DA Form 3508 Application for Remission or Cancellation of Indebtedness

What Is DA Form 3508?

DA Form 3508, Application for Remission or Cancellation of Indebtedness is a form used for evaluating whether a service member's debt to the United States is eligible for remission and cancellation.

The Department of the Army (DA) released the latest version of the form - sometimes incorrectly referred to as the DD Form 3508 - in June 2016. An up-to-date DA Form 3508 fillable version is available for download and filing below or can be found via the Army Publishing Directorate website.

A wide range of debts may be considered for remission and cancellation. A hardship or injustice may serve as the basis for filing the application for remission.

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Use additional blank sheet for continuation
APPLICATION FOR REMISSION OR CANCELLATION OF INDEBTEDNESS
of items identifying each item by number.
For use of this form, see AR 600-4; the proponent agency is DCS, G-1.
DATA REQUIRED BY THE PRIVACY ACT OF 1974
10 USC Section 4837 and 32 USC Section 710.
AUTHORITY:
To evaluate an application from a military member for remission and cancellation of debt to the United States.
PRINCIPAL PURPOSE:
ROUTINE USES:
Information provided in this form, and other supporting documentation (including message applications), serves to substantiate your request, and will be used as a basis to
support recommendation for approval or disapproval. This documentation will be maintained as part of your Personal Financial record.
Voluntary. However, failure to supply all pertinent information may result in the request being returned without action.
DISCLOSURE:
INSTRUCTIONS: Answer each question. (Questions that are not applicable, state NA.)
SECTION 1
(Complete address and telephone number of unit Cdr.)
1. TO:
2. FROM:
3. SERVICE DATA
(Include DSN (Not applicable for out of service Soldiers)).
a. NAME
(Last, first, MI)
a. ETS
MRD
Date of Separation
b. RANK
c. PAY GRADE
(YYYYMMDD)
b. BASD
c. PEBD
d. SSN
d. PMOS
DMOS
e. E-MAIL ADDRESS
BASIC BRANCH
CNTL BRANCH
4. PRESENT ORGANIZATION, STATION ADDRESS, DSN
5a. STATION/UNIT WHERE DEBT INCURRED
(INCLUDE THE STATE)
6. INTEND TO
(Enlisted Soldiers only)
AND COMMERCIAL NUMBER
(INCLUDING AREA CODE)
a. REENLIST
YES
NO
OR CURRENT HOME ADDRESS/TELEPHONE NUMBER
b. EXTEND
YES
NO
a.
b. DATE DEBT INCURRED
(YYYYMMDD)
c. UNDECIDED
YES
NO
c. DSSN/ADSN AT TIME OF DEBT INCURRED
b. DSN
7. MARITAL STATUS
MARRIED
NEVER MARRIED
WIDOWED
DIVORCED
LEGALLY SEPARATED
SEPARATED
8. NAME OF SPOUSE
9. DOES SPOUSE RESIDE WITH SOLDIER? 10. IS SPOUSE IN MILITARY?
(Last, first, MI, maiden)
11. WAS SPOUSE IN MILITARY?
(If no, explain)
YES
NO
YES
(If yes, list spouse's SSN, BASD, ETS/MRD)
(If yes, list spouse's SSN, BASD, ETS/
YES
Date of Separation)
a. SSN
b. BASD
a. SSN
b. BASD
c. ETS/MRD/DATE OF SEPARATION
c. ETS/DATE OF SEPARATION
NO
NO
12. NAME OF FAMILY MEMBERS
DATE OF BIRTH
RESIDE WITH SOLDIER
RELATIONSHIP
(Other than spouse)
(YYYYMMDD)
(If no, explain in item 48)
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
13. INITIAL AMOUNT AND CATEGORY OF INDEBTEDNESS
14. DATE APPLICANT NOTIFIED OF INDEBTEDNESS 15. APPLICATION BASED ON
(i.e., BAQ; BAS; FSA; COLA;SHA; HHG; EB; RRB; Report of Survey, etc.)
(YYYYMMDD)
AMOUNT
CATEGORY
HARDSHIP
INJUSTICE
BOTH
AMOUNT
CATEGORY
AMOUNT
CATEGORY
COMPLETION OF SECTION II, III, IV, V, AND VI NOT REQUIRED IF APPLICATION IS BASED
ON INJUSTICE ONLY. TURN TO SECTION VII
TOTAL
PREVIOUS EDITIONS ARE OBSOLETE.
DA FORM 3508, JUN 2016
PAGE 1 OF 6
APD LC v1.00ES
Use additional blank sheet for continuation
APPLICATION FOR REMISSION OR CANCELLATION OF INDEBTEDNESS
of items identifying each item by number.
For use of this form, see AR 600-4; the proponent agency is DCS, G-1.
DATA REQUIRED BY THE PRIVACY ACT OF 1974
