CODES
(FOR OFFICE USE ONLY - DO NOT WRITE IN THIS SECTION - Go on to Page 2, Question 20.)
16. APTITUDE TEST RESULTS
GS
AR
WK
PC
MK
EI
AS
MC
AO
VE
a. TEST ID b. TEST SCORES
AFQT
PERCENTILE
17. DEP ENLISTMENT DATA
a. DATE OF ENLISTMENT - DEP
b. PROJ ACTIVE DUTY DATE
c. ES d. RECRUITER IDENTIFICATION
e. STN ID
f. PEF
(YYYYMMDD)
(YYYYMMDD)
i. PAY
l. AD OBLIGA-
h. WAIVER
(2)
(3)
(4)
(5)
(6)
j. SVC ANNEX CODES
k. MSO
g. T-E MOS/AFS
(YYWW)
(1)
GRADE
TION
(YYWW)
18. ACCESSION DATA
e. AD/RC OBLIGATION
d. MSO
a. DATE OF ENLISTMENT
b. ACTIVE DUTY SERVICE DATE
c. PAY ENTRY DATE
(YYMMWWDD)
(YYWW)
(YYYYMMDD)
(YYYYMMDD)
(YYYYMMDD)
f. WAIVER
j.
(2)
(3)
(4)
(5)
(6)
g. PAY GRADE
h. DATE OF GRADE
YRS./HIGHEST
i. ES
(YYYYMMDD)
(1)
ED GR COMPL
r.
k. RECRUITER IDENTIFICATION
l. STN ID
m. PEF
n. T-E MOS/AFS
o. PMOS/AFS
p. YOUTH
q. OA
STATE
GUARD
s. SVC ANNEX CODES
t. REPLACES ANNEXES
u. TRANSFER TO (UIC)
19. SERVICE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
REQUIRED
CODES
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
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135
136
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139
140
DD FORM 1966/1, SEP 2014
PREVIOUS EDITION IS OBSOLETE.
Adobe Professional X
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 136, Under Secretary of Defense for Personnel and Readiness; 504, Persons Not Qualified; 505, Regular components:
qualifications, term, grade; and 12102, Reserve Components: Qualifications; 14 U.S.C. 351, Enlistments; term, grade; and 632, Functions and powers
vested in the Commandant ; DoDI 1304.2, Accession Processing Data Collection Forms; DoDI 1304.26, Qualification Standards for Enlistment,
Appointment, and Induction; AR 601-270, OPNAVINST 1100.4C Ch-2, AFI 36-2003_IP, MCO 1100.75E, and COMDTINST M 1100.2E, Military Entrance
Processing Station (MEPS); AR 601-210, Active and Reserve Components Enlistment Program; AFPD 36-20, ; and E.O. 9397, as amended (SSN).
PRINCIPAL PURPOSE(S): Military recruiters use the information you provide on this form to collect additional information from the individuals, schools,
and employers you list so that we can determine if you meet recruitment standards. If you do meet these standards and enlist, the information you provide
on this form starts your Official Military Personnel File. During the recruiting process we use the information on this form to verify your identity. This form
also contains a section where you are asked to provide your signed consent for your medical provider(s) to release your medical records to the DoD.
While completed forms are covered by recruiting and official military personnel file SORNs maintained by each of the Services the primary SORN may be
found at: http://dpclo.defense.gov/Privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/6156/a0601-270-usmepcom-dod.aspx.
ROUTINE USE(S): Information is disclosed to the Selective Service System (SSS) to update the SSS registrant database and may also be disclosed to
local and state Government agencies for compliance with laws and regulations governing control of communicable diseases. The specific DoD Blanket
Routine Uses identified below (and also found at http://dpclo.defense.gov/Privacy/SORNsIndex/BlanketRoutineUses.aspx) also apply to this collection.
