Sample "Active Duty Finance Forms Packet - the Air University"

Active Duty Finance Forms Packet - the Air University is a 7-page legal document that was released by the U.S. Air Force and used nation-wide.

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Download Sample "Active Duty Finance Forms Packet - the Air University"

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Finance: For FIAR BAH Audit Use Only
APPLICATION AND AUTHORIZATION TO START, STOP OR CHANGE BASIC ALLOWANCE FOR QUARTERS (BAQ)
OR DEPENDENCY REDETERMINATION
PRIVACY ACT STATEMENT
AUTHORITY: 37 U.S.C. SECTIONS 403 AND 405 ; EXECUTIVE ORDER 9397.
PURPOSE: TO DOCUMENT A MEMBER’S REQUEST FOR, AND SUSEQUENT AUTHORIZATION OF, AN ADVANCE HOUSING ALLOWANCE.
ROUTINE USES: INFORMATION COLLECTED ON THIS FORM BECOMES PART OF THE JOINT UNIFORM MILITARY PAY SYSTEM (JUMPS), AND IS SUBJECT TO ALL THE
ROUTINE DISCLOSURES MADE BY THAT SYSTEM AS MORE FULLY DESCRIBED IN AFP 12-36. ROUTINE RECIPIENTS OF JUMPS DISCLOSURES INCLUDE, BUT ARE NOT
LIMITED TO, OTHER FEDERAL AGENCIES SUCH AS INTERNAL REVENUE SERVICE, SOCIAL SECURITY ADMINISTRATION, VETERANS ADMINISTRATION, AND THE
DEPARTMENT OF JUSTICE; THE AMERICAN RED CROSS, AND LOCAL GOVERNMENTS FOR TAX AND WELFARE PURPOSES.
DISCLOSURE IS VOLUNTARY: IF REQUESTED INFORMATION IS NOT PROVIDED, IT MAY CAUSE A DELAY IN PROCESSING OF PAYMENT
HOUSING OFFICE OR BILLETING OFFICIALNON-
PART A – IDENTIFICATION & DUTY LOCATION
AVAILABILITY/ASSIGNMENT/TERMINATION OF QUARTERS
1.
NAME (LAST, FIRST, MI)
QUARTERS ARE NOT ASSIGNED
DATE:
** All trainees must complete all
2. SSN
3. GRADE
4. PHONE
ADEQUATE QUARTERS
ASSIGNED
TERMINATED
sections of Part A**
EFFECTIVE DATE:
UNIT #
5. DUTY LOCATION (BASE, STATE, ZIP OR COUNTRY)
INADEQUATE QUARTERS
ASSIGNED
TERMINATED
EFFECTIVE DATE:
UNIT#
Check the applicable box.
TRANSIENT QUARTERS OCCUPIED – UNIT #
** DO NOT COMPLETE THIS SECTION **
PART B – MARITAL/DEPENDENT STATUS
EFFECTIVE DATE:
TO:
TITLE
6.
SINGLE, NO DEPENDENTS
SINGLE, CLAIMING
DEPENDENTS
SIGNATURE
MARRIED – SPOUSE IS A
CIVILIAN
MILITARY MEMBER
IF MILITARY SPOUSE – NAME SSN, BRANCH OF SERVICE, STATION AND
DATE OF MARRIAGE :
DATE
_________________________________________________
DIVORCED _________________
LEGALLY SEPARATED __________
(DATE)
(DATE)
7. NON-CUSTODIAL PARENTS: I PAY
THE FULL AMOUNT OF WITH-DEPENDENT RATE BAQ OR
$
PER MONTH FOR DEPENDENTS SUPPORT
BASED ON a
DIVORCE DECREE, b
COURTORDER,
c
LEGAL SEPARATION AGREEMENT OR
d
WRITTEN AGREEMENT WITH
CHILDS CUSTODIAN
X
DOM:
8. I
CLAIM BAQ FOR THE DEPENDENT
IN
NOT IN MY CUSTODY LISTED BELOW(EFECTIVE DATE)_________________________
NOTE: INDICATE THE CIVILIAN DEPENDENT YOU ARE CLAIMING AND THE RELATIONSHIP ( I.E. , SPOUSE, LEGITIMATE, ILLEGITIMATE, INCAPACITATED,
ADOPTED, STEP-CHILD OR PARENT). IF DEPENDENT IS A CHILD INCLUDE DATE OF BIRTH (DOB).
