Fillable Printable Authorization to Start, Stop or Change an Allotment
Fillable Printable Authorization to Start, Stop or Change an Allotment
Authorization to Start, Stop or Change an Allotment
AUTHORIZATION TO START, STOP OR CHANGE AN ALLOTMENT
PRIVACY ACT STATEMENT
AUTHORITY: 37 U.S.C., E.O. 9397.
PRINCIPAL PURPOSE: To permit starts, changes, or stops to allotments. To maintain a record of allotments and ensure starts, changes, and
stops are in keeping with member’s desires.
ROUTINE USES: Information may be released to computer service centers and other accounting services when such centers and services act as
authorized agents of organizations specified by the member to receive allotments. Disclosure may be made to the Federal Reserve System when
payment of allotment is made through the electronic fund transfer system to financial organizations. Records may also be disclosed to Congress;
allottees, Secret Service; General Accounting Office, Federal, State and local courts; U.S. Treasury; and to the Department of Justice, in some
cases for prosecution, civil litigation, or for investigative purposes.
DISCLOSURE: Voluntary; however, failure to provide the requested information as well as the SSN may result in the member not being able to
start, change, or stop allotments.
TO BE COMPLETED BY ALLOTTER
2. NAME OF ALLOTTER
(Last, First , Middle Initial)
(Print or type)
3. SSN 4. PAY GRADE
5. ADDRESS OF ALLOTTER
(Street or Box Number, City, State,
ZIP Code)
7. EFFECTIVE
DATE
(YYYYMM)
8. MONTHLY AMOUNT
OF ALLOTMENT
$
9. NAME OF ALLOTTEE
(First, Middle Initial, Last)
12. CREDIT LINE
(If applicable)
10. ALLOTMENT ACTION
(X one)
START STOP CHANGE
13. ALLOTMENT CLASS AUTHORIZED
(X one)
- OTHER
(Specify)
14. ALLOTTEE’S MAILING ADDRESS
(Street or Box Number,
City, State, ZIP Code)
15. IF FOREIGN ADDRESS COMPLETE AS FOLLOWS
(Province,
Country)
16. REMARKS
18. ACCOUNT NUMBER/POLICY NUMBER
19. TOTAL CLASS L AMOUNT
$
20. TOTAL CLASS T AMOUNT
$
21. SIGNATURE OF ALLOTTER 22. DATE
(YYYYMMDD)
NOTE 1. Must be different address than allotter. Each dependent allotment must have a different credit line. Only one support allotment per
dependent is allowed.
NOTE 2. This is a voluntary allotment and can be to any payee you desire.
DD FORM 2558, NOV 1996 (EG)
Designed using Perform Pro, WHS/DIOR, Nov 96
1. BRANCH OF SERVICE
(X one)
AIR FORCE
ARMY
MARINE CORPS
NAVY
6. DAYTIME TELEPHONE
NUMBER
(Include Area
Code)
11. TERM IN MONTHS
C - CHARITY/CFC
D - DISCRETIONARY ALLOTMENTS
(Includes dependent support, payment
to financial institution, insurance, repayment of home loan, rent, etc.
(Notes 1 and 2))
F - CHARITY - EMERGENCY/ASSISTANCE FUND CONTRIBUTION
L - REPAYMENT OF LOAN TO SERVICE ORGANIZATION
(Red Cross, Relief
Society, etc. - Navy and Marine Corps only)
N - NSLI OR USGLI INSURANCE PREMIUM
T - PAYMENT OF DEBTS TO U.S., DELINQUENT STATE OR LOCAL INCOME/
EMPLOYMENT TAXES
17. COMPANY CODE/FINANCIAL INSTITUTION/ROUTING
TRANSIT NUMBER
STATEMENT OF UNDERSTANDING
I understand that this allotment is legal and that by voluntarily completing this form, I am responsible for:
- Ensuring that the information is correct;
- Reviewing my Leave and Earnings Statement to ensure the allotment stops, starts, or changes as directed including amount and payee;
- Collecting overpayments from the receiver (payee) of the allotment, if I do not change or stop the allotment after a loan is repaid;
- Contacting the receiver (payee) of the allotment, at my expense, to obtain monthly statements for my personal records.
I also understand that any problems once the allotment is delivered to the receiver (payee) are beyond the control of the Defense Finance and
Accounting Service (DFAS) and that DFAS is only responsible for ensuring proper delivery of any voluntary allotment for the per iod directed. I
further understand that pursuant to conditions listed in the DoD 7000.14-R, Volume 7A, changes can be made by DFAS to an allottee’s name,
address, or account number.
PREVIOUS EDITION IS OBSOLETE.
