Army Forms Archive

DD Form 2864 — DD Form 2864, Voluntary Separation Incentive (VSI) Beneficiary Designation, September 2003

VSI Beneficiary Designation

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DD Form 2864 — a Department of Defense document. Title of record: DD Form 2864, Voluntary Separation Incentive (VSI) Beneficiary Designation, September 2003. Stated purpose: VSI Beneficiary Designation. Edition date not stated; 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.

Common users: service members regardless of branch, Defense civilian staff, and the offices that file, verify or retain the finished document.

When the form is filed is a matter of not stated and local instruction. The description here covers the document itself and how to obtain a copy.

Available formats: PDF. The form runs 1 pages and contains approximately 31 fillable fields.

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.

The xfdl release corresponds to IBM Lotus Forms. This format carried Department-wide form distribution for years and opens only in IBM Lotus Forms Viewer or a compatible client, not in a pdf reader.

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

  • Member name and grade.
  • 1.a. Name of first beneficiary (First, Middle Initial, Last).
  • 1.b. Address (include zip code).
  • 1.c. Social security number. Do not include dashes.
  • 1.d. Relationship (spouse, son, daughter, brother, sister, father, mother, other).
  • 1.e. Date of birth (4 digit year, 2 digit month, 2 digit day).
  • 1.f. Percent.
  • 1.a. Name of second beneficiary (First, Middle Initial, Last).
  • 1.b. Address (include zip code).
  • 1.c. Social security number.
  • 1.d. Relationship.
  • 1.e. Date of birth.
  • 1.f. Percent.
  • 1.a. Name of third beneficiary (First, Middle Initial, Last).
  • 1.b. Address (include zip code).
  • 1.c. Social security number.
  • 1.d. Relationship.
  • 1.e. Date of birth.
  • 1.f. Percent.
  • 1.a. Name of fourth beneficiary (First, Middle Initial, Last).
  • 1.b. Address (include zip code).
  • 1.c. Social security number.
  • 1.d. Relationship.
  • 1.e. Date of birth.

Order of completion: identification block first, substantive entries second, certification and signature last. The blank is laid out in that sequence and the sequence is not arbitrary — later entries often depend on data established in the header.

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.

Guidance for specific entries sits on the form face and in not stated; the directive is authoritative where the two do not agree.

The completed document moves to the office named in not stated or in local guidance. A retained copy is conventional practice.

Cross-referenced forms are found through the numbering system. The DD sequence is Department-level and unified, which means a number cited on the page identifies one document across the whole Department.

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.

Revision occurs when the prescribing directive is reissued, when the data collected changes, or when statutory notice language is amended. Verification of the edition date at download addresses all three.

This page distributes a published Department of Defense document and describes it. It is not a source of legal advice and makes no representation about acceptance of any completed form. Questions of applicability, eligibility or procedure belong to not stated, the servicing personnel office, or the office named in not stated.

Questions and answers

What is DD Form 2864?
DD Form 2864, Voluntary Separation Incentive (VSI) Beneficiary Designation, September 2003
Which edition is current?
Not stated by the publisher
Who is responsible for this form?
Not stated
In which formats can it be downloaded?
PDF

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