PRIVACY ACT STATEMENT
In accordance with the Privacy Act of 1974 (Public Law 93-579), this notice informs you of the purpose for collection of information on this form. Please read it before completing the form.
AUTHORITY: 10 U.S.C 3013, Secretary of the Army, 10 U.S.C. 5013, Secretary of the Navy, 10 U.S.C. 5043, Commandant of the Marine Corps, 10 U.S.C. 8013, Secretary of the Air Force; 44 U.S.C. 3101, Records Management by Federal Agencies; DoDD 1300.15, Military Funeral Support; DoDD 1300.22, Mortuary Affairs Policy; DoDI 1300.18, Personnel Casualty Matters, Policies, and Procedures; E.O. 9397 (SSN), as amended; and SORN A0600-8-1c AHRC DoD.
PRINCIPAL PURPOSE: The primary purpose of this form is to obtain information to conduct and support funeral honors for deceased Marine Corps personnel.
ROUTINE USES: Information may be accessed by Marine Corps personnel with a need to know in order to meet the purpose. Information may be disclosed to individuals and organizations authorized to provide services to the individual. A complete list and explanation of the applicable routine uses is published in the authorizing SORN available at: https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570058/a0600-8-1cahrc-dod/.
DISCLOSURE: Voluntary. However, failure to provide the requested information may result in a delay in the provision of funeral honors for the deceased service member.
RECORD MANAGEMENT: This form shall be managed in accordance with record schedule 5360.2a, "Death and Funeral Records" of SECNAV M-5210.1.