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Direct Premium Remittance System (DPRS)

Signature Date Field Instruction

Signature Date

Select the calendar icon for the date that the enrollee signed the SF 2809. Each down arrow displays a list; select the correct year, month, and date.

Note: Only the calendar icon can be used to enter dates. Must select year and month, then select calendar date. It is important that you follow the order; otherwise, the calendar will automatically go back to the current date.

See Also

Field Instructions

Account Type Field Instruction

Action Effective Date Field Instruction

Add Registration SF2809 Field Instruction

Address Field Instruction

Address 1 Field Instruction

Address 2 Field Instruction

Cell Phone Field Instruction

City Field Instruction

Claim Number Field Instruction

Complete (Registration) Field Instruction

Confirm New Password Field Instruction

Correct Registration SF2809 Field Instruction

Country Field Instruction

Current Enrollment Plan Field Instruction

Date Field Instruction

Date of Birth Field Instruction

Date of Certification Field Description

Date Received Field Instruction

Delete (Registration) Field Instruction

Delete Field Instruction

DOB Field Instruction

DOD Activity Field Instruction

DOD Component Field Instruction

DOD Location Field Instruction

Domestic Field Instruction

Edit Field Instruction

Effective Date Field Description

Email Field Instruction

Enter New Password Field Instruction

Event Code Field Description

Event Date Field Instruction

First Name (Certifying Official) Field Description

First Name Field Instruction

Home Phone Field Instruction

Insurance Policy Number Field Instruction

Last Date of Pay Period Field Instruction

Last Name (Certifying Official) Field Description

Last Name Field Instruction

Married Field Instruction

Medicare Claim Number Field Instruction

Middle Initial Field Instruction

Name of Agency/Retirement System Field Instruction

New Enrollment Plan Field Instruction

Number Hours (DOD Only) Field Instruction

Other Insurance Field Instruction

Other Insurance Name Field Instruction

Password Field Instruction

Payroll Contact First Name Field Instruction

Payroll Contact Last Name Field Instruction

Payroll Office Number Field Instruction

Payroll Phone Number Field Instruction

Personnel Phone Number Field Instruction

Public Law Field Instruction

Relationship Field Instruction

Relationship To Employee Field Instruction

REMARKS Field Instruction

Search/Complete Registration SF2809 Field Instruction

Separation Date Field Instruction

Separation/Event Date Field Instruction

Sex Field Instruction

Signature Field Instruction

Social Security Number Field Instruction

SON Number Field Instruction

SSN Field Instruction

State Field Instruction

User ID Field Instruction

UserID (Certifying Official) Field Description

View Certified SF2809 Field Instruction

Work Phone Field Instruction

Zip Field Instruction