01. Law Enforcement Routine Use: If a system of records maintained by a DoD Component to carry out its functions indicates a violation or potential
violation of law, whether civil, criminal, or regulatory in nature, and whether arising by general statute or by regulation, rule, or order issued pursuant
thereto, the relevant records in the system of records may be referred, as a routine use, to the agency concerned, whether federal, state, local, or foreign,
charged with the responsibility of investigating or prosecuting such violation or charged with enforcing or implementing the statute, rule, regulation, or order
issued pursuant thereto.
02. Disclosure When Requesting Information Routine Use: The DoD may disclose your information to a federal, state, or local agency maintaining civil,
criminal, or other relevant enforcement information or other pertinent information, such as current licenses, if necessary to obtain information relevant to
your enlistment request (ie., a DoD decision concerning the hiring or retention of an employee).
04. Congressional Inquiries Disclosure Routine Use: The DoD may disclosure your record to your congressperson if your congressional office makes an
inquiry at your request.
09. Disclosure to the Department of Justice for Litigation Routine Use: The DoD may disclose your record to the Department of Justice for the purpose of
representing the Department of Defense, or any officer, employee or member of the Department in pending or potential litigation to which the record is
pertinent.
12. Disclosure of Information to the National Archives and Records Administration Routine Use:
The DoD may disclose your record to the National Archives and Records Administration for the purpose of records management inspections conducted
under authority of 44 U.S.C. 2904 and 2906.15. Data Breach Remediation Purposes Routine Use: The DoD may disclose your record to an appropriate
agency, entity, or person when (1) The DoD suspects or has confirmed that the security or confidentiality of the information in the system of records has
been compromised; (2) the DoD has determined that as a result of the suspected or confirmed compromise there is a risk of harm to economic or property
interests, identity theft or fraud, or harm to the security or integrity of this system or other systems or programs (whether maintained by the DoD or another
agency or entity) that rely upon the compromised information; and (3) the disclosure made to such agencies, entities, and persons is reasonably
necessary to assist in connection with efforts to respond to the suspected or confirmed compromise and prevent, minimize, or remedy such harm.
DISCLOSURE: Voluntary. However, if you fail to provide the requested information you might not be able to enlist. Your Social Security Number is used
during the recruiting process to conduct background screening (e.g., law enforcement, medical, or educational records checks; former employer checks,
work status, etc.), keep all of your records together during the enlistment process, and ensure your test results are properly recorded.
Applicable SORNs:
Accession:
U.S. Military Processing Command:
(http://dpclo.defense.gov/Privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/6156/a0601-270-usmepcom-dod.aspx)
Army (http://dpclo.defense.gov/Privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/6131/a0600-8-104-ahrc.aspx)
Navy (http://dpclo.defense.gov/Privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/6411/n01131-1.aspx;
http://dpclo.defense.gov/Privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/6413/n01133-2.aspx)
Marine Corps (http://dpclo.defense.gov/Privacy/SORNsIndex/DODComponentArticleView/tabid/7489/Article/6777/m01133-3.aspx)
Air Force (http://dpclo.defense.gov/Privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/5820/f036-aetc-r.aspx)
Coast Guard (http://edocket.access.gpo.gov/2008/E8-29845.htm)
Official Military Personnel Files:
Army (http://dpclo.defense.gov/Privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/6128/a0600-8-104b-ahrc.aspx;
http://dpclo.defense.gov/Privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/6129/a0600-8-104b-ngb.aspx)
Navy (http://dpclo.defense.gov/Privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/6405/n01070-3.aspx)
Marine Corps (http://dpclo.defense.gov/Privacy/SORNsIndex/DODComponentArticleView/tabid/7489/Article/6775/m01070-6.aspx)
Air Force (http://dpclo.defense.gov/Privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/5876/f036-af-pc-c.aspx)
Coast Guard (http://edocket.access.gpo.gov/2008/E8-29793.htm)
WARNING
Information provided by you on this form is FOR OFFICIAL USE ONLY and will be maintained and used in strict compliance with Federal laws and
regulations. The information provided by you becomes the property of the United States Government, and it may be consulted throughout your military
service career, particularly whenever either favorable or adverse administrative or disciplinary actions related to you are involved.
