ENCLOSURE (2) TO COMDTINST 1754.9A
REIMBURSEMENT REGISTRATION FOR ADOPTION EXPENSES
(See Privacy Act Statement on Reverse)
I hereby register my intention to apply for reimbursement of adoption expenses under the
provisions of COMDTINST 1754.9 (series), Reimbursement of Adoption Expenses. I am an active
duty member of the United States Coast Guard on continuous active duty for at least 180 days. The
date of my home study report was: _____________________. Documentation supporting this
event is furnished. (A letter stipulating the dates of the home study report and the placement of the
child from the agency, is sufficient for this purpose.)
To the best of my knowledge, no other military member has requested or will request
reimbursement for expenses related to the adoption of the same child. I understand that
reimbursement is limited to ,000 per child with a maximum reimbursement to one member of
,000 in any calendar year, or couples where both spouses are members of the armed forces.
DEPT. OF TRANSP., USCG, CG-5553 (10-92)
LOCAL REPRO
Previous Page
