Blank Dd214 Form Template

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NPRC can correct administrative errors (typographical or transposition) on DD Forms 214; however, amending military records (changing substantive information) is under the jurisdiction of the service department which created the record. This Center can also make corrections when directed by a separation activity.

Examples of such corrections include: misspelled name, wrong initial(s), reversed first and middle name, reversed first and last name, nickname cited rather than full legal name, incorrect date of birth, transposed digits of Social Security number or service number, etc. A DD Form 215 can correct an error(s) on a single DD Form 214. If the error(s)(example, date of birth) appears on more than one separation document, you must issue a DD Form 215 for each separation document that contains the error.

You may also add information such as medals, if the record indicates the individual was entitled to the medal.

INSTRUCTIONS FOR COMPLETING DD FORM 215, AS REVISED 2/2000

Army

Be sure to use the revised form. Previous versions are obsolete.

1. Blocks 1-4. The information you enter in blocks 1-4 of the DD Form 215 should be exactly as shown on the DD Form 214 that you are correcting, even if any of the information is wrong. The correction will be shown in block 5 of the DD Form 215.

2. Block 5. First, on the blank line below 'CORRECTED TO READ,' type the separation date (the 'effective date') shown on the separation document that you are correcting. Enter this date exactly as shown on the separation document, with a space between each number (or name of the month). For example, 76 12 13; or 2 Jan 71, or 73 Jan 2. (See the NOTE just below if you are correcting one of the old separation documents issued before DD Form 214 was first used.)

In the 'ITEM NUMBER' column in block 5, indicate which numbered item (or 'block') on the separation document is being corrected, and then enter the correct information in the 'CORRECTED TO READ' column, also in block 5. When preparing DD Form 215, if the record (or other official document) provides the veteran's middle name, then make a correction in block 5. (Example: Item #1, Is amended to read: SMITH, John Joseph). Sometimes items being corrected can be lengthy; therefore, it is acceptable to use the words 'DELETE' and 'ADD,' rather than typing all of the information that is shown in the item number you wish to correct. An example would be the 'Decorations/Medals' section of the DD Form 214, to which you may wish to 'ADD' a particular medal that had been overlooked when the DD Form 214 was prepared.

After the corrections have been completed, type the words 'LAST ENTRY' in the middle of the next line in block 5, immediately below the last line of corrections, and type a series of asterisks (*****) or dashes (-----) on both sides of the words 'LAST ENTRY.' This line, which indicates that there are no more corrections, should extend entirely across the form, from the left border to the right border.

NOTE: When correcting an 'old' separation document, (such as NAVPERS 553, NAVMC 78PD, or WD AGO 53-55), indicate this on the DD Form 215 by marking out (xxx) the words 'DD Form 214' on the line that says, 'Separation Date on DD Form 214 being corrected ________.' Then, directly above the words 'DD Form 214' that you have marked out, type the form number of the separation document that you are correcting.

3. Block 6. Type the eight digits for Block 6 in the order shown on the form, without spaces or slashes. For example, March 28, 2001, is written as 20010328. Below the date, type NARA. Do not add anything else to indicate that the DD Form 215 was prepared by NARA (such as a routing symbol or the initials of the person who typed the form). HOWEVER, if you send the form outside your branch/core to be signed, be sure to attach an NA Form 13098, Routing Slip, that clearly shows which core (branch) typed the form, the core or branch room number, and name of the person to whom the signed form is to be returned. Please print if necessary to ensure legibility.

4. Block 7. Type the name of the official authorized to sign, in block 7a as shown below. Note that the typed name is entered as last, first, middle initial. Type the name in all capitals, and if there is no middle initial, type (NMI). Place the NARA seal over the signature of the Core managers who sign DD Forms 215 for Air Force and Coast Guard veterans. The following are the names, grades, and titles to use:

BRANCH of SERVICETYPED NAMEGRADETITLE
NavyMARTIN, DENA M.GS-11HEAD, RETIRED RECORDS SECTION
Marine CorpsHUYNH, T. N.CW04MC LIAISON OFFICER, NPRC
Army1FARRISEE, GINA S.BGUSA Adjutant General
Air ForceLAST NAME, FIRST NAME, and MIDDLE INITIAL of core manager. If there is no middle initial, type (NMI).GS-12Manager, Reference Core (One, Two, Three, Four or Five), NPRC
Coast GuardLAST NAME, FIRST NAME, and MIDDLE INITIAL of core manager. If there is no middle initial, type (NMI).GS-12Manager, Reference Core (One, Two, Three, Four or Five), NPRC
1 The Army does not require a signature. However, the NARA seal must be affixed to the completed document.

ISSUING A SECOND DD FORM 215

A second DD Form 215 may be issued to correct the same DD Form 214. The second DD Form 215 is prepared and distributed in the same manner as the first. The file copy is stapled to the DD 214 that it corrects, along with the first DD Form 215. No more than two DD Forms 215 may be issued to correct the same DD Form 214. Issuance of a new DD Form 215 voids any prior DD Forms 215. When issuing a second DD Form 215, the following statement should be typed on the DD Form 215 being prepared: 'DD 215 issued (date issued) should be destroyed.' Include all previous corrections, in addition to the new corrections, on the new DD Form 215.

NOTE: Mark 'VOID' across the first DD Form 215 and retain it in the record. No changes or erasures may be made in the shaded areas of a DD Form 215.

If another change is ever needed to the same DD Form 214, it will be necessary for the service department to prepare a new DD Form 214.

DD FORM 215 DISTRIBUTION

Send 'Member-1' original to the veteran, plus 'Member-4' if the requester asks. Each core has its own procedures for collecting the 'Veterans Administration-3' and 'Department of Labor-5' copies, and mailing several at a time to the addresses shown in NPRC 1865.87. Other copies are retained in the OMPF unless the requester asks us to do otherwise.

Effective February 28, 2003, 'Department of Labor-5' copy will be mailed to:

Lockheed Martin Information Technology, U.S. Depart of Labor, Federal Claims Control Center, P.O. Box 785070, Orlando, FL 32878-5070

Source: NPRC 1865.87 and DoD Instruction 1336.1 with changes