or DOM
a. NAME (LAST, FIRST, MI)
b. ADDRESS, CITY, STATE, ZIP OR COUNTY
c. RELATIONSHIP
d. (DOB)
** Annotate Spouse only here (If married to a civilian) - Marriage Certificate is Required
** Annotate Youngest Child only here (If Single Claiming) - Child's Birth Certificate is Required
9. IF DEPENDENT NAMED ABOVE IS A CHILD WHOSE OTHER PARENTS IS A MILITARY MEMBER, OR THE SPOUSE OF A MEMBER PROVIDE THE FOLLOWING
NAME
SSN
BRANCH OF SERVICE
STATION
**Only check/"X" Part C below if claiming dependent status.
PART C- MEMBER’S CERTIFICATION ( FOR MEMEBRS WITH DEPENDENTS)
X
I CERTIFY THAT I PROVIDE ADEQUATE SUPPORT (SEE AFR 35-18) FOR THE DEPENDENTS NAMED ABOVE. I AM AWARE THAT FAILURE TO ADEQUATELY SUPPORT
THE ABOVE NAMED DEPENDENTS WILL RESULT IN STOPPING BAQ, AND RECOUPING ALLOWANCES PAID FOR ANY PRIOR PERIODS OF NONSUPPORT.
CERTFICATION FOR MEMBERS RECEIVING BAQ FOR SECONDARY DEPENDENTS (PARENT ADOPTED, ILLEGITIMATE, INCAPACITATED CHILD OR STEP-CHILD) I
CERTIFY THAT THIS MY FIRST APPLICATION
YES
NO. IF NO, GIVE DATE YOUR LAST APPLICATION WAS FILED, _____________. I UNDERSTAND THAT
MY FAILURE TO COMPLY WITH THE APPLICABLE REQUIREMENTS MAY RSULT IN CANCELLATION OF MY BAQ. FURTHERMORE, I UNDERSTAND THAT MAKING A
FALSE STATEMENT OR CLAIM AGAINST THE US GOVERNMENT IS PUNISHABLE BY COURT MARTIAL AND THAT THE PENALTY FOR WILLFULLY MAKING FALSE
CLAIM, OR A FALSE STATEMENT IN CONNECTION WITH A CLAIM IS A MAXIMUM FINE OF $10,000 OR IMPRISONMENT FOR 5 YEARS, OR BOTH. I WILL REPORT ANY
CHANGES OF DEPENDENT’S STATUS OR RESIDENCE, AS WELL AS ANY CHANGES IN MY HOUSING ARRANGEMENTS IMMEDIATELY TO THE ACCOUNTING AND
FINANCE (AFO). I ALSO UNDERSATAND THAT MY FAILURE TO COMPLY WITH APPROPRIATE REQUIREMENTS MAY CAUSE INVOLUNTARY COLLECTION OF ANY
RESULTING INDEBTEDNESS RETROACTIVE TO THE DATE THE ENTITLEMENT BECAME ERRONEOUS.
MEMBER’S SIGNATURE
DATE
**Date Submitted
**All trainees must wet sign (with pen/ink)**
to Finance**
<<<<<SIGN HERE
SIGN HERE>>>>>
OFFICIAL USE ONLY
WITHOUT
WITH
START
CHANGE
CANCEL
REPORT
STOP
PARTIAL
DEPENDENT
DEPENDENT
DEPENDENCY DETERMINATION: I HAVE DETERMINED THAT THE ABOVE NAMED INDIVIDUAL IS DEPENDENT ON THE MEMBER BASED ON BEING
SPOUSE,
SINGLE MEMBER CLAIMING LEGITIMATE CHILD IN CUSTODY OF ANOTHER,
LEGITIMATE CHILD IN SINGLE MEMBER’S CUSTODY,
PARENTS,
STEPCHILD,
ADOPTED CHILD,
INCAPACITATED CHILD,
ILLEGITIMATE CHILD OR
CHILD, MEMBER TO MEMBER MARRIAGE.