10 USC Section 4837 and 32 USC Section 710.
AUTHORITY:
To evaluate an application from a military member for remission and cancellation of debt to the United States.
PRINCIPAL PURPOSE:
ROUTINE USES:
Information provided in this form, and other supporting documentation (including message applications), serves to substantiate your request, and will be used as a basis to
support recommendation for approval or disapproval. This documentation will be maintained as part of your Personal Financial record.
Voluntary. However, failure to supply all pertinent information may result in the request being returned without action.
DISCLOSURE:
INSTRUCTIONS: Answer each question. (Questions that are not applicable, state NA.)
SECTION 1
(Complete address and telephone number of unit Cdr.)
1. TO:
2. FROM:
3. SERVICE DATA
(Include DSN (Not applicable for out of service Soldiers)).
a. NAME
(Last, first, MI)
a. ETS
MRD
Date of Separation
b. RANK
c. PAY GRADE
(YYYYMMDD)
b. BASD
c. PEBD
d. SSN
d. PMOS
DMOS
e. E-MAIL ADDRESS
BASIC BRANCH
CNTL BRANCH
4. PRESENT ORGANIZATION, STATION ADDRESS, DSN
5a. STATION/UNIT WHERE DEBT INCURRED
(INCLUDE THE STATE)
6. INTEND TO
(Enlisted Soldiers only)
AND COMMERCIAL NUMBER
(INCLUDING AREA CODE)
a. REENLIST
YES
NO
OR CURRENT HOME ADDRESS/TELEPHONE NUMBER
b. EXTEND
YES
NO
a.
b. DATE DEBT INCURRED
(YYYYMMDD)
c. UNDECIDED
YES
NO
c. DSSN/ADSN AT TIME OF DEBT INCURRED
b. DSN
7. MARITAL STATUS
MARRIED
NEVER MARRIED
WIDOWED
DIVORCED
LEGALLY SEPARATED
SEPARATED
8. NAME OF SPOUSE
9. DOES SPOUSE RESIDE WITH SOLDIER? 10. IS SPOUSE IN MILITARY?
(Last, first, MI, maiden)
11. WAS SPOUSE IN MILITARY?
(If no, explain)
YES
NO
YES
(If yes, list spouse's SSN, BASD, ETS/MRD)
(If yes, list spouse's SSN, BASD, ETS/
YES
Date of Separation)
a. SSN
b. BASD
a. SSN
b. BASD
c. ETS/MRD/DATE OF SEPARATION
c. ETS/DATE OF SEPARATION
NO
NO
12. NAME OF FAMILY MEMBERS
DATE OF BIRTH
RESIDE WITH SOLDIER
RELATIONSHIP
(Other than spouse)
(YYYYMMDD)
(If no, explain in item 48)
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
13. INITIAL AMOUNT AND CATEGORY OF INDEBTEDNESS
14. DATE APPLICANT NOTIFIED OF INDEBTEDNESS 15. APPLICATION BASED ON
(i.e., BAQ; BAS; FSA; COLA;SHA; HHG; EB; RRB; Report of Survey, etc.)
(YYYYMMDD)
AMOUNT
CATEGORY
HARDSHIP
INJUSTICE
BOTH
AMOUNT
CATEGORY
AMOUNT
CATEGORY
COMPLETION OF SECTION II, III, IV, V, AND VI NOT REQUIRED IF APPLICATION IS BASED
ON INJUSTICE ONLY. TURN TO SECTION VII
TOTAL
PREVIOUS EDITIONS ARE OBSOLETE.
DA FORM 3508, JUN 2016
PAGE 1 OF 6
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DO NOT LIST ANY ONE EXPENSE IN TWO DIFFERENT LOCATIONS
SECTION II - (INCOME)
SECTION III - (EXPENSES)
AVERAGE MONTHLY INCOME
HUSBAND
WIFE
AVERAGE MONTHLY EXPENSES
$
$
$
16a.
MONTHLY GROSS MILITARY SALARY
21.
RENT OR MORTGAGE PAYMENT
$
$
$
16b.
MONTHLY GROSS CIVILIAN SALARY
22.
FOOD
$
$
$
16c.
TOTAL GROSS SALARY
23.
TELEPHONE
$
17a.
DEDUCTION
24.
UTILITIES
$
$
$
FEDERAL, STATE, AND LOCAL INCOME TAXES
25.
LAUNDRY
$
$
$
17b.
SGLI/SOLDIER'S HOME
26.
CLOTHING
$
$
$
17c.
FICA
27.
MEDICAL (Nonreimbursable)
17d.
OTHER (Specify) (Do not list allotments or debt
$
28.
CAR OPERATING EXPENSE (Gas, etc)
payments - list only normal deductions)
$
29a.
CAR INSURANCE
b.
$
OTHER INSURANCE - NOT INCLUDED IN 17d. (Specify)
$
30.
OTHER TRANSPORTATION EXPENSE (bus, train, etc.)
$
$
31.
OTHER LIVING EXPENSES NOT LISTED IN SECTION IV (Specify)
$
17e.
TOTAL DEDUCTIONS (Item 17a through 17d)
18.
NET TAKE HOME PAY (Subtract item 17e from
$
$
item 16c)
$
32.
SUB TOTAL
$
$
33.
ALLOTMENTS (Total from Section IV, item 37g)
$
19.
PENSION COMPENSATION, CHILD SUPPORT,
ALIMONY, VA BENEFITS, OR OTHER INCOME
(Specify)
34.
MONTHLY PAYMENTS ON INSTALLMENT CONTRACTS AND
$
OTHER DEBTS (Total from Section IV, item 36f)
20.
TOTAL MONTHLY NET INCOME (Item 18 plus
$
$
item 19)
$
35.
TOTAL MONTHLY EXPENSES (Items 32 through 34)
