Periodic Certification of Full-Time School Attendance Form
Individuals between the ages of eighteen (18) and twenty-two (22) who receive a survivor annuity as a student-child must file periodic certification to indicate that they are pursuing a full-time course of resident study or training in a recognized educational institution. DCRB must verify that the child survivor has resumed school attendance within five (5) months after the end of the past school year. DCRB also needs to update the information on the student's plans for school attendance after the current school year. If you receive a survivor annuity as a student-child, you should complete the form below for each semester/quarter of enrollment and mail, email, or fax it to the DCRB Member Services Center.