Attachment 5 - DD2088 - Statement of Ecclesiastical Endorsement.pdf

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Catholic Priest Services
Solicitation number
FA251725Q0081
Issued by

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DD Form 2088 is a Statement of Ecclesiastical Endorsement used for verifying professional and ecclesiastical qualifications of Religious Ministry Professionals seeking appointment or change of status in Military Services chaplaincy. The form requires completion by an Ecclesiastical Endorsing Agent authorized to represent a religious organization, who verifies the prospect's credentials meet military chaplaincy standards per DoD Instruction 1304.28. The document is part of a solicitation for a Catholic Priest Services contract (Solicitation Number: FA251725Q0081) with Space Base Delta 1, involving endorsement of a religious professional for military chaplain service. The form contains sections for prospect information, religious organization details, and is protected under the Privacy Act of 1974, with disclosure being voluntary and used for professional qualification verification.

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DD FORM 2088, JAN 2019 Page 1 of 1

PREVIOUS EDITION IS OBSOLETE.

CUI (when filled in)

CUI (when filled in)

Controlled by: OUSD(P&R) CUI Category: PRVCY

LDC: FEDCON

POC: osd.pentagon.ousd-p-r.mbx.forms@mail.mil

(Updated 20250527)

STATEMENT OF ECCLESIASTICAL ENDORSEMENT

OMB No. 0704-0190 OMB approval expires 20270831

The public reporting burden for this collection of information, 0704-0190, is estimated to average 45 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE ABOVE ADDRESS. RETURN COMPLETED FORM TO CHIEF OF CHAPLAINS (ITEM 3).

PRIVACY ADVISORY

Disclosure of this information is voluntary and will be used to verify the professional and ecclesiastical qualifications of Religious Ministry Professionals for initial appointment or chaplains change of career status appointments as chaplains in the Military Services. This form is an essential element of a chaplain’s professional qualifications and will become part of a chaplain’s military personnel record. When completed, this form contains personally identifiable information and is protected by the Privacy Act of 1974, as amended.

For additional information, see the official military personnel records and accessions system of records notices, located at: Army Personnel (https://dpcld.defense.gov/Portals/49/Documents/Privacy/ SORNs/Army/A006-8-104-AHRC.pdf); Navy Personnel (http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570310/n01070-3/); Marine Corps Personnel (http:// dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570626/m01070-6/); Air Force Personnel (http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article- View/Article/569821/f036-af-pc-c/); Coast Guard Personnel (https://www.federalregister.gov/documents/2008/12/19/E8-29793/privacy-act-of-1974-united-states-coast-guard-014-military-pay-and-personnel-system-of-records); and DoD Accessions (https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-Wide-Notices/DOD-Wide-Article-List/).

1. ECCLESIASTICAL ENDORSING AGENT (Complete entire form)

a. AS THE ECCLESIASTICAL ENDORSING AGENT AUTHORIZED TO REPRESENT (Name of religious organization) (Item 4a)

, I HEREBY VERIFY THAT THE PERSON INDICATED IN SECTION 2,

BELOW, IS CREDENTIALED AND QUALIFIED FOR AN APPOINTMENT WITHIN THE MILITARY CHAPLAINCY (as indicated in blocks 2(j) and 2(k))

IN ACCORDANCE WITH THE STANDARDS CONTAINED IN DODI 1304.28. (Date of agent authorization - YYYYMMDD:)

b. TYPED OR PRINTED NAME (Last, First, Middle Initial) c. E-MAIL ADDRESS

d. ADDRESS. (1) STREET (Include apartment or suite number) (2) CITY (3) STATE (4) ZIP CODE

e. TELEPHONE (Include Area Code)

f. FAX NUMBER (Include Area Code)

g. SIGNATURE h. DATE SIGNED (YYYYMMDD)

2. PROSPECT INFORMATION. a. IS THIS AN INITIAL ENDORSEMENT? (X one) u YES NO

b. TYPED OR PRINTED NAME (Last, First, Middle Initial) c. SOCIAL SECURITY NUMBER (Last 4) d. TELEPHONE (Include area code)

e. ADDRESS. (1) STREET (Include apartment or suite number) (2) CITY (3) STATE (4) ZIP CODE

f. E-MAIL ADDRESS g. DATE OF BIRTH

(YYYYMMDD)

h. NUMBER OF YEARS OF PROFESSIONAL MINISTRY

EXPERIENCE PROSPECT HAS COMPLETED

i. NUMBER OF MONTHS OF PRIOR ACTIVE MILITARY SERVICE PROSPECT HAS COMPLETED

(1) OFFICER (2) ENLISTED

j. SOURCE OF ORDINATION/PROFESSIONAL CREDENTIALS k. DATE OF ORDINATION/PROFESSIONAL

CREDENTIALS (YYYYMMDD)

l. APPLICATION IS FOR (X one)