YOU CAN BE PUNISHED BY FINE, IMPRISONMENT OR BOTH IF YOU ARE FOUND GUILTY OF MAKING KNOWING AND WILLFUL FALSE
STATEMENT ON THIS DOCUMENT.
INSTRUCTIONS
(Read carefully BEFORE filling out this form.)
1. Read Privacy Act Statement above before completing form.
2. Type or print LEGIBLY all answers. If the answer is “None” or “Not Applicable”, so state. “Optional” questions may be left blank.
3. Unless otherwise specified, write all dates as 8 digits (with no spaces or marks) in YYYYMMDD fashion. June 1, 2014 is written 20140601.
DD FORM 1966/1, SEP 2014
Back of Page 1
20. NAME
21. SOCIAL SECURITY NUMBER
(Last, First, Middle Initial)
SECTION III - OTHER PERSONAL DATA
22. EDUCATION
a. List all high schools and colleges attended.
(5) GRADUATE
(List dates in YYYYMM format.)
(1) FROM
(2) TO
(3) NAME OF SCHOOL
(4) LOCATION
YES
NO
YES
NO
b. Have you ever been enrolled in ROTC, Junior ROTC, Sea Cadet Program or Civil Air Patrol?
23. MARITAL/DEPENDENCY STATUS AND FAMILY DATA
(If "Yes," explain in Section VI, "Remarks.")
a. Is anyone dependent upon you for support?
b. Is there any court order or judgment in effect that directs you to provide alimony or support for children?
c. Do you have an immediate relative (father, mother, brother, or sister) who: (1) is now a prisoner of war or is missing
in action (MIA); or (2) died or became 100% permanently disabled while serving in the Armed Services?
d. Are you the only living child in your immediate family?
24. PREVIOUS MILITARY SERVICE OR EMPLOYMENT WITH THE U.S. GOVERNMENT
(If "Yes," explain in Section VI, "Remarks.")
a. Are you now or have you ever been in any regular or reserve branch of the Armed Forces or in the Army National Guard
or Air National Guard?
b. Have you ever been rejected for enlistment, reenlistment, or induction by any branch of the Armed Forces of the United
States?
c. Are you now or have you ever been a deserter from any branch of the Armed Forces of the United States?
d. Have you ever been employed by the United States Government?
e. Are you now drawing, or do you have an application pending, or approval for: retired pay, disability allowance, severance
pay, or a pension from any agency of the government of the United States?
25. ABILITY TO PERFORM MILITARY DUTIES
(If "Yes," explain in Section VI, "Remarks.")
a. Are you now or have you ever been a conscientious objector? (That is, do you have, or have you ever had, a firm, fixed,
and sincere objection to participation in war in any form or to the bearing of arms because of religious belief or training?)
b. Have you ever been discharged by any branch of the Armed Forces of the United States for reasons pertaining to being a
conscientious objector?
c. Is there anything which would preclude you from performing military duties or participating in military activities whenever
necessary (i.e., do you have any personal restrictions or religious practices which would restrict your availability)?
26. DRUG USE AND ABUSE
(If "Yes," explain in Section VI, "Remarks.")
Have you ever tried, used, sold, supplied, or possessed any narcotic (to include heroin or cocaine), depressant (to include
quaaludes), stimulant, hallucinogen (to include LSD or PCP), or cannabis (to include marijuana or hashish), or any
mind-altering substance (to include glue or paint), or anabolic steroid, except as prescribed by a licenced physician?
DD FORM 1966/2, SEP 2014
Page 2
27. NAME
28. SOCIAL SECURITY NUMBER
(Last, First, Middle Initial)
SECTION IV - CERTIFICATION
29. CERTIFICATION OF APPLICANT
(Your signature in this block must be witnessed by your recruiter.)
a. I certify that the information given by me in this document is true, complete, and correct to the best of my knowledge and belief.
