DA 5960 PDF Template

DA 5960 PDF Template

The DA 5960 form is a document used by the U.S. Army to request a waiver for certain requirements related to military training and education. This form is essential for service members seeking exceptions based on their unique circumstances. To get started on filling out the DA 5960, click the button below.

Article Guide

The DA 5960 form plays a crucial role in the military landscape, particularly in the context of service members' financial management. It serves as a formal request for a Basic Allowance for Housing (BAH) or a change in the current BAH status. This form is essential for those who are relocating, experiencing a change in duty station, or undergoing a significant life event that impacts their housing situation. By providing accurate information about a service member's marital status, dependents, and housing arrangements, the DA 5960 enables the military to assess eligibility for housing allowances effectively. Furthermore, it requires careful attention to detail, as any discrepancies can lead to delays in processing or even financial repercussions. Understanding the nuances of this form is vital for service members seeking to navigate their financial responsibilities while fulfilling their duties.

DA 5960 Preview

START
CORRECT
CANCEL
STOP
CHANGE
RECERTIFICATION
REPORT
6.
5.
DUTY LOCATION
(Include Station, Name, City, State, and Zip Code)
I certify ALL information regarding this authorization is correct. I will immediately notify the FAO/HRO of any changes in the information above, due to divorce,
marriage, death, living in government quarters etc, which could affect by BAQ or VHA entitlement.
IMPORTANT: Making a false statement or claim against the US Government is punishable by courts-martial. The penalty for willfully making a false claim or a false
statement in connection with claims is a maximum fine of $10,000 or imprisonment for 5 years, or both.
PRIVACY ACT STATEMENT
AUTHORITY:
PRINCIPLE PURPOSE:
ROUTINE USE:
DISCLOSURE IS VOLUNTARY:
AUTHORIZATION TO START, STOP, OR CHANGE
BASIC ALLOWANCE FOR QUARTERS (BAQ),
AND/OR VARIABLE HOUSING ALLOWANCE (VHA)
For use of this form, see AR 37-104-4; the proponent agency is ASA(FM)
37 USC 403; Public Law 96-343; EO 9397.
To start, adjust or terminate military member's entitlement
to basic allowance for quarters (BAQ) and/or variable
housing allowance (VHA).
DATE 15.DATE 13.
Landlord's Name and Address: Rental/Residential Address:
(3)
MARITAL/DEPENDENCY STATUS
(2)
(4)
(2)
c. b. a.
(1)
(2)
(3)
(3)
(4)
(Member in grade E7 and
above)
(2) (1)
(3)(2)
(4)
(1)
(5)
(6)
c.
a.
d.
b. INADEQUATE
(see blocks (1), (2) & (4))
QUARTERS ASSIGNMENT/AVAILABILITY
e.
DEPENDENT CHILD
(see blocks (4), (5) & (6))
c. b.
d.
a.
DATE/ACTION
(YYYYMMDD)
9.
GRADE SOCIAL SECURITY NUMBER
4.
WITHOUT DEPENDENTS
If you check "OTHER" above, prepare DD Form 137 to establish dependency.
MEMBER'S SIGNATURE
EXPENSES, IF AUTHORIZED, I AM REQUESTING VHA BASED ON
If child support received from another military member, complete (1), (2) & (3).
CERTIFICATION OF DEPENDENT SUPPORT
BAQ TYPE
WITH DEPENDENTS PARTIAL
TRANSIENT
(see block (3))
ADEQUATE
(see block (1))
NOT AVAILABLE
QUARTERS
NO.
FAIR RENTAL
VALUE $
CERTIFYING OFFICER'S SIGNATURE
Sharer/Lease Information
Effective Date: Expiration Date: Landlord's Phone No.
My permanent duty station: My dependent's location: Both my permanent duty station and dependent's location.
DOB OF CHILDREN
DependentMember
TOTALS
Monthly Expenses:
Insurance
Other
RELATIONSHIPNAME OF DEPENDENT/SHARER
Spouse/Former
Spouse SSN
Child in
Custody of:
SINGLE
LEGALLY SEPARATED
Member Spouse Former Spouse Other
Spouse/Former
Spouse Duty Station
Date of Marriage,
Divorce/Separation
7.
8.
10.
COMMANDER
DETERMINATION
(Attached)
MEMBER ELECTION
12.
11.
Address Information
2.
TYPE OF ACTION
3.
FROM:
16.
(1)
(1)
14.
DA FORM 5960, SEP 1990
REPLACES DA FORM 3298, JUL 80 AND DA FORM 5545, JUL 86 WHICH ARE OBSOLETE
APD AEM v2.06ES
1.
NAME (Last, First, MI)
(see blocks (1), (2) & (3))
DEPENDENTS/SHARERS (Continue on back if required)
Number of Sharers (show name(s) and address in block 10.)
Mortgage (PITI) or Rent
COMPLETE CURRENT ADDRESS
(Include ZIP Code)
DIVORCED (see
blocks (1), (2) & (3))
(see blocks (1), (2) & (3))
To adjust member's military pay record, information may
be disclosed to Army components, such as USAFAC,
major commands, and other Army installations; to other
DOD components; other federal agencies such as IRS,
Social Security Administration and VA, GAO, members of
Congress; State and local government; US and State
courts, and various law enforcement agencies. Social
Security Number (SSN) is used for positive identification.
Nondisclosure may result in nonpayment of BAQ and/or
VHA. Disclosure of your SSN is voluntary. However, this
form will not be processed without your SSN because
