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Please complete this form if you are a child survivor of a deceased police officer or firefighter member who wishes to make a change of status. Once you have completed the form, mail, email, or fax it to the DCRB Member Services Center. The original form should be mailed to DCRB.
Please Note: In accordance with D.C. Code §5-701 (5), to remain eligible to receive benefits as a child survivor, you must be unmarried, between the ages of 18 and 22, and a student pursuing a full-time course of study in an accredited educational institution or unmarried, regardless of age, and incapable of self-support due to a mental or physical disability incurred before the age of 18.