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Appendix C to Part 113

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2. TYPED NAME (Last, First, Middle initial)

b, SKGHATURE

DATE SIGNED

DD FORM 2653, NOV 94 (BACK)

Appendix D to Part 113

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Appendix D to Part 113

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of the court.

f. If you contest the involuntary allotment on any basis other than exigencies of military duty, you must return this form and your response to me. This form, the application package, and your response will then be returned to the deskonated DFAS (or Coast Guard Pay and Personnel Center) official who will consider your response and determine whenter to establish the involuntary alotment. The designated DFAS (or Coast Guard Pay and Personnel Center) official has decision authority on al issues other than exigencies of military duty.

DD FORM 2654, NOV 94

PAGE 2 OF 4 PAGES

Appendix D to Part 113

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12. MEMBER
.. SIGNATURE

8. DATE SIGNED

DD FORM 2654, NOV 94

PAGE 3 OF 4 PAGES NOTE: Commander must provide member a copy of this form within 5 days of mattery wont designated DFAS (or Coast Guard

Appendix D to Part 113

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Pay and Porsonnel Conter) official.

16. F THE APPLICANT CHOOSER TO APPEAL MY EXIGENCY DETERMMATION, THE APPEAL MUST BE SENT TO: .. TITLE OF APPEAL AUTHOSITY

b. STREET ADDRESS

CITY

d. STATE

CODE

17. COMMANDER OR DESIGNE a. SILATURE

b. SIGNATURE PLOCK

0, DATE SIGNED

DD FORM 2654, NOV 94

PAGE 4 OF 4 PAGES

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