DD Form 2656-1 Survivor Benefit Plan (SBP) Election Statement for Former Spouse Coverage

What Is DD Form 2656-1?

DD Form 2656-1, SBP Election Statement for Former Spouse Coverage is a form used to convert an existing SBP spouse coverage election into former spouse coverage for eligible spouses of service members within the United States Military.

The latest available edition of the DD 2656-1 was issued by the Department of Defense (DoD) in April 2009. An up-to-date fillable version of the form is available for download or digital filing below.

The retiree and former spouse must complete the form indicating whether the election is being made pursuant to a court order, a written agreement, or voluntarily. The DD Form 2656-1 is a part of a package of forms related to establishing retainer or retired pay accounts, electing Survivor Benefit Program (SBP) coverage or terminating SBP participation.


DD Form 2656-1 Instructions

The DD Form 2656-1 must be submitted within one year of the court order requiring coverage in order to convert the coverage from spouse to former spouse. Unless this is done, the former spouse will not be covered.

Retired members must complete Sections I, II and III. Retiring members file Sections II and III only, making the election on the DD Form 2656, Data for Payment of Retired Personnel. All service members and former spouses must complete Section III when filing the form.

  1. Section I, Election of Coverage is filed only by retired members. Place an X in the appropriate block to indicate if the election is for a former spouse with children or for a former spouse alone.
  2. Section II, Retired and Retired Members consists of Items 2 through 11. Indicate your marital status in Item 2. Choose the legal reasons for coverage out of Items 3, 4 or 5. Items 6 and 7 are self-explanatory and describe the date of birth of the former spouse and the date of your marriage to them. Enter the date of divorce decree in Item 8.

    Item 9 is filed if the former spouse has remarried. If former spouse remarries before the age of 55, the coverage will be suspended and premiums will not be deducted from members retired pay for the duration of that marriage. Coverage will resume if the marriage ends by divorce, death or annulment.

    Item 10 is for listing eligible children from the former marriage. Indicate in a child is incapable of supporting themselves in Block 10e and attach proof if any is available.

    Item 11 may be used for comments or any additional information.

  3. Section III is for certification and is filed and signed by the retiree, former spouse and their two witnesses.

DD 2656-1 Related Forms

The DD 2656-1 has eight related SBP-themed forms, each with its distinctive features and a specific purpose.

  1. DD Form 2656, Data for Payment of Retired Personnel provides data needed to establish a retainer or retired pay account, designate beneficiaries for unpaid retired pay or establishing a SBP election.
  2. DD Form 2656-2, SBP Termination Request is used to voluntarily discontinue participation in the SBP and is valid only if the spouse's or former spouse's concurrence is witnessed by a Notary public or a designated SBP Counsellor.
  3. DD Form 2656-5, RCSBP Election Certificate is used by Reserve Component Members to make an election for the Reserve Component SBP after receiving notification of being eligible to claim their Reserve retired pay.
  4. DD Form 2656-6, SBP Election Change Certificate is used to change a SBP election by retired members of the military.
  5. DD Form 2656-7, Verification for Survivor Annuity is used by the surviving or former spouse and dependent children to verify eligibility for an annuity under the Retired Servicemen's Family Protection Plan, Reserve Component SBP or the SBP.
  6. DD Form 2656-8, SBP Automatic Coverage Fact Sheet is used to record the marital and dependency status of the servicemember to establish and maintain an accurate accounting of the RPA (retired pay account).
  7. DD Form 2656-10, SBP/RC SBP Request for Deemed Election is used by former spouses to provide information related to SBP coverage to a Uniformed Service designated agent.
  8. DD Form 2656-11, Statement Certifying Number of Months of SBP Premiums Paid is filed if the individual disagrees with the number of months credited toward paid-up SBP by the Defense Finance and Accounting Service (DFAS).

Download DD Form 2656-1 Survivor Benefit Plan (SBP) Election Statement for Former Spouse Coverage

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