DD Form 137-6 "Dependency Statement - Full Time Student 21 - 22 Years of Age"

What Is DD Form 137-6?

This is a form that was released by the U.S. Department of Defense (DoD) on March 1, 2018. The form, often mistakenly referred to as the DA Form 137-6, 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 4-page document available for download in PDF;
  • The latest version available from the Executive Services Directorate;
  • Additional instructions and information can be found on page 1 of the document;
  • Editable, printable, and free to use;
  • Fill out the form in our online filing application.

Download an up-to-date fillable DD Form 137-6 down below in PDF format or browse hundreds of other DoD Forms compiled in our online library.

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DD Form 137-6 Instructions

The DD 137-6 contains 15 sections overall. No sections can be left blank: enter NOT APPLICABLE or N/A if there is no information to provide. Forms with sections left blank will take much longer to process.

The service member filing the form must file Sections 1 and 15. The student, service member or the child's custodian must file Sections 2 through 14 before the form is notarized.

  1. Section 1 describes the entitlements requested. Put an X next to each applicable entitlement and provide a date and status for previous applications. BAH stands for Basic Allowance for Housing and USIP stands for Uniform Service Identification and Privilege Card or ID card.
  2. Section 2 requires the service member's name, DoD ID, rank and status in Blocks a through d and a residence and military service addresses in Blocks e and f. If the member is retired, put N/A into Block f. The rest of the section requires the applicant to provide their marital status, phone number, and email address. The phone number and email must be accurate - this information will be used for immediate communication.
  3. Sections 3 and 4 are for providing the student's personal information and all information about their school.
  4. Section 5 provides personal identifying information about the other parent. Complete Blocks c and d if the other parent is serving in any branches of the military including the Reserve and National Guard.
  5. Section 6 is for describing the type of residence where the student is currently living. The applicant must provide the student's residence during them attending school and the address where the student lives while not attending school for periods exceeding 90 days.
  6. Section 7, Persons Living In Household With Student, must include a list of all people sharing a household with the child including the child themselves. This section cannot be left blank even if the member and their child are the only people living in the household.
  7. Section 8 is for listing all household expenses for all persons living in the home. All one-time purchases must be added up and listed as an expense for the past 12 months (Column 2).
  8. Section 9 is for describing the student's personal expenses excluding the personal expenses of the service member filing the form.
  9. Section 10 lists school expenses specifically. All expenses should be covered, including those that are covered by a scholarship, a grant or financial aid.
  10. Section 11 describes the claimed student's gross income, both taxable and nontaxable.
  11. Section 12 describes the student's employment. The section is filed in cases if the claimed child had any jobs within the last 12 months.
  12. Section 13 is for specifying all contribution toward caring for the child for the period of the last 12 months.
  13. Section 14 is for additional remarks and Section 15 is for the signatures, dates, and notarization.

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CUI (when filled in)
DEPENDENCY STATEMENT - FULL TIME STUDENT
OMB No. 0730-0014
OMB approval expires
21 - 22 YEARS OF AGE
June 30, 2024
The public reporting burden for this collection of information, 0730-0014, is estimated to average 30-60 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 the burden estimate or burden
reduction suggestions 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.
RETURN COMPLETED FORM TO YOUR LOCAL SERVING PERSONNEL/PAYROLL OFFICE.
PRIVACY ACT STATEMENT
AUTHORITY: 5 U.S.C. 301, Departmental Regulations; 37 U.S.C., Pay and Allowances of the Uniformed Services; DoD Directive 5154.29, DoD Pay and Allowances Policy and
Procedures; DoD 7000.14-R, DoD Financial Management Manual, Volume 7A, Military Pay Policy and Procedures – Active Duty and Reserve Pay; and Joint Travel Regulations (JTR)
current edition.
PURPOSE(S): The information will be used to determine the relationship and dependency of the claimed dependents and determine the member's entitlement of authorized benefits.
ROUTINE USE(S): To the Treasury Department to provide information on check issues and electronic funds transfers. To Federal, state, and local governmental agencies in response
to an official request for information with respect to law enforcement, investigatory procedures, criminal prosecution, civil court action and regulatory order. Additional routine uses can
be found within the applicable system of records notices, T7344, Defense Joint Military Pay System-Reserve Component; T7340, Defense Joint Military Pay System-Active Component;
and M01040-3, Marine Corps Manpower Management Information System Records, located at: http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-Component-Notices/
DISCLOSURE: Voluntary: however, failure to provide this information will result in a suspension of the dependent entitlements until the member can provide the required certificate.
