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Le): YES (complete 17a-1, 17a-2, 18a, 19a & 20a). 17a-1. Is custodian/spouse receiving Basic Allowance for Housing with dependents? NO YES 17a-2. Is custodian/spouse assigned to government owned/leased quarters? NO YES PRIVACY ACT STATEMENT In accordance with 5 USC Section 522a(e)(3), the following information is provided to you when supplying personal information to the U. S. Coast Guard: Authority - 37 USC Section 403 and E.O. 9397. Principal Purpose(s) - Used to indicate start or chan.

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