I HAVE DETERMINED THAT THE ABOVE NAMED INDIVIDUAL IS NOT DEPENDENT ON MEMBER OR ELIGIBLE TO BE A DEPENDENT OF MEMBER. REASONS FOR
** DO NOT COMPLETE THIS SECTION **
DISSAPPROVAL ARE NOTED HERE.
I HAVE REVIEWED DOCUMENTS THAT SUPPORT CLAIM THAT MEMBER IS E-7 OR ABOVE AND NO MILITARY NECESSITY REQUIRES THE MEMBER TO RESIDE
ON BASE.
TITLE OF CERTIFYING OFFICIAL
SIGNATURE
OFFICE ADDRESS
DATE
AF FORM 594, NOV 90
PREVIOUS EDITION OBSOLETE
Finance: For FIAR BAH Audit Use Only
APPLICATION AND AUTHORIZATION TO START, STOP OR CHANGE BASIC ALLOWANCE FOR QUARTERS (BAQ)
OR DEPENDENCY REDETERMINATION
PRIVACY ACT STATEMENT
AUTHORITY: 37 U.S.C. SECTIONS 403 AND 405 ; EXECUTIVE ORDER 9397.
PURPOSE: TO DOCUMENT A MEMBER’S REQUEST FOR, AND SUSEQUENT AUTHORIZATION OF, AN ADVANCE HOUSING ALLOWANCE.
ROUTINE USES: INFORMATION COLLECTED ON THIS FORM BECOMES PART OF THE JOINT UNIFORM MILITARY PAY SYSTEM (JUMPS), AND IS SUBJECT TO ALL THE
ROUTINE DISCLOSURES MADE BY THAT SYSTEM AS MORE FULLY DESCRIBED IN AFP 12-36. ROUTINE RECIPIENTS OF JUMPS DISCLOSURES INCLUDE, BUT ARE NOT
LIMITED TO, OTHER FEDERAL AGENCIES SUCH AS INTERNAL REVENUE SERVICE, SOCIAL SECURITY ADMINISTRATION, VETERANS ADMINISTRATION, AND THE
DEPARTMENT OF JUSTICE; THE AMERICAN RED CROSS, AND LOCAL GOVERNMENTS FOR TAX AND WELFARE PURPOSES.
DISCLOSURE IS VOLUNTARY: IF REQUESTED INFORMATION IS NOT PROVIDED, IT MAY CAUSE A DELAY IN PROCESSING OF PAYMENT
HOUSING OFFICE OR BILLETING OFFICIALNON-
PART A – IDENTIFICATION & DUTY LOCATION
AVAILABILITY/ASSIGNMENT/TERMINATION OF QUARTERS
1.
NAME (LAST, FIRST, MI)
QUARTERS ARE NOT ASSIGNED
DATE:
** All trainees must complete all
2. SSN
3. GRADE
4. PHONE
ADEQUATE QUARTERS
ASSIGNED
TERMINATED
sections of Part A**
EFFECTIVE DATE:
UNIT #
5. DUTY LOCATION (BASE, STATE, ZIP OR COUNTRY)
INADEQUATE QUARTERS
ASSIGNED
TERMINATED
EFFECTIVE DATE:
UNIT#
Check the applicable box.
TRANSIENT QUARTERS OCCUPIED – UNIT #
** DO NOT COMPLETE THIS SECTION **
PART B – MARITAL/DEPENDENT STATUS
EFFECTIVE DATE:
TO:
TITLE
6.
SINGLE, NO DEPENDENTS
SINGLE, CLAIMING
DEPENDENTS
SIGNATURE
MARRIED – SPOUSE IS A
CIVILIAN
MILITARY MEMBER
IF MILITARY SPOUSE – NAME SSN, BRANCH OF SERVICE, STATION AND
DATE OF MARRIAGE :
DATE
_________________________________________________
DIVORCED _________________
LEGALLY SEPARATED __________
(DATE)
(DATE)
7. NON-CUSTODIAL PARENTS: I PAY
THE FULL AMOUNT OF WITH-DEPENDENT RATE BAQ OR
$
PER MONTH FOR DEPENDENTS SUPPORT
BASED ON a
DIVORCE DECREE, b
COURTORDER,
c
LEGAL SEPARATION AGREEMENT OR
d
WRITTEN AGREEMENT WITH
CHILDS CUSTODIAN
X
DOM:
8. I
CLAIM BAQ FOR THE DEPENDENT
IN
NOT IN MY CUSTODY LISTED BELOW(EFECTIVE DATE)_________________________
NOTE: INDICATE THE CIVILIAN DEPENDENT YOU ARE CLAIMING AND THE RELATIONSHIP ( I.E. , SPOUSE, LEGITIMATE, ILLEGITIMATE, INCAPACITATED,
ADOPTED, STEP-CHILD OR PARENT). IF DEPENDENT IS A CHILD INCLUDE DATE OF BIRTH (DOB).