INSTRUCTIONS: This form is used to determine Basic Allowance for Housing (BAH) eligibility for students 21 - 22 years of age. Member completes items 1 and 15. Member, student,
or student's custodian completes Items 2 through 14, and has the form notarized. Answer every question. If any question does not apply, write "NOT APPLICABLE" or "N/A" in that
block. Report and verify any income in GROSS amounts. A verification of enrollment at an institution of higher learning is required. Verification must be on official school letterhead,
and include the school's name and address, the student's status (full-time or part-time), the projected graduation date, and the school's official stamp. Proof of member's contribution
(dependent support allotments, cancelled checks, copies of money order receipts, etc., is required.
1. ENTITLEMENTS REQUESTED (X and complete as applicable)
a. TYPE
b. FIRST APPLICATION?
c. LAST APPLICATION WAS
BAH
USIP CARD
YES
(If No, give date of last application)
APPROVED
TRAVEL ALLOWANCE
NO
(YYYYMMDD)
DISAPPROVED
2. MEMBER INFORMATION
a. NAME (Last, First, Middle Initial)
b. DoD ID NUMBER
c. RANK
d. STATUS (X and complete as applicable)
ACTIVE DUTY
NATIONAL GUARD
ARMY
NAVY
DECEASED
(Date of death) (YYYMMDD)
RETIRED
RESERVE
MARINE CORPS
AIR FORCE
OTHER
(Specify)
e. COMPLETE RESIDENCE ADDRESS (Street, Apartment Number, City, State, ZIP Code)
f. COMPLETE MILITARY ADDRESS (Include assignment: squadron and base)
g. TELEPHONE NUMBERS (Include DSN or Area Code)
i. MARITAL STATUS (X one)
h. E-MAIL ADDRESS
(1) WORK
(2) HOME
SINGLE
SEPARATED
WIDOWED
MARRIED
DIVORCED
3. STUDENT
a. NAME (Last, First, Middle Initial)
b. DOD ID NUMBER
c. DATE OF BIRTH (YYYYMMDD)
f. HAS CHILD EVER BEEN MARRIED? (If Yes, attach a copy of annulment decree, final
d. COMPLETE ADDRESS (Street, Apartment Number, City, State, ZIP Code)
divorce decree, or death certificate of child's spouse.)
YES
NO
4. SCHOOL INFORMATION
a. NAME OF SCHOOL
b. COMPLETE SCHOOL ADDRESS (Street, City, State, ZIP Code)
c. X ALL MONTHS STUDENT ATTENDS SCHOOL
YEAR
JAN
FEB
MAR
APR
MAY
JUN
JULY
AUG
SEP
OCT
NOV
DEC
e. MONTH AND YEAR STUDENT EXPECTS TO GRADUATE
d. DOES STUDENT ATTEND SCHOOL ON A FULL-TIME BASIS?
NO
YES
DD FORM 137-6, MAR 2018
Controlled by: DFAS
Page 1 of 4
CUI (when filled in)
Category: PRVCY
PREVIOUS EDITION IS OBSOLETE.
Distribution/DISTRO: FEDCON
POC: (888) 332-7411
CUI (when filled in)
DEPENDENCY STATEMENT - FULL TIME STUDENT
OMB No. 0730-0014
OMB approval expires
21 - 22 YEARS OF AGE
June 30, 2024
The public reporting burden for this collection of information, 0730-0014, is estimated to average 30-60 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 the burden estimate or burden
reduction suggestions 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.
RETURN COMPLETED FORM TO YOUR LOCAL SERVING PERSONNEL/PAYROLL OFFICE.
PRIVACY ACT STATEMENT
AUTHORITY: 5 U.S.C. 301, Departmental Regulations; 37 U.S.C., Pay and Allowances of the Uniformed Services; DoD Directive 5154.29, DoD Pay and Allowances Policy and
Procedures; DoD 7000.14-R, DoD Financial Management Manual, Volume 7A, Military Pay Policy and Procedures – Active Duty and Reserve Pay; and Joint Travel Regulations (JTR)
current edition.
PURPOSE(S): The information will be used to determine the relationship and dependency of the claimed dependents and determine the member's entitlement of authorized benefits.
ROUTINE USE(S): To the Treasury Department to provide information on check issues and electronic funds transfers. To Federal, state, and local governmental agencies in response
to an official request for information with respect to law enforcement, investigatory procedures, criminal prosecution, civil court action and regulatory order. Additional routine uses can
be found within the applicable system of records notices, T7344, Defense Joint Military Pay System-Reserve Component; T7340, Defense Joint Military Pay System-Active Component;
and M01040-3, Marine Corps Manpower Management Information System Records, located at: http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-Component-Notices/
DISCLOSURE: Voluntary: however, failure to provide this information will result in a suspension of the dependent entitlements until the member can provide the required certificate.