SECTION IV
(INSTALLMENT CONTRACT AND OTHER DEBTS)
Show here ALL debts which you are required to pay in regular monthly installments, such as Government debt, car, television, washing machine, payments to retailers, banks, finance companies,
repayment of money borrowed for any purpose, doctor bills, hospital bills, etc. DO NOT include living expenses or allotments. NOTE: If payment of a debt is not on a monthly basis, write "O"
in column f and describe arrangements in Section VII - REMARKS.
DATE DEBT
LIQUIDATION
PURPOSE OF
ORIGINAL AMOUNT
UNPAID
AMOUNT DUE
AMOUNT PAST
NAME AND ADDRESS OF CREDITOR
INCURRED
DATE
DEBT
OF DEBT
BALANCE
MONTHLY
DUE (If any)
(YYYYMMDD)
(YYYYMMDD)
a
b
c
d
e
f
g
h*
$
$
$
$
36a.
$
$
$
$
36b.
$
$
$
$
36c.
DA FORM 3508, JUN 2016
PAGE 2 OF 6
APD LC v1.00ES
SECTION IV - (Continued)
DATE DEBT
LIQUIDATION
PURPOSE OF
ORIGINAL AMOUNT
UNPAID
AMOUNT DUE
AMOUNT PAST
INCURRED
DATE
NAME AND ADDRESS OF CREDITOR
DEBT
OF DEBT
BALANCE
MONTHLY
DUE (If any)
(YYYYMMDD)
(YYYYMMDD)
a
b
c
d
e
f
g
h*
36d.
$
$
$
$
$
$
$
$
36e.
$
$
$
$
36f.
TOTAL
*IF REVOLVING ACCOUNT, STATE ACTUAL DATE ACCOUNT WILL BE LIQUIDATED IF NO OTHER PURCHASES ARE MADE
(ALLOTMENTS CURRENTLY IN EFFECT)
DATE
ESTIMATED EXPIRATION DATE
PURPOSE
STARTED
CLASS
PAYEE
AMOUNT
(Provide date obligation will be paid
(i.e., car, furniture, savings)
(YYYYMMDD)
in full)
a
b
c
d
e
f
37a.
SUPPORT
$
a.
b.
c.
37b.
INSURANCE
$
a.
b.
c.
37c.
FINANCIAL INSTITUTION (Specify - Institution and Purpose)
$
a.
b.
c.
37d.
OTHER (i.e., red Cross, AER, etc.) (Specify)
$
a.
b.
c.
37e. SUBTOTAL (Add 37a through 37d)
37f. PROVIDE TOTAL AMOUNT FORM 37a THROUGH 37d THAT GOES INTO SAVINGS ACCOUNT
37g. TOTAL (Subtract line 37f from 37e)
DA FORM 3508, JUN 2016
PAGE 3 OF 6
APD LC v1.00ES
SECTION V
(ADDITIONAL DATA)
38a.
HAVE YOU EVER DECLARED BANKRUPTCY
b.
c.
LOCATION OF COURT
d.
DOCKET NUMBER OF KNOWN
DATE DISCHARGED FROM BANKRUPTCY (YYYYMMDD)
(City and State)
39.
ENLISTMENT OR REENLISTMENT BONUS, LIST EACH INCREMENT OF SRB BONUS. PROVIDE INFORMATION FOR ANY BONUS RECEIVED DURING THIS ENLISTMENT/ REENLISTMENT AND ANY
KNOWN AMOUNTS TO BE RECEIVED IN THE FUTURE. OFFICERS INCLUDE OFFICER ACCESSION BONUS AND OFFICER AFFLIATION BONUS IN BLOCK 39D (if applicable)
TYPE OF BONUS
AMOUNT RECEIVED
DATE
(s)
RECEIVED
AMOUNT TO BE RECEIVED
DATE
(s)
INCREMENTS WILL BE RECEIVED
(YYYYMMDD)
(YYYYMMDD)
$
$
a. EB
b. SRB
$
$
$
$
c. RRB
$
$
d. OTHER
$
$
e. TOTAL
40. CASH (Item a-g: Provide total amount, not monthly amount for each category)
41. REAL ESTATE OWNED OR BEING PURCHASED (Approximate retail value)
$
$
a. CHECKING
$
$
b. SAVINGS
$
c. BUILDING AND LOAN
$
$
d. US SAVINGS BONDS (Current value)
42. PURCHASES SINCE AWARENESS OR NOTIFICATION OF INDEBTEDNESS (Specify: TV; CB;
$
e. OTHER BONDS (i.e. Municipal)
Stereo; Appliances; Furniture; Jewelry; Photographic equipment, etc. and cost.)
$
f. OTHER (Specify)
a.
$
$
g. CASH ON HAND
$
b.
$
h. TOTAL
$
c.
43.
VEHICLES (List all)
DATE PURCHASED
MAKE
YEAR
MODEL
MILEAGE
(YYYYMMDD)
AUTOMOBILE
TRUCK
MOTOR CYCLE
TRAILER
CAMPER
BOAT
44. OTHER ASSETS (Not listed in item 43)
DA FORM 3508, JUN 2016
PAGE 4 OF 6
APD LC v1.00ES
SECTION VI
SUMMARY
45a. COMBINED MONTHLY INCOME (Section II, item 20)
b. COMBINED MONTHLY EXPENSES (Section III, item 35)
c. BALANCE (Subtract 45b from 45a)
$
$
$
TOTAL FOR APPLICANT AND SPOUSE
TOTAL FOR APPLICANT AND SPOUSE
46. HOW MUCH OF THE BALANCE IN ITEM 45c CAN YOU APPLY TO YOUR DEBT
47. IF TOTAL MONTHLY EXPENSES EXCEED MONTHLY INCOME, HOW DO YOU PAY THE DIFFERENCE
TO THE US GOVERNMENT ON A MONTHLY BASIS
$
SECTION VII
REMARKS
48. USE THIS SPACE AND ADDITIONAL SHEETS IF NECESSARY TO SUPPLY ANY OTHER PERTINENT INFORMATION AND TO CONTINUE YOUR ANSWERS TO PREVIOUS ITEMS.
INDICATE ITEM NUMBER
(s)
TO WHICH YOUR COMMENTS APPLY. (DO NOT USE FOR SWORN STATEMENT)
DA FORM 3508, JUN 2016
PAGE 5 OF 6
APD LC v1.00ES

