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For USCG, NOAA and USPHS Military Personnel Only

Collection of Information

This collection of information (COI) is targeted only to USCG personnel, retired USCG members, and dependents. If you are not a member of one of the targeted groups, please do not submit information to the Coast Guard through this form. The Coast Guard will immediately delete any submissions that it receives from persons who do not fit into one of these categories.


The Pay and Personnel Retiree and Annuitant Services Branch (PPC-RAS) no longer pre-mails retirement certificates. Retirement certificates must be requested by the member's unit using the web form below. The unit must submit the certificate request at least 60 days prior to the date planned for the member's retirement ceremony.

  • PPC (RAS) issues three types of certificates: Retirement, Spousal Appreciation and Presidential. We do NOT issue certificates to significant others, children or pets. Children's certificates are processed at the unit level.
  • The information on the Direct Access/Global Pay database is what is used to populate the names on the certificates. PPC-RAS cannot deviate from this for nicknames or AKA situations.
  • Effective 2/11/15 certificate request will be accepted for member's with APPROVED SEPARATION AUTHORIZATIONS vice APPROVED ORDERS.

Retirement Certificate Order Form - To be submitted by member's Unit.


Please fill out the following form to order retirement certificates. A PPC representative will review the information, print the certificates, and mail to the address provided below as soon as possible.

If you are a Reservists transferring into a RET-2 status or if you are a drilling reservists reaching age 60, your certificates will be sent to you automatically based on your Reserve Retirement Transfer Request (CG-2055A).

Fields with a (required) next to them are required fields.

Your E-Mail Address (e.g. ""):

Only use this method for requesting certificates if one of the following applies:
If you have any other circumstances, please feel free to call us at (800) 772-8724.

Enter the full name of the retiree:

Gender: (required)

Enter the retiree's Employee ID Number: (required)

Please verify the retiree's Employee ID Number: (required)

Please choose the retiree's rate/rank: (required)

If the retiree's Rate/Rank is not listed, please select "Not listed" in these boxes, and type the correct entry into the "Comments" area below.

Is the retiree Active Duty or Reserve? (required)

Will a certificate be issued for retiring member's spouse?

Enter the retiree's spouse's name (if applicable):

Spouse's Gender: (required) Select One: (required)

Enter the date of the retirement ceremony: (required)

Enter the retirement date: (required)

Enter the active duty base date: (required)

Enter the retiree's total years in service: (required)

Enter the unit name (e.g. "Coast Guard Base New Orleans"):

Enter the unit's mailing address:

Branch/Attn: (required)

Address Line 1: (required)

Address Line 2:

City: (required)

State (APO/FPO): (required) Zip/Postal Code: (required)

Enter Point of Contact information, should we need to get in touch with you:

Your Title/Rate/Rank (e.g "YN1"): (required)

Your Name: (required)

Your Daytime Phone Number with Area Code and Extension:

Enter any other comments or requests here:

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Last Modified 5/7/2015