I understand that I am being accepted for enlistment based on the information provided by me in this document; that if any of the
information is knowingly false or incorrect, I could be tried in a civilian or military court and could receive a less than honorable
discharge which could affect my future employment opportunities.
c. SIGNATURE
b. TYPED OR PRINTED NAME (Last, First, Middle
d. DATE SIGNED (YYYYMMDD)
Initial)
30. DATA VERIFICATION BY RECRUITER
(Enter description of the actual documents used to verify the following items.)
a. NAME (X one)
b. AGE (X one)
c. CITIZENSHIP (X one)
(1) BIRTH CERTIFICATE
(1) BIRTH CERTIFICATE
(1) BIRTH CERTIFICATE
(2) OTHER (Explain)
(2) OTHER (Explain)
(2) OTHER (Explain)
f. OTHER DOCUMENTS USED
d. SOCIAL SECURITY NUMBER (SSN) (X one)
e. EDUCATION (X one)
(1) SSN CARD
(1) DIPLOMA
(2) OTHER (Explain)
(2) OTHER (Explain)
31. CERTIFICATION OF WITNESS
a. I certify that I have witnessed the applicant's signature above and that I have verified the data in the documents required as prescribed by my
directives. I further certify that I have not made any promises or guarantees other than those listed and signed by me. I understand my liability to
trial by courts-martial under the Uniform Code of Military Justice should I effect or cause to be effected the enlistment of anyone known by me to
be ineligible for enlistment.
e. SIGNATURE
b. TYPED OR PRINTED NAME (Last, First,
c. PAY
d. RECRUITER I.D.
f. DATE SIGNED
GRADE
Middle Initial)
(YYYYMMDD)
32. SPECIFIC OPTION/PROGRAM ENLISTED FOR, MILITARY SKILL, OR ASSIGNMENT TO A GEOGRAPHICAL AREA GUARANTEES
a. SPECIFIC OPTION/PROGRAM ENLISTED FOR (Completed by Guidance Counselor, MEPS Liaison NCO, etc., as specified by sponsoring service.)
(Use clear text English.)
c. APPLICANT'S
b. I fully understand that I will not be guaranteed any specific military skill or assignment to a geographic area except
INITIALS
as shown in Item 32.a. above and annexes attached to my Enlistment/Reenlistment Document (DD Form 4).
33. CERTIFICATION OF RECRUITER OR ACCEPTOR
a. I certify that I have reviewed all information contained in this document and, to the best of my judgment and belief, the applicant fulfills all legal
policy requirements for enlistment. I accept him/her for enlistment on behalf of the United States
(Enter Branch of Service)
and certify that I have not made any promises or guarantees other than those listed in Item 32.a.
above. I further certify that service regulations governing such enlistments have been strictly complied with and any waivers required to effect
applicant's enlistment have been secured and are attached to this document.
e. SIGNATURE
b. TYPED OR PRINTED NAME (Last, First,
c. PAY
d. RECRUITER I.D. OR
f. DATE SIGNED
GRADE
ORGANIZATION
Middle Initial)
(YYYYMMDD)
SECTION V - RECERTIFICATION
34. RECERTIFICATION BY APPLICANT AND CORRECTION OF DATA AT THE TIME OF ACTIVE DUTY ENTRY
a. I have reviewed all information contained in this document this date. That information is still correct and true to the best of my knowledge and
belief. If changes were required, the original entry has been marked "See Item 34" and the correct information is provided below.
b. ITEM NUMBER
c. CHANGE REQUIRED
d. APPLICANT
e. WITNESS
(1) SIGNATURE
(3) SIGNATURE
(2) DATE SIGNED
(1) TYPED OR PRINTED NAME (Last,
(2) RANK/
GRADE
(YYYYMMDD)
First, Middle Initial)
DD FORM 1966/3, SEP 2014
Page 3
35. NAME
36. SOCIAL SECURITY NUMBER
(Last, First, Middle Initial)
SECTION VI - REMARKS
(Specify item(s) being continued by item number. Continue on separate pages if necessary.)
