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Dd Form 1351-5

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Dd Form 1351-5
Dd Form 1351-5
DD FORM 1351-5, JUL 1999
GOVERNMENT QUARTERS AND/OR MESS
(See Privacy Act Statement and Instructions on back.)
PREVIOUS EDITION IS OBSOLETE.
1. TRAVELER'S NAME (Last, First, Middle Initial) 2. GRADE 3. SOCIAL SECURITY NUMBER 4. DATE OF STATEMENT
(YYYYMMDD)
4. QUARTERS
a. GOVERNMENT QUARTERS WERE NOT AVAILABLE TO THE ABOVE-NAMED MEMBER ON THE FOLLOWING DATES OR FOR THE FOLLOWING
PERIODS:
b. GOVERNMENT QUARTERS (were not) (will not be) AVAILABLE TO BOTH THE ABOVE-NAMED MEMBER AND HIS DEPENDENT(S) ON THE FOLLOWING
DATES OR FOR THE FOLLOWING PERIODS:
c. UTILIZATION OF GOVERNMENT QUARTERS BY THE ABOVE-NAMED MEMBER (is) (was) IMPRACTICABLE FOR THE FOLLOWING DATES OR THE
FOLLOWING PERIODS:
5. MESS
a. GOVERNMENT MESS WAS NOT AVAILABLE TO THE ABOVE-NAMED MEMBER FOR THE NUMBER OF MEALS SHOWN OPPOSITE EACH OF THE
FOLLOWING DATES OR PERIODS.
b. GOVERNMENT MESS (was not) (will not be) AVAILABLE TO BOTH THE ABOVE-NAMED MEMBER AND HIS DEPENDENT(S) FOR THE NUMBER OF
MEALS SHOWN OPPOSITE THE FOLLOWING DATES OR PERIODS.
c. UTILIZATION OF GOVERNMENT MESS AVAILABLE AT THIS STATION BY THE ABOVE-NAMED MEMBER (will be) (is) (was) IMPRACTICABLE FOR
THE NUMBER OF MEALS SHOWN OPPOSITE THE FOLLOWING DATES OR PERIODS.
d. OFFICERS' OPEN MESS WAS NOT AVAILABLE TO THE ABOVE-NAMED OFFICER FOR AT LEAST TWO MEALS ON THE FOLLOWING DATES
GOVERNMENT QUARTERS WERE AVAILABLE.
(1) DATE (YYYYMMDD) (2) NO. MEALS (1) DATE (YYYYMMDD) (2) NO. MEALS (1) DATE (YYYYMMDD) (2) NO. MEALS
6. REMARKS (Continue on back if more space is required.)
7. ISSUING ORGANIZATION AND STATION
8. AUTHORIZED APPROVING CERTIFYING OFFICER
a. TYPED NAME (Last, First, Middle Initial) b. GRADE c. TITLE d. SIGNATURE
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Dd Form 1351-5
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