Download DA Form 3508 Application for Remission or Cancellation of Indebtedness

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How to Fill Out DA Form 3508?

The form is maintained as a part of Personal Financial Report. An overview of the form and filing guidelines can be found in the Army Regulation 600-4, Remission or Cancellation of Indebtedness, released in July 2016. DA Form 3508 instructions are as follows:

  1. Section I requires basic information about the applicant. This includes their name, rank, SSN and e-mail address along with information about their service (expiration term of service, date of separation, basic branch), their current home or organization address and the location where the debt was incurred.
  2. Applicants must specify their marital status and their spouse's personal information, list all family members and their personal information as well. The form must also include the initial amount and category of indebtedness and the basis for applying . The DA 3508 Form is valid under any chosen option.
  3. Section II requires specifying the amount of income the applicant has, and - if they are married - their spouse's income from any sources.
  4. Section III is for listing all expenses and their total amount.
  5. Section IV is for listing installment contracts and other debts. It requires the name and the address of the creditor, the purpose of debt, the current allotments, any unpaid balance and the amount due monthly.
  6. Section V is reserved for additional data. This includes details on the date of bankruptcy, any received enlistment and reenlistment bonuses, information on saved cash, any savings or other bonds, expensive purchases and aby real estate or vehicles in possession.
  7. Section VI summarizes the money flow of the applicant.
  8. Any additional information may be entered in Section VII, reserved for remarks. The DA Form 3508 also allows using an additional blank sheet for continuation if the space provided on the main form is not enough.
  9. Section VII, Verification, requires the signature of the applicant and spouse with a date of signing the form. This section must also contain the verification form an immediate commander along with their name, the date of signing and signature.
  10. Section IX is used only by the Financial Assistance Office (FAO) or United States Property & Fiscal Office (USPFO).
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