(1) CHAPLAIN CANDIDATE

(2) RESERVE

(3) NATIONAL GUARD

(4) ACTIVE DUTY (Army and Navy Only: X (a) or (b))

(a) Initial Active Duty - 3 Years

(b) Extended Active Duty - Indefinite

(5) WITHDRAWAL OF ENDORSEMENT

(6) RESERVE (AGR)

3. TO

a. CHIEF OF CHAPLAINS (X appropriate block)

(1) ARMY (2) NAVY

(3) AIR FORCE

b. ADDRESS. (1) STREET (Include apartment or suite number)

(2) CITY (3) STATE (4) ZIP CODE

4. FROM

a. TYPED OR PRINTED NAME OF RELIGIOUS ORGANIZATION GRANTING

RELIGIOUS MINISTRY PROFESSIONAL ENDORSEMENT

b. DATE OF CURRENT INTERNAL REVENUE CODE (IRC) 501(c)(3)

EXEMPT STATUS (YYYYMMDD)

c. EMPLOYER IDENTIFICATION

NUMBER (IRC)

d. TELEPHONE (Include Area Code) e. FAX NUMBER (Include Area Code)

f. ADDRESS. (1) STREET (Include apartment or suite number) (2) CITY (3) STATE (4) ZIP CODE

g. E-MAIL ADDRESS h. WEB SITE

5. COMMENTS

mailto:whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil https://dpcld.defense.gov/Portals/49/Documents/Privacy/SORNs/Army/A006-8-104-AHRC.pdf https://dpcld.defense.gov/Portals/49/Documents/Privacy/SORNs/Army/A006-8-104-AHRC.pdf http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570310/n01070-3/ http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570626/m01070-6/ http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570626/m01070-6/ http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/569821/f036-af-pc-c/ http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/569821/f036-af-pc-c/ https://www.federalregister.gov/documents/2008/12/19/E8-29793/privacy-act-of-1974-united-states-coast-guard-014-military-pay-and-personnel-system-of-records https://www.federalregister.gov/documents/2008/12/19/E8-29793/privacy-act-of-1974-united-states-coast-guard-014-military-pay-and-personnel-system-of-records https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-Wide-Notices/DOD-Wide-Article-List/

DD FORM 2088, JAN 2019

Page of

PREVIOUS EDITION IS OBSOLETE.

CUI (when filled in) Document classification when filled in is CUI CUI (when filled in) Document classification when filled in is CUI Controlled by: OUSD(P&R) CUI Category: PRVCY LDC: FEDCON POC: osd.pentagon.ousd-p-r.mbx.forms@mail.mil (Updated 20250527)

DD FORM XXXX (BACK), 20YYMMDD DRAFT

Page of

PREVIOUS EDITION IS OBSOLETE.

CUI (when filled in) Document classification when filled in is CUI CUI (when filled in) Document classification when filled in is CUI (Updated 20250527)

INSTRUCTIONS

PREVIOUS EDITION IS OBSOLETE.

DD FORM XXXX, 20YYMMDD DRAFT

Page of

STATEMENT OF ECCLESIASTICAL ENDORSEMENT

OMB No. 0704-0190 OMB approval expires 20270831 The public reporting burden for this collection of information, 0704-0190, is estimated to average 45 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE ABOVE ADDRESS. RETURN COMPLETED FORM TO CHIEF OF CHAPLAINS (ITEM 3).

PRIVACY ADVISORY

Disclosure of this information is voluntary and will be used to verify the professional and ecclesiastical qualifications of Religious Ministry Professionals for initial appointment or chaplains change of career status appointments as chaplains in the Military Services. This form is an essential element of a chaplain’s professional qualifications and will become part of a chaplain’s military personnel record. When completed, this form contains personally identifiable information and is protected by the Privacy Act of 1974, as amended.

For additional information, see the official military personnel records and accessions system of records notices, located at: Army Personnel (https://dpcld.defense.gov/Portals/49/Documents/Privacy/SORNs/Army/A006-8-104-AHRC.pdf); Navy Personnel (http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570310/n01070-3/); Marine Corps Personnel (http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570626/m01070-6/); Air Force Personnel (http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/569821/f036-af-pc-c/); Coast Guard Personnel (https://www.federalregister.gov/documents/2008/12/19/E8-29793/privacy-act-of-1974-united-states-coast-guard-014-military-pay-and-personnel-system-of-records); and DoD Accessions (https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-Wide-Notices/DOD-Wide-Article-List/).