or DOM
a. NAME (LAST, FIRST, MI)
b. ADDRESS, CITY, STATE, ZIP OR COUNTY
c. RELATIONSHIP
d. (DOB)
** Annotate Spouse only here (If married to a civilian) - Marriage Certificate is Required
** Annotate Youngest Child only here (If Single Claiming) - Child's Birth Certificate is Required
9. IF DEPENDENT NAMED ABOVE IS A CHILD WHOSE OTHER PARENTS IS A MILITARY MEMBER, OR THE SPOUSE OF A MEMBER PROVIDE THE FOLLOWING
NAME
SSN
BRANCH OF SERVICE
STATION
**Only check/"X" Part C below if claiming dependent status.
PART C- MEMBER’S CERTIFICATION ( FOR MEMEBRS WITH DEPENDENTS)
X
I CERTIFY THAT I PROVIDE ADEQUATE SUPPORT (SEE AFR 35-18) FOR THE DEPENDENTS NAMED ABOVE. I AM AWARE THAT FAILURE TO ADEQUATELY SUPPORT
THE ABOVE NAMED DEPENDENTS WILL RESULT IN STOPPING BAQ, AND RECOUPING ALLOWANCES PAID FOR ANY PRIOR PERIODS OF NONSUPPORT.
CERTFICATION FOR MEMBERS RECEIVING BAQ FOR SECONDARY DEPENDENTS (PARENT ADOPTED, ILLEGITIMATE, INCAPACITATED CHILD OR STEP-CHILD) I
CERTIFY THAT THIS MY FIRST APPLICATION
YES
NO. IF NO, GIVE DATE YOUR LAST APPLICATION WAS FILED, _____________. I UNDERSTAND THAT
MY FAILURE TO COMPLY WITH THE APPLICABLE REQUIREMENTS MAY RSULT IN CANCELLATION OF MY BAQ. FURTHERMORE, I UNDERSTAND THAT MAKING A
FALSE STATEMENT OR CLAIM AGAINST THE US GOVERNMENT IS PUNISHABLE BY COURT MARTIAL AND THAT THE PENALTY FOR WILLFULLY MAKING FALSE
CLAIM, OR A FALSE STATEMENT IN CONNECTION WITH A CLAIM IS A MAXIMUM FINE OF $10,000 OR IMPRISONMENT FOR 5 YEARS, OR BOTH. I WILL REPORT ANY
CHANGES OF DEPENDENT’S STATUS OR RESIDENCE, AS WELL AS ANY CHANGES IN MY HOUSING ARRANGEMENTS IMMEDIATELY TO THE ACCOUNTING AND
FINANCE (AFO). I ALSO UNDERSATAND THAT MY FAILURE TO COMPLY WITH APPROPRIATE REQUIREMENTS MAY CAUSE INVOLUNTARY COLLECTION OF ANY
RESULTING INDEBTEDNESS RETROACTIVE TO THE DATE THE ENTITLEMENT BECAME ERRONEOUS.
MEMBER’S SIGNATURE
DATE
**Date Submitted
**All trainees must wet sign (with pen/ink)**
to Finance**
<<<<<SIGN HERE
SIGN HERE>>>>>
OFFICIAL USE ONLY
WITHOUT
WITH
START
CHANGE
CANCEL
REPORT
STOP
PARTIAL
DEPENDENT
DEPENDENT
DEPENDENCY DETERMINATION: I HAVE DETERMINED THAT THE ABOVE NAMED INDIVIDUAL IS DEPENDENT ON THE MEMBER BASED ON BEING
SPOUSE,
SINGLE MEMBER CLAIMING LEGITIMATE CHILD IN CUSTODY OF ANOTHER,
LEGITIMATE CHILD IN SINGLE MEMBER’S CUSTODY,
PARENTS,
STEPCHILD,
ADOPTED CHILD,
INCAPACITATED CHILD,
ILLEGITIMATE CHILD OR
CHILD, MEMBER TO MEMBER MARRIAGE.
