Supplemental Instructions 

DD Form 2789 Waiver/Remission of Indebtedness Application 

When to use this form: 

The DD Form 2789 is used if the retiree or retired pay annuitant is indebted to the United States 

government due to an overpayment and wishes to request a waiver of said indebtedness. 

To complete the DD Form 2789, please follow the instructions below. Please note that an 

incomplete DD Form 2789 will delay the processing of the waiver consideration. Carefully 

read and complete all information as requested, and be sure to include any required 

documentation with your submission. If DFAS does not receive a valid DD Form 2789, the 

indebtedness will continue to be collected from the retired or annuity pay account. 

Instructions by Section

1. Type of claim (X one) Always “Waiver”

Section I – Civilian/Military/Retiree/Annuitant Information

Section Instructions

2. Name Debtor’s name: Last, First, Middle Initial 

3. Rank/Grade Retirees: Current rank/rate 

Annuitants: Not applicable (Mark N/A) 

4. Social Security Number Debtor’s Social Security Number 

5. Agency/Service Retirees: Mark branch of service 

Annuitants: Mark “Other” and specify Annuitant 

6. Status Retirees: Mark “Retired” and provide date of 

retirement 

Annuitants: Mark “Annuitant” 

7. Current Mailing Address Current mailing address 

8. Place of Assignment or Employment Retirees: Not applicable (Mark N/A) 

Annuitants: Not applicable (Mark N/A) 

9a. Work Telephone Work telephone number (if applicable) 

9b. Home Telephone Home and/or Cell telephone number 

9c. E-Mail Address E-Mail address (if applicable)

10. Type of Debt or Pay and Allowance 

Erroneously Paid 

Brief description of debt as stated in debt notification 

letter 

11. Gross Debt Amount Gross debt amount provided on debt notification letter 

12. State the date and how you first 

became aware of erroneous payment. 

Date debt notification letter (or other correspondence, 

if applicable) was received. Attach copy of 

notification letter. 

13. If you were aware of debt or 

erroneous payment, explain the 

actions you took to correct the 

situation. 

Explain any actions taken to correct debt or prevent 

debt from occurring. If needed, explanation can 

continue on additional pages. Any additional 

explanations and documentation showing your 

attempts should be submitted with completed form. 
14. Reason for requesting

Waiver/Remission and why you feel it

should be approved.

Explain why you think your waiver request should be 

approved. Submit any additional documentation 

with completed form. 

15. For annuitants, provide name, SSN, 

and date of deceased military 

member/sponsor. 

Retirees: Not Applicable (Mark N/A) 

Annuitants: State deceased spouse/sponsor’s full name, 

SSN, and date of death. 

16. Attach copies of all pertinent 

documents. 

Attach any supporting documentation from parts 

#12 through 14 

17a. If Military or Civilian, did you receive 

Leave and Earning Statement(s)? 

Retirees and Annuitants: Not Applicable 

17b. If Military or Civilian, did you 

request them on EMSS/MyPay? 

Retirees and Annuitants: Not Applicable 

17c. If Retiree or Annuitant, did you 

receive an Account Statement? 

Retirees and Annuitants: Mark “Yes” if you received 

an Account Statement regarding the debt. Mark “No” if 

you did not receive an Account Statement regarding the 

debt. If “Yes”, attach a copy of the statement covering 

before, during, and after notification. 

17d. If Retiree or Annuitant, did you 

review them? 

Retirees and Annuitants: Mark “Yes” if you reviewed 

the Account Statement. Mark “No” if you did not 

review the Account Statement. 

18. Have you filed for a Correction of 

Military Records? 

Retirees: Mark “Yes” if you have filed for a Correction 

to Military Record. Mark “No” if you have not filed for 

a Correction to Military Record. Annuitants: Not 

Applicable 

19a. Signature Retirees and Annuitants: Sign form if you certify that 

your statements on this form are true and correct to the 

best of your knowledge. An unsigned form is 

considered invalid, cannot be processes and will be 

returned. 

19b. Job Title/Career Field Retirees: Mark “Retired” 

Annuitants: Mark “Annuitant” 

19c. Date Signed Retirees and Annuitants: Mark date form was 

completed and signed. An undated form is considered 

invalid, cannot be processes and will be returned. 

Parts 20 through 31 – Administrative Use Only

RETIREES:

Please return all documents to: 

Defense Finance and Accounting Service 

U.S. Military Retired Pay

8899 E 56th Street

Indianapolis IN 46249-1200 
ANNUITANTS:

Please return all documents to: 

Defense Finance and Accounting Service 

U.S. Military Annuitant Pay

8899 E 56th Street

Indianapolis IN 46249-1300

Please direct questions to the address above or call our customer service representatives at 800-

321-1080.