INSTRUCTIONS: This form is used to determine Basic Allowance for Housing (BAH) eligibility for students 21 - 22 years of age. Member completes items 1 and 15. Member, student,
or student's custodian completes Items 2 through 14, and has the form notarized. Answer every question. If any question does not apply, write "NOT APPLICABLE" or "N/A" in that
block. Report and verify any income in GROSS amounts. A verification of enrollment at an institution of higher learning is required. Verification must be on official school letterhead,
and include the school's name and address, the student's status (full-time or part-time), the projected graduation date, and the school's official stamp. Proof of member's contribution
(dependent support allotments, cancelled checks, copies of money order receipts, etc., is required.
1. ENTITLEMENTS REQUESTED (X and complete as applicable)
a. TYPE
b. FIRST APPLICATION?
c. LAST APPLICATION WAS
BAH
USIP CARD
YES
(If No, give date of last application)
APPROVED
TRAVEL ALLOWANCE
NO
(YYYYMMDD)
DISAPPROVED
2. MEMBER INFORMATION
a. NAME (Last, First, Middle Initial)
b. DoD ID NUMBER
c. RANK
d. STATUS (X and complete as applicable)
ACTIVE DUTY
NATIONAL GUARD
ARMY
NAVY
DECEASED
(Date of death) (YYYMMDD)
RETIRED
RESERVE
MARINE CORPS
AIR FORCE
OTHER
(Specify)
e. COMPLETE RESIDENCE ADDRESS (Street, Apartment Number, City, State, ZIP Code)
f. COMPLETE MILITARY ADDRESS (Include assignment: squadron and base)
g. TELEPHONE NUMBERS (Include DSN or Area Code)
i. MARITAL STATUS (X one)
h. E-MAIL ADDRESS
(1) WORK
(2) HOME
SINGLE
SEPARATED
WIDOWED
MARRIED
DIVORCED
3. STUDENT
a. NAME (Last, First, Middle Initial)
b. DOD ID NUMBER
c. DATE OF BIRTH (YYYYMMDD)
f. HAS CHILD EVER BEEN MARRIED? (If Yes, attach a copy of annulment decree, final
d. COMPLETE ADDRESS (Street, Apartment Number, City, State, ZIP Code)
divorce decree, or death certificate of child's spouse.)
YES
NO
4. SCHOOL INFORMATION
a. NAME OF SCHOOL
b. COMPLETE SCHOOL ADDRESS (Street, City, State, ZIP Code)
c. X ALL MONTHS STUDENT ATTENDS SCHOOL
YEAR
JAN
FEB
MAR
APR
MAY
JUN
JULY
AUG
SEP
OCT
NOV
DEC
e. MONTH AND YEAR STUDENT EXPECTS TO GRADUATE
d. DOES STUDENT ATTEND SCHOOL ON A FULL-TIME BASIS?
NO
YES
DD FORM 137-6, MAR 2018
Controlled by: DFAS
Page 1 of 4
CUI (when filled in)
Category: PRVCY
PREVIOUS EDITION IS OBSOLETE.
Distribution/DISTRO: FEDCON
POC: (888) 332-7411
CUI (when filled in)
5. STUDENT'S OTHER PARENT(S)
a.
b.
(1) NAME (Last, First, Middle Initial)
(1) NAME (Last, First, Middle Initial)
(2) RELATIONSHIP TO STUDENT
(2) RELATIONSHIP TO STUDENT
(3) COMPLETE ADDRESS (Street, Apartment Number, City, State, ZIP Code)
(3) COMPLETE ADDRESS (Street, Apartment Number, City, State, ZIP Code)
c. IS/ARE OTHER PARENT(S) IN ANY BRANCH OF SERVICE, INCLUDING RESERVE OR NATIONAL GUARD (X one)
NO
YES
(If Yes, show rank, name, SSN, and military address.)
d. DOES OTHER PARENT CLAIM CHILD FOR BASIC ALLOWANCE FOR HOUSING (BAH), TRAVEL ALLOWANCE, OR USIP CARD (X one)
NO
YES
(If Yes, explain.)
