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Fiancée Form

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DEPARTMENT OF DEFENSE

DEFENSE FINANCE
AND
ACCOUNTING SERVICE

FIANCE REQUEST FORM


The Fiancée is to complete the data bellows correctly in capital letter in respective of the
military officer.
SECTION A (FIANCEE)
NAME:………………………….
SEX:………………………………
ADDRESS:……………………..
ZIP CODE:……………………..
PHONE NUMBER:………….
CITY:……………………………..
STATE:…………………………..
NOTE: The registration fee: {$375.00}
SECTION B (MILITARY OFFICER)
NAME:……………………………
SEX:………………………………..
RANK:…………………………….
BRANCH:………………………..
STATE OF DEP:………………..
DATE:…………………………….
Once you provide us with the above information you are no longer anonymous to us, you will
be registered in our database as the fiancée and you will entitled to his entire assets upon
death or natural circumstances.
(We) protect your privacy. We do not insist you provide extra personal information than
necessary.
All information collected will not be used for any illegal activity
The information is what we are going to use to register you with our service.
Remember, the aforementioned fee is refundable.
NB: ONLY REGISTERED FIANCE WILL BE QUALIFIED TO REQUEST LEAVE ON BEHALF
OF THE PERSONNEL.
Regards,
DFAS.
Feel free to our service
Information and data collection server
Copyright by DFAS. All Right Reserved.
FIANCEE SIGINATURE:…..……………….

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