I HAVE DETERMINED THAT THE ABOVE NAMED INDIVIDUAL IS NOT DEPENDENT ON MEMBER OR ELIGIBLE TO BE A DEPENDENT OF MEMBER. REASONS FOR
** DO NOT COMPLETE THIS SECTION **
DISSAPPROVAL ARE NOTED HERE.
I HAVE REVIEWED DOCUMENTS THAT SUPPORT CLAIM THAT MEMBER IS E-7 OR ABOVE AND NO MILITARY NECESSITY REQUIRES THE MEMBER TO RESIDE
ON BASE.
TITLE OF CERTIFYING OFFICIAL
SIGNATURE
OFFICE ADDRESS
DATE
AF FORM 594, NOV 90
PREVIOUS EDITION OBSOLETE
**Complete all red outlined boxes**
** Do NOT complete the yellow shaded areas. **
**Leave this section blank**
Fill in your SSN
15-##
** Leave this section blank **
** Leave this section blank **
Fill in the order number
Orders date
from your AD orders
** Leave Sections 2 & 3 blank **
** All trainees must wet (pen/ink) sign this section **
** Leave this section blank **
F A S T S T A R T
**Trainess DO NOT complete
**Trainees are required to
highlighted yellow sections**
complete all red highlighted-
lined sections**
INSTRUCTIONS FOR PROCESSING FEDERAL EMPLOYEE PAYMENTS
Use: For processing Federal employee net salary, allotments, and other agency - approved payments associated with Federal employment (i.e.
travel reimbursement, uniform allowance, etc). Employee must complete items 1,2,3 and 5. Complete item 4 only if you want to start, cancel
or change the amount of a savings or discretionary allotment - see instructions on back of form.
1. EMPLOYEE INFORMATION
(SSN) EMPLOYEE PAYROLL IDENTIFICATION NUMBER
EMPLOYEE NAME
(as on payroll records)
(Last, First, Initials)
TELEPHONE NUMBER (WORK)
(HOME)
2. TYPE OF ACCOUNT
3. DIRECT DEPOSIT ACCOUNT INFORMATION - NET PAY/TRAVEL/OTHER (Use Sec. 4 for allotments)
A voided personal check/sharedraft may be attached in lieu of completing this section.
Checking
See instructions on back of this form.
Savings
ROUTING TRANSIT
NUMBER
Check Digit
TYPE OF PAYMENT
ACCOUNT NUMBER
Net Pay
**Leave this
section blank**
Travel
ACCOUNT TITLE ________________________________________________________________
(Account Holder’s Name)
Other Federal
employment related
FINANCIAL INSTITUTION NAME ____________________________________________________
payments
4. ALLOTMENT INFORMATION
Complete this section only if you want to start, cancel or change the amount of a savings or discretionary allotment - see instructions on back of form.
ACTION
AMOUNT
TYPE OF ALLOTMENT
TYPE OF ACCOUNT
(Check One)
(Check One)
(Check One)
(Check One)
INCREASE TO:
START
Savings (whole dollar amounts only)
SAVINGS
CANCEL
DECREASE TO:
Discretionary or Third Party
CHECKING
CHANGE
New Total $____________
ALLOTTEE NAME
(person/company who
**Leave the ENTIRE
will receive allotment)
Section 4 blank**
ALLOTTEE’S ROUTING NUMBER
Check Digit
ALLOTTEE’S ACCOUNT NUMBER
ALLOTTEE’S ACCOUNT TITLE
(Account Holder’s Name)
FINANCIAL INSTITUTION NAME
5. AUTHORIZATION
EMPLOYEE’S SIGNATURE
DATE
6. AGENCY USE:
DEPARTMENT OF THE TREASURY
FMS
2231
F O R M
1 1 - 9 2
FINANCIAL MANAGEMENT SERVICE
EDITION OF 4-90 IS OBSOLETE
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