6. STUDENT'S RESIDENCE
a. ADDRESS WHERE STUDENT RESIDES WHILE ATTENDING SCHOOL (Street, Apartment Number, City, State, ZIP Code)
b. TYPE OF RESIDENCE (X and complete as applicable)
STUDENT'S OWN HOME OR APARTMENT
HOME OR APARTMENT OF OTHER PARENT
HOME OR APARTMENT OF MEMBER
HOME OR APARTMENT OF FRIEND OR RELATIVE (State relationship)
HOME OR APARTMENT OF MEMBER'S FORMER SPOUSE
HOME OR APARTMENT OF MEMBER'S WIDOW OR WIDOWER
OTHER (Explain)
STUDENT DORMITORY OR OTHER ON-CAMPUS FACILITY
c. ADDRESS WHERE STUDENT RESIDES, IN EXCESS OF 90 DAYS, WHILE NOT ATTENDING SCHOOL (Street, Apartment Number, City, State, ZIP Code)
d. TYPE OF RESIDENCE (X and complete as applicable)
STUDENT'S OWN HOME OR APARTMENT
HOME OR APARTMENT OF OTHER PARENT
HOME OR APARTMENT OF MEMBER
HOME OR APARTMENT OF FRIEND OR RELATIVE (State relationship)
HOME OR APARTMENT OF MEMBER'S FORMER SPOUSE
HOME OR APARTMENT OF MEMBER'S WIDOW OR WIDOWER
OTHER (Explain)
STUDENT DORMITORY OR OTHER ON-CAMPUS FACILITY
7. PERSONS LIVING IN HOUSEHOLD WITH STUDENT
List all persons who live in the household, including claimed student. If employed, show hours per week worked. Continue in Remarks if more space is needed.
d. MARRIED (X)
e. EMPLOYED
b. RELATIONSHIP
a. NAME (Last, First, Middle Initial)
c. AGE
TO STUDENT
YES
NO
HOURS PER WEEK
NO (X)
8. HOUSEHOLD EXPENSES
List the household expenses for all persons living in the home. If expense was one-time only, such as purchase of a new chair, do not show this as a monthly expense; list it as an expense for the
past 12 months. If student resides in the member's household or in a dwelling owned by the member, use Fair Rental Value (FRV) for dwelling. If student does not reside in member's household or
in a dwelling owned by member, list actual mortgage, rent, or FRV if dwelling is mortgage-free. If FRV is used, give a brief explanation of how Fair Rental Value was obtained using the Remarks
section.
FAIR RENTAL VALUE (FRV): FRV is a single monthly sum for the entire dwelling where the student lives. This sum is an amount the owner can reasonably expect to receive from a stranger to
rent the dwelling. FRV will not include food, utilities, furniture, and home repairs, which are listed separately.
(1)
(2)
(1)
(2)
ITEM
PRESENT MONTHLY
TOTAL EXPENSE FOR
ITEM
PRESENT MONTHLY
TOTAL EXPENSE FOR
EXPENSE
PAST 12 MONTHS
EXPENSE
PAST 12 MONTHS
a. (X one)
d. FURNITURE AND
RENT
FRV
APPLIANCES
MORTGAGE (Specify
amount of tax and
insurance if applicable)
e. REPAIRS ON HOME
TAX
INSURANCE
b. FOOD
f. OTHER (Itemize in Remarks
c. UTILITIES (Heat, power,
section)
water, and telephone)
DD FORM 137-6, MAR 2018
Page 2 of 4
CUI (when filled in)
PREVIOUS EDITION IS OBSOLETE.
CUI (when filled in)
9. STUDENT'S PERSONAL EXPENSES.
List all of the student's personal expenses regardless of who is paying for them.
AVERAGE MONTHLY
AVERAGE MONTHLY
ITEM
ITEM
EXPENSE
EXPENSE
f. PERSONAL TAXES (Specify)
a. CLOTHING
g. PRIVATE AUTO PAYMENTS (If auto is
b. LAUNDRY AND DRY CLEANING
registered in child's name)
h. MONTHLY TRANSPORTATION PAYMENTS
c. MEDICAL (Do not include expenses paid by
(Include gas, oil, insurance, repairs, and public
insurance, welfare, or Medicare)
transportation)
d. VALUE OF USIP CARD (Verification of
i. OTHER (Specify)
amount is required)
e. PERSONAL INSURANCE (Specify)
10. STUDENT'S SCHOOL EXPENSES.
List all of the student's school expenses even if covered by scholarship, grant, or other financial aid.
AVERAGE MONTHLY
AVERAGE MONTHLY
ITEM
ITEM
EXPENSE
EXPENSE
a. TUITION
e. BOARD (Food)
f. OTHER SCHOOL EXPENSES (Specify)
b. BOOKS
c. SPECIAL FEES
d. ROOM (Rent)
11. STUDENT'S INCOME
All gross income received by or in behalf of the student, whether taxable or nontaxable, and whether received monthly, quarterly, or yearly, must be listed. This includes any income received by
persons in the capacity of custodian or administrator for the student. If any income received during the past 12 months was a lump-sum (one-time) payment, be sure to state this. Verification
documents are required.
