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Defense Department form, series DD, number 2656-6. Full title: DD Form 2656-6, SBP Election Change Certificate, April 2009. Function: Survivor Benefit Plan Election Change Certificate. Edition in force: not stated. Publisher status: not stated.
Prescribing authority: not stated. Proponent: not stated. Unlike service-specific publications, DD forms carry Department-level authority and apply across the Army, Navy, Air Force, Marine Corps, Space Force and Coast Guard when operating under Defense jurisdiction.
The form reaches military personnel across the services, civilian employees of the Department, and the personnel and records specialists who receive it.
Timing of submission is fixed by not stated and by the implementing guidance of the submitting organization. What follows describes the blank document, not agency procedure.
Formats offered: PDF. Length: 2 pages. Fillable field count: roughly 58.
The pdf is the primary distribution format. A fillable pdf accepts typed entries in defined field boxes and stores them in the file; a printable pdf is a flat image of the blank, meant for pen entry after printing. The distinction matters for legibility and for records that pass between offices.
An xfdl file is provided as well. Xfdl is the IBM Lotus Forms format, historically standard across Defense form distribution, and it requires IBM Lotus Forms Viewer or an equivalent reader; ordinary pdf software will not open it.
Every listed format is free to download. Modern pdf software handles the pdf files, with the caveat that browser-embedded viewers sometimes ignore field properties that a desktop reader honours.
What the form asks for
- 3. Date of retirement: 4 digit year, 2 digit month, 2 digit day.
- 4. Date of birth: 4 digit year, 2 digit month, 2 digit day.
- 5. mailing address: street, apartment number, city, state and zip code.
- 6. Telephone number, include area code.
- Section 2 - Current coverage. 7. My current coverage is: Press space bar to mark X in first box if no coverage, second box if spouse only, third box if child only, fourth box if spouse and child, fifth box if insurable interest, sixth box if former spouse, seventh box if former spouse and child, or eighth box if suspended coverage.
- Section 3 - Conditions that trigger eligibility to change coverage. 8. I am requesting a change in coverage based on: Mark X if marriage.
- Mark X if remarriage.
- If remarriage, X first box if resume existing coverage, second box if increase coverage, third box if not resume coverage, or fourth box if coverage for new spouse if current coverage is for former spouse.
- Mark X if acquiring a dependent child.
- Mark X if divorce.
- Mark X if death of spouse.
- Section 1 - Member Information. 1. Name: last, first, middle initial.
- 2. Social security number. Do not include dashes.
- Section 4 - Requested change to coverage. 9. Indicate new coverage election by marking X in first box if resume existing coverage, second box if spouse only, third box if spouse and child(ren), fourth box if child(ren) only, or fifth box if suspend coverage.
- Section 5 - Level of Coverage. 10. Indicate monthly amount coverage will be based on. X first box if full retired pay, second box if reduced amount of retired pay.
- Enter reduced monthly amount of retired pay (cannot be less than $300.00).
- Section 6 - Spouse and children information. 11.a. Spouse's name: last, first, middle initial.
- 11.b. Social security number.
- 11.c. Date of birth: 4 digit year, 2 digit month, 2 digit day.
- 12. Date of marriage: 4 digit year, 2 digit month, 2 digit day.
- 13. Dependent children. a. Name: last, first, middle initial, line 1 of 6.
- 13.b. Social security number.
- 13. c. Date of birth : 4 digit year, 2 digit month, 2 digit day.
- 13. d. Relationship. Son, daughter, stepson, etc. Indicate "FS" if from previous marriage.
Completion runs in the order printed on the page: identifying data at the head, the body of the entry next, certification at the foot. Header data frequently governs what belongs in the fields below it.
Verify the edition date against not stated before entry. Department-level revisions replace the blank across every service simultaneously, so an old copy in a desk drawer may no longer correspond to current field numbering.
Field-level instructions appear on the form itself and in not stated. The directive is the controlling text.
After completion, the copy goes to the office designated by not stated or by local procedure. Retention of a personal copy is ordinary practice and costs nothing.
Associated forms are traced by number within the series. Because the DD sequence is common to all military departments, no service qualifier is needed to identify a referenced form.
Where a DA form is cited alongside a DD form, the two belong to different systems: DA numbering is Army-specific and administered by an Army proponent, while DD numbering is Defense-wide under not stated or an equivalent Department office. Numbers do not translate between the systems.
Editions change because the underlying directive changes, because collection requirements are revised, or because Privacy Act language is updated. Checking the edition date at the point of download is the practical response.
The material here is descriptive. Nothing on the page constitutes legal or procedural advice, and no statement here determines whether a submitted form will be accepted. Such questions go to not stated, a servicing administrative office, or the authority identified in not stated.
Questions and answers
- What is DD Form 2656-6?
- DD Form 2656-6, SBP Election Change Certificate, April 2009
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?