DoD · Official form

DD Form 2656-5, Reserve Component Survivor Benefit Plan (RCSBP) Election Certificate

DD Form 2656-5 records a Guard or Reserve member’s Reserve Component Survivor Benefit Plan election after receiving the 20-year Notification of Eligibility. Fill in the official PDF below and download it.

This is the genuine DoD PDF, unmodified. Source: DoD official page.

What is DD Form 2656-5?

DD Form 2656-5, Reserve Component Survivor Benefit Plan Election Certificate, is how a National Guard or Reserve member with 20 qualifying years chooses survivor coverage before reaching retired pay age. When the member receives the Notification of Eligibility for retired pay (the 20-year letter), the form lets them elect when RCSBP coverage would begin and who it would cover.

The election choices are commonly described as Option A (decline coverage until age 60), Option B (an annuity that would begin on what would have been the member’s 60th birthday), and Option C (an immediate annuity beginning on the member’s death). Because the election affects a surviving spouse’s income, spouse concurrence is generally required when the member elects less than full immediate coverage.

Who files DD Form 2656-5?

  • National Guard and Reserve members who have just received their 20-year Notification of Eligibility
  • Members updating beneficiary information after a marriage, divorce, or birth of a child
  • Members electing coverage for a spouse, spouse and children, children only, or an insurable interest
  • Retirement services and personnel staff who process RCSBP elections for their component

How to fill out DD Form 2656-5

  1. Fill in your personal and service information and the date you received the Notification of Eligibility.
  2. Choose your election option and the beneficiary category the coverage will apply to.
  3. Provide dependent information for the spouse or children the election covers.
  4. Obtain the spouse’s notarized or witnessed concurrence if you elect anything less than full immediate coverage.
  5. Download the PDF and return it to your Reserve component’s personnel or retirement services office within the deadline stated on your notification letter.
Worth knowing: The election window on your Notification of Eligibility is strict, and spouse concurrence rules apply to reduced coverage. Route the completed form through your Reserve component’s retirement services office, and keep proof of the date you submitted it.

Quick fill DD Form 2656-5 on this page

Prefer to see the form itself while you type? Open DD Form 2656-5 in the editor to fill it on the actual pages, add a signature, and download.

These are the form's own fields, in the order they appear on the pages. Fill in what you know; anything left blank stays a fillable field in the PDF, so you can finish it in any PDF reader. Nothing you type here is sent to DoD.

Page 1 41 fields
Page 2 20 fields
Page 3 15 fields

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Frequently asked questions

What happens if I never send the form back?

The election window that starts with your Notification of Eligibility is limited, generally 90 days. Missing it does not end the matter, but it removes choices: married members who make no valid election are typically covered automatically at the full level. Read your letter and confirm with your component’s retirement services office.

Can I change my RCSBP election later?

Elections are largely irrevocable once the window closes, with narrow exceptions for events such as divorce, remarriage, or specific open seasons authorized by Congress. Treat the election as permanent when you make it.

Is RCSBP the same as SBP?

They are related. SBP covers members who retire from active service; RCSBP extends similar protection to Guard and Reserve members during the years between qualifying for retirement and reaching retired pay age.