(1)
(2)
(1)
(2)
PRESENT
TOTAL INCOME
PRESENT
TOTAL INCOME
SOURCE
SOURCE
MONTHLY
FOR PAST 12
MONTHLY
FOR PAST 12
INCOME
MONTHS
INCOME
MONTHS
g. SOCIAL SECURITY PAYMENTS,
a. WAGES, SALARIES, TIPS, OR
DISABILITY OR REGULAR
OTHER CASH GRATUITIES
(Specify)
b. INTEREST ON INVESTMENTS,
BONDS, SAVINGS, TRUST
h. SUPPLEMENTAL
FUNDS, ETC.
SECURITY INCOME (SSI)
c. INSURANCE OR PUBLIC/
i. VETERANS ADMINISTRATION
GOVERNMENT PENSION
PAYMENTS (Specify type)
PAYMENTS,UNEMPLOYMENT
OR DISABILITY COMPENSATION
(Specify type)
j. STATE OR LOCAL WELFARE AID,
INCLUDING AID TO DEPENDENT
d. CONTRIBUTIONS FROM
CHILDREN (Include agency and
PERSONS OTHER THAN
address in Remarks section)
MEMBER
e. SCHOLARSHIPS OR
k. OTHER (Specify)
EDUCATIONAL GRANTS
f. TAX REFUNDS (Specify)
12. STUDENT'S EMPLOYMENT
a. HAS STUDENT BEEN EMPLOYED DURING THE PAST 12 MONTHS?
YES
NO (If Yes, furnish the following:)
c. DATE EMPLOYMENT
d. DATE EMPLOYMENT
e. MONTHLY SALARY
b. NAME OF EMPLOYER
STARTED (YYYYMMDD)
ENDED (YYYYMMDD)
(Gross)
f. TYPE OF WORK PERFORMED
g. REASON EMPLOYMENT ENDED
13. MEMBER'S CONTRIBUTION
a. SHOW THE TOTAL AMOUNT THE MEMBER HAS CONTRIBUTED TO THE STUDENT'S SUPPPORT FOR EACH OF THE PAST 12 MONTHS.
(1) MONTH AND YEAR
(2) AMOUNT
(1) MONTH AND YEAR
(2) AMOUNT
(1) MONTH AND YEAR
(2) AMOUNT
ALLOTMENT
PERSONAL CHECK
MONEY ORDER
b. MEMBER PROVIDES SUPPORT BY (X one)
OTHER
(Explain)
DD FORM 137-6, MAR 2018
Page 3 of 4
CUI (when filled in)
PREVIOUS EDITION IS OBSOLETE.
CUI (when filled in)
14. REMARKS (Use a separate sheet of paper if necessary)
READ THE PENALTY PROVISIONS, SIGN AND DATE THE FORM, AND HAVE IT NOTARIZED.
NOTE: Whoever, in any matter within the jurisdiction of any department or agency of the United States, knowingly and willfully falsifies, conceals, or covers up by
any trick, scheme, or device, a material fact, or makes any false, fictitious, or fraudulent statements or representations, or makes or uses any false writing or
document knowing the same to contain any false, fictitious, or fraudulent statement or entry, shall be fined as provided in Title 18, or imprisoned not more than 5
years, or both (U.S. Code, title 18, section 1001). The information provided in this form may be referred to the appropriate Military Service investigative agency.
I make the foregoing claim with full knowledge of the penalties involved for willfully making a false claim. (U.S. Code, title 18, section 287,
formerly section 80, provides a penalty as follows: Imprisonment for not more than five years and subject to a fine in the amount provided in this
title.)
15. SIGNATURES
a. CUSTODIAN
I/we
(print name(s)) will immediately notify
the service concerned of any change in child's financial circumstances, marital status, physical custody, or change in dependency upon the service member as shown in this form.
(1) SIGNATURE
(2) DATE SIGNED (YYYYMMDD)
b. NOTARY PUBLIC
Subscribed and duly sworn (or affirmed) to before me according to law by the above named affiant(s).
This
day of
,
, at city (or town) of
, county of
,
and state (or territory) of
.
(Notary)
(Official Seal)
(Official Title)
c. MEMBER
(1) SIGNATURE
(2) DATE SIGNED (YYYYMMDD)
DD FORM 137-6, MAR 2018
Page 4 of 4
CUI (when filled in)
PREVIOUS EDITION IS OBSOLETE.
Page of 4