1. ECCLESIASTICAL ENDORSING AGENT (Complete entire form)

a. AS THE ECCLESIASTICAL ENDORSING AGENT AUTHORIZED TO REPRESENT (Name of religious organization) (Item 4a)

, I HEREBY VERIFY THAT THE PERSON INDICATED IN SECTION 2,

BELOW, IS CREDENTIALED AND QUALIFIED FOR AN APPOINTMENT WITHIN THE MILITARY CHAPLAINCY (as indicated in blocks 2(j) and 2(k)) IN ACCORDANCE WITH THE STANDARDS CONTAINED IN DODI 1304.28. (Date of agent authorization - YYYYMMDD:)

2. PROSPECT INFORMATION. a. IS THIS AN INITIAL ENDORSEMENT? (X one) u

i. NUMBER OF MONTHS OF PRIOR ACTIVE MILITARY SERVICE PROSPECT HAS COMPLETED

k. DATE OF ORDINATION/PROFESSIONAL

l. APPLICATION IS FOR (X one)

3. TO

a. CHIEF OF CHAPLAINS (X appropriate block)

4. FROM

9.0.0.2.20120627.2.874785 DD Form 2088, "Statement of Ecclesiastical Endorsement"

CurrentPage:
PageCount:
4. FROM - h. WEB SITE:
I HEREBY VERIFY THAT THE PERSON INDICATED IN SECTION 2, BELOW, IS CREDENTIALED AND QUALIFIED FOR AN APPOINTMENT WITHIN THE MILITARY CHAPLAINCY (as indicated in blocks 2(j) and 2(k)) IN ACCORDANCE WITH THE STANDARDS CONTAINED IN DODI 1304.28. (Date of agent authorization - YYYYMMDD:):
1. ECCLESIASTICAL ENDORSING AGENT - g. SIGNATURE:
1. ECCLESIASTICAL ENDORSING AGENT - h. DATE SIGNED (YYYYMMDD):
2. PROSPECT INFORMATION. a. IS THIS AN INITIAL ENDORSEMENT? (X one) - Select for "yes.": 0
2. PROSPECT INFORMATION. a. IS THIS AN INITIAL ENDORSEMENT? (X one) - Select for "no.": 0
2. PROSPECT INFORMATION. - g. DATE OF BIRTH (YYYYMMDD):
2. PROSPECT INFORMATION. - h. NUMBER OF YEARS OF PROFESSIONAL MINISTRY EXPERIENCE PROSPECT HAS COMPLETED :
2. PROSPECT INFORMATION. - i. NUMBER OF MONTHS OF PRIOR ACTIVE MILITARY SERVICE PROSPECT HAS COMPLETED - (1) OFFICER :
2. PROSPECT INFORMATION. - i. NUMBER OF MONTHS OF PRIOR ACTIVE MILITARY SERVICE PROSPECT HAS COMPLETED - (2) ENLISTED :
2. PROSPECT INFORMATION. - k. DATE OF ORDINATION/PROFESSIONAL CREDENTIALS (YYYYMMDD):
2. PROSPECT INFORMATION. - l. APPLICATION IS FOR (X one) - Select for "(1) CHAPLAIN CANDIDATE": 0
2. PROSPECT INFORMATION. - l. APPLICATION IS FOR (X one) - Select for "(2) RESERVE": 0
2. PROSPECT INFORMATION. - l. APPLICATION IS FOR (X one) - Select for "(3) NATIONAL GUARD": 0
2. PROSPECT INFORMATION. - l. APPLICATION IS FOR (X one) - Select for "(4) ACTIVE DUTY (Army and Navy Only: X (a) or (b))": 0
2. PROSPECT INFORMATION. - l. APPLICATION IS FOR (X one) -NAVY ONLY - Select for "(a) Initial Active Duty - 3 Years": 0
2. PROSPECT INFORMATION. - l. APPLICATION IS FOR (X one) - NAVY ONLY - Select for "(b) Extended Active Duty - Indefinite": 0
2. PROSPECT INFORMATION. - l. APPLICATION IS FOR (X one) - Select for "(5) WITHDRAWAL OF ENDORSEMENT ": 0
2. PROSPECT INFORMATION. - l. APPLICATION IS FOR (X one) - Select for "(6) RESERVE (AGR)": 0
3. TO - a. CHIEF OF CHAPLAINS (X appropriate block) - Select for "(1) ARMY": 0
3. TO - a. CHIEF OF CHAPLAINS (X appropriate block) - Select for "(2) NAVY": 0
3. TO - a. CHIEF OF CHAPLAINS (X appropriate block) - Select for "(3) AIR FORCE": 0
Enter comments.:
4. FROM - b. DATE OF CURRENT INTERNAL REVENUE CODE (IRC) 501(c)(3) EXEMPT STATUS (YYYYMMDD):
4. FROM - c. EMPLOYER IDENTIFICATION NUMBER (IRC):

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