YES
DD FORM 1966/5
ATTACHED?
NO
(X one)
SECTION VII - STATEMENT OF NAME FOR OFFICIAL MILITARY RECORDS
37. NAME CHANGE.
If the preferred enlistment name (name given in Item 2) is not the same as on your birth certificate, and it has not been changed by legal procedure
prescribed by state law, and it is the same as on your social security number card, complete the following:
a. NAME AS SHOWN ON BIRTH CERTIFICATE
b. NAME AS SHOWN ON SOCIAL SECURITY NUMBER CARD
c. I hereby state that I have not changed my name through any court or other legal procedure; that I prefer to use the name of
by which I am known in the community as a matter of convenience
and with no criminal intent. I further state that I am the same person as the person whose name is shown in Item 2.
d. APPLICANT
(1) SIGNATURE
(2) DATE SIGNED
(YYYYMMDD)
e. WITNESS
(3) SIGNATURE
(1) TYPED OR PRINTED NAME (Last, First, Middle Initial)
(2) PAY GRADE
DD FORM 1966/4, SEP 2014
Page 4

Download DD Form 1966 Record of Military Processing - Armed Forces of the United States

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How to Read DD Form 1966?

The form consists of five subsections: DD Form 1966/1, DD Form 1966/2, DD Form 1966/3, DD Form 1966/4, DD Form 1966/5. The instructions are on the back of the first page along with the privacy act statement.

DD Form 1966 Instructions

A complete overview of the form is included in the Army Regulation 601-210, released on May 16th, 2005. The guidance counselor will review and ensure that DD 1966 is properly completed and compare all entries to verification documents and the SF 86 (Standard Form 86, Questionnaire for National Security Positions). The final completed DD Form 1966 should be free of errors and must be legible. The counselor will print all entries.

The first page of the form consists of four blocks and two sections. Block A is for information on the service processing for. Block B is providing information about prior service and the duration of that past service. Block C is for selective service classification if there is any. Block D is for a selective service registration number if there is one.

  1. Section I consists of 15 Blocks all for providing personal data. This includes the name of the enlistee, their SSN, current address and home of record, citizenship data, date of birth, marital status and information about education and dependents - if any.
  2. Section II is for providing examination and entrance data processing codes. Block 16 is for aptitude test results (results are provided by MEPS personnel, system or DMDC). Block 17 is for DEP enlistment data. Block 18 is for Accession Data. Block 19 is for providing Service required codes. (DEP/ACCESSION RECORD is to be completed by MEPS personnel).
  3. The second page starts with Blocks 20 (Name) and 21 (SSN) and a Section III where other personal information must be provided. This Section consists of Block 22 (Education), Block 23 (Marital/Dependency Status and Family Data), Block 24 (Previous military service or employment with US government, Block 25 (Ability Perform Military Duties), Block 26 (Drug abuse). All blocks in Section III are yes or no questions.
  4. The third page contains Section IV and Section V as well as the same two blocks for the name and SSN of the enlistee.
    • Section IV is for the certification by all of the different parties involved in the enlistment process. This includes the names, verification signatures and other personal information of the applicant, the recruiter, a witness, and the acceptor.
    • Section V is for recertification and is filed at the time of entering active duty if any changes are required.
  5. The fourth page contains lines for the name and the SSN as well as Sections VI (Remarks) and Section VII (Statement of Name). Section VII specifies the name as shown on the birth certificate and SSN card for official military records and records any changes of name that may have taken place.
  6. Page five is for Section VIII - Parental/Guardian Consent For Enlistment. This page should be used only if any of the provided options are applicable to the record of military processing.
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