Acceptable documents for proof of Personal Expenses Paid

List personal expenses for the claimed dependent. Do not list personal expenses for the sponsor, the sponsor’s immediate family that is not the claimed dependent, or any other person. Documentation to show proof of personal expenses paid is required. Any substantiating documentation submitted must be dated within the past 12 months of receipt of application.

DD 137 Form Requests:

• Clothing - Average monthly cost associated with clothing purchases.
• Laundry - Any expense associated with keeping the dependent’s clothing clean. (For example:  cleaning products, laundromat expenses, dry cleaning expenses, etc.)
• Medical - All out-of-pocket medical expenses. (For example: co-pays, for doctor visits and prescriptions, over the counter medications, first aid items, medical equipment, etc.)
• Value of USIP Card - This is the benefit the dependent realizes from having the USIP/ID card.
  • Realized value and supporting documentation include medical expenses covered by Tricare (supported by Explanation of Benefit (EOB) statements from Tricare), value of medical visits to a military medical facility (supported by Medical Cost Estimate from the military medical facility’s patient administration office), decreased medication costs (supported by either an EOB from Tricare or a statement from your pharmacy).
• Personal Insurance - Premiums paid for any insurance for the dependent (For example: life, health, dental, etc.)
• Personal Taxes - Any taxes the dependent pays. (For example: payroll taxes the dependent pays)
• Private Auto Payment - The dependent’s total vehicle payments.
  • Only list vehicles registered in the claimed dependent’s name. (Exception: the purchase of a handicap accessible vehicle for the claimed dependent can be claimed if registered in the sponsor’s name.)
• Transportation - All expenses related to transporting the claimed dependent from one location to another regardless of the destination (For example: bus and cab fare, gas, oil, tires, vehicle maintenance, etc.)
• Other - Any amount listed should be itemized in the remarks section of the DD Form 137 and a dollar figure provided for each one. This expense includes all personal expenses that are not already accounted for on the form. (For example: personal hygiene items, entertainment (movies, going out to eat, hobbies, etc.), haircuts, food items specific to the dependent, special needs equipment, storage, etc.)

Acceptable Documents to show Proof of Personal Expenses Paid:

• Annual tax return showing amounts paid.
• Court order showing required payments.
• Receipt(s) - Agencies reserve the right to examine receipts and remove unapproved items
• Invoices/Purchase receipts marked paid by the vendor
• Bills along with form of payment (For example: Cancelled check—front & back, credit card statement,  or bank statement—highlighting the transaction amount)
• Vehicle registration / License renewal forms
• Documentation from Tricare showing medical expenses paid.
• Medical or Dental records showing amount paid.
  • Including insurance statements showing out of pocket costs paid and payment from claimed dependents: Flexible spending account (FSA), Health reimbursement account (HRA), Health savings account (HSA), Medical savings account (MSA), Health Flexible Spending Account (HFSA), Dependent Care FSA (DCFSA), etc.
• Daycare records showing amount paid.
• Qualified Education Expenses - National Student Clearinghouse, School Billing Statement, or School Register documentation that shows amounts paid for tuition, school fees, student activity fees, and other related expenses that are required for enrollment in school.
  • Receipts, credit card statements and/or bank statements, to support expenses for books, supplies, equipment the student needs for a course of study.

DFAS cannot accept the following documents to show Proof of Personal Expenses Paid:

• Cash contributions
• ATM withdrawal receipts
• Bank statements showing withdrawals to unknown source(s)