Form DD-2088 Appointment of Chaplains for the Military Services

OMB Number 0704-0190
OMB approval expires

STATEMENT OF ECCLESIASTICAL ENDORSEMENT

The public reporting burden for this collection of information is estimated to average 45 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services, Executive Services Directorate, Information Management Division, 1155 Defense
Pentagon, Washington, DC 20301-1155 (0704-0190). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with
a collection of information if it does not display a currently valid OMB control number.

PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE ABOVE ORGANIZATION. RETURN COMPLETED FORM TO CHIEF OF CHAPLAINS (ITEM 2).

PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. Sections 136, 533(a)(1), 643, 827, 3353(a)(1), and 5600(a)(1); DoD Directive 1304.19; DoD 1304.28; and E.O. 9397, as amended (SSN).
PRINCIPAL PURPOSE(S): The information collected on this form is used to verify the professional and ecclesiastical qualifications of Religious Ministry Professionals for
initial appointment or chaplains change of career status appointments as chaplains in the Military Services. This form is an essential element of a chaplain's professional
qualifications and will become part of a chaplain's military personnel record. Completed forms are covered by recruiting and official military personnel file SORNs
maintained by each of the Services.
ROUTINE USE(S): The DoD "Blanket Routine Uses" found at http://privacy.defense.gov/blanket_uses.shtml apply to this collection.
DISCLOSURE: Voluntary. However, failure to provide the requested information may significantly delay the processing of this endorsement.

1. FROM (To be completed by Endorsing Agent)
a. TYPED OR PRINTED NAME OF RELIGIOUS ORGANIZATION GRANTING
RELIGIOUS MINISTRY PROFESSIONAL ENDORSEMENT

f. ADDRESS. (1) STREET (Include apartment or suite number)
g.

E-MAIL ADDRESS

c. EMPLOYER IDENTIFICATION
NUMBER (IRC)

d. TELEPHONE (Include Area Code)

e. FAX NUMBER (Include Area Code)

(2) CITY

(3) STATE

N E E D S

h. WEB SITE

D D

(4) ZIP CODE

6 7

b. ADDRESS. (1) STREET (Include apartment or suite number)

2. TO
a. CHIEF OF CHAPLAINS
(X appropriate block)

b. DATE OF CURRENT INTERNAL
REVENUE CODE (IRC) 501(c)(3)
EXEMPT STATUS

(1) ARMY
(2) NAVY

(2) CITY

(3) STATE

(4) ZIP CODE

(3) AIR FORCE

3. PROSPECT INFORMATION. a. IS THIS AN INITIAL ENDORSEMENT? (X one)

NO

YES

b. TYPED OR PRINTED NAME (Last, First, Middle Initial)

c. SOCIAL SECURITY NUMBER

d. TELEPHONE (Include Area Code)

e. ADDRESS. (1) STREET (Include apartment or suite number)

(2) CITY

(3) STATE

f.

(4) ZIP CODE

E-MAIL ADDRESS

g. NUMBER OF YEARS OF PROFESSIONAL MINISTRY
EXPERIENCE PROSPECT HAS COMPLETED
i. APPLICATION IS FOR
(X one)

h. NUMBER OF MONTHS OF PRIOR ACTIVE MILITARY SERVICE PROSPECT HAS COMPLETED
(1) OFFICER

(2) ENLISTED

(1) RESERVE (Non-Active Duty)

(4) EXTENDED ACTIVE DUTY (Indefinite)

(2) NATIONAL GUARD

(5) REGULAR COMMISSIONED OFFICER

(3) INITIAL ACTIVE DUTY (3 years)

(6) RESERVE (AGR)

4. ECCLESIASTICAL ENDORSING AGENT (To be completed by Endorsing Agent)
a. AS THE ECCLESIASTICAL ENDORSING AGENT AUTHORIZED TO REPRESENT

,

(Name of religious organization) (Item 1)

I HEREBY VERIFY THE ABOVE PROSPECTIVE CANDIDATE TO BE PROFESSIONALLY QUALIFIED AS A RELIGIOUS MINISTRY
PROFESSIONAL FOR THE MILITARY CHAPLAINCY.
b. TYPED OR PRINTED NAME (Last, First, Middle Initial)

c. E-MAIL ADDRESS

d. ADDRESS. (1) STREET (Include apartment or suite number)

(2) CITY

e. TELEPHONE
(Include Area Code)

f. FAX NUMBER
(Include Area Code)

g. SIGNATURE

(3) STATE

(4) ZIP CODE

h. DATE SIGNED (YYYYMMDD)

5. COMMENTS

DD FORM 2088, 20110525 DRAFT

PREVIOUS EDITION IS OBSOLETE.

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