PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
DD Form 2789
for the current year.
DD Form 2789 Waiver / Remission of Indebtedness Application
What Is DD Form 2789?
DD Form 2789, Waiver/Remission of Indebtedness Application is a form used by current, former, or retired civilian employees and active, separated, or retired service members and annuitants to request a waiver of indebtedness if that indebtedness was caused by an overpayment. In the case of enlisted members, the DD 2789 is filed to request a remission of these debts
The form - sometimes incorrectly referred to as the DA Form 2789 - was released by the Department of Defense (DoD) on May 1, 2008 , with all previous editions being obsolete.
The current edition of the form is unclassified and approved for public release. A DD Form 2789 fillable version is available for digital filing and download below{class="scroll_to"} or can be found through the Executive Services Directorate website.
How to Fill Out DD Form 2789?
The form is made up of two pages with no filing guidelines provided by the DoD. DD Form 2789 instructions are as follows:
- The type of claim identified in Block 1 should always be "Waiver." Remission is only applicable to active dutyenlisted personnel (see DoDFMR, Volume 7A for more information);
- The claimant has to provide their full name, rank or grade, and social security number in Blocks 2 through 4;
- Block 5 is for specifying the claimants' branch of service. Annuitants should check the "Other" box and specify their annuitant status;
- Block 6 requires the claimants status;
- The current mailing address of the claimant should be in Block 7. Annuitants and retirees should write N/A in Block 8, others should provide their place of assignment or employment. Block 9 is for specifying the applicant's work and home phone numbers and email address;
- The type of debt or pay should be specified in Block 10. The gross debt amount is entered in Block 11;
- The date and the consequences in which the claimant found out about the debt should be identified in Block 12. A notification or any additional documentation can be attached if needed;
- If the claimant was aware of the debt, they should provide the actions they took to correct the situation in Block 13;
- Any reasons for the request to be approved are provided in Block 14. Any supporting documentation must be attached to the form;
- Annuitants should fill Block 15 with name, social security number, and date deceased of military member or sponsor;
- All supporting documentation for Blocks 12 through 14 should be listed in Block 16;
- Block 17 contains a set of questions with yes-or-no answers. Negative answers should be explained;
- Block 18 specifies whether the claimant has requested military records correction;
- The claimant provides their signature, the date of filing the form, and their job title in Block 19;
- Blocks 20 through 22 and the entire Section II - Report of Investigation - are for administrative use only.
Download DD Form 2789 Waiver / Remission of Indebtedness Application
1
2