the Army identifies you for pay purposes by your SSN.
I certify that I can provide, or willing to provide, adequate support for the above named dependents. I am aware that failure to support the above named
dependents may result in stopping BAQ and recouping BAQ for any prior periods/nonsupport.
IAW service regulations. I certify that the dependency status of my primary dependents, on whose behalf I am receiving BAQ, has not changed so as to affect
my entitlement thereto for the period.
TO:
MARRIED
START
CORRECT
CANCEL
STOP
CHANGE
RECERTIFICATION
REPORT
6.
5.
DUTY LOCATION
(Include Station, Name, City, State, and Zip Code)
I certify ALL information regarding this authorization is correct. I will immediately notify the FAO/HRO of any changes in the information above, due to divorce,
marriage, death, living in government quarters etc, which could affect by BAQ or VHA entitlement.
IMPORTANT: Making a false statement or claim against the US Government is punishable by courts-martial. The penalty for willfully making a false claim or a false
statement in connection with claims is a maximum fine of $10,000 or imprisonment for 5 years, or both.
PRIVACY ACT STATEMENT
AUTHORITY:
PRINCIPLE PURPOSE:
ROUTINE USE:
DISCLOSURE IS VOLUNTARY:
AUTHORIZATION TO START, STOP, OR CHANGE
BASIC ALLOWANCE FOR QUARTERS (BAQ),
AND/OR VARIABLE HOUSING ALLOWANCE (VHA)
For use of this form, see AR 37-104-4; the proponent agency is ASA (FM)
37 USC 403; Public Law 96-343; EO 9397.
To start, adjust or terminate military member's entitlement
to basic allowance for quarters (BAQ) and/or
variable housing allowance (VHA).
DATE 15.DATE 13.
Landlord's Name and Address: Rental/Residential Address:
(3)
MARITAL/DEPENDENCY STATUS
(2)
(4)
(2)
c. b. a.
(1)
(2)
(3)
(3)
(4)
(Member in grade E7 and
above)
(2) (1)
(3)(2)
(4)
(1)
(5)
(6)
c.
a.
d.
b. INADEQUATE
(see blocks (1), (2) & (4))
QUARTERS ASSIGNMENT/AVAILABILITY
e.
DEPENDENT CHILD
(see blocks (4), (5) & (6))
c. b.
d.
a.
DATE/ACTION
(YYYYMMDD)
9.
GRADE SOCIAL SECURITY NUMBER
4.
WITHOUT DEPENDENTS
If you check "OTHER" above, prepare DD Form 137 to establish dependency.
MEMBER'S SIGNATURE
EXPENSES, IF AUTHORIZED, I AM REQUESTING VHA BASED ON
If child support received from another military member, complete (1), (2) & (3).
CERTIFICATION OF DEPENDENT SUPPORT
BAQ TYPE
WITH DEPENDENTS PARTIAL
TRANSIENT
(see block (3))
ADEQUATE
(see block (1))
NOT AVAILABLE
QUARTERS
NO.
FAIR RENTAL
VALUE $
CERTIFYING OFFICER'S SIGNATURE
Sharer/Lease Information
Effective Date: Expiration Date: Landlord's Phone No.
My permanent duty station: My dependent's location: Both my permanent duty station and dependent's location.
DOB OF CHILDREN
DependentMember
TOTALS
Monthly Expenses:
Insurance
Other
RELATIONSHIPNAME OF DEPENDENT/SHARER
Spouse/Former
Spouse SSN
Child in
Custody of:
SINGLE
LEGALLY SEPARATED
Member Spouse Former Spouse Other
Spouse/Former
Spouse Duty Station
Date of Marriage,
Divorce/Separation
7.
8.
10.
COMMANDER
DETERMINATION
(Attached)
MEMBER ELECTION
12.
11.
Address Information
2.
TYPE OF ACTION
3.
FROM:
16.
(1)(1)
14.
DA FORM 5960, SEP 1990
REPLACES DA FORM 3298, JUL 80 AND DA FORM 5545, JUL 86 WHICH ARE OBSOLETE
1.
NAME (Last, First, MI)
(see blocks (1), (2) & (3))
DEPENDENTS/SHARERS (Continue on back if required)
Number of Sharers (show name(s) and address in block 10.)
Mortgage (PITI) or Rent
COMPLETE CURRENT ADDRESS
(Include ZIP Code)
DIVORCED (see
blocks (1), (2) & (3))
(see blocks (1), (2) & (3))
To adjust member's military pay record, information may
be disclosed to Army components, such as USAFAC,
major commands, and other Army installations; to other
DOD components; other federal agencies such as IRS,
Social Security Administration and VA, GAO, members
of Congress; State and local government; US and State
courts, and various law enforcement agencies. Social
Security Number (SSN) is used for positive identification.
Nondisclosure may result in nonpayment of BAQ and/or
VHA. Disclosure of your SSN is voluntary. However, this
form will not be processed without your SSN because
the Army identifies you for pay purposes by your SSN.
I certify that I provide, or am will to provide adequate support for the above named dependents. I am aware that failure to support the above named
dependents may result in stopping BAQ and recouping BAQ for any prior periods/nonsupport.
IAW service regulations, I certify that the dependency status of my primary dependents, on whose behalf I am receiving BAQ, has not changed so as to affect
my entitlement thereto for the period
TO:
MARRIED
APD AEM v2.06ES
START
CORRECT
CANCEL
STOP
CHANGE
RECERTIFICATION
REPORT
6.
5.
DUTY LOCATION
(Include Station, Name, City, State, and Zip Code)
I certify ALL information regarding this authorization is correct. I will immediately notify the FAO/HRO of any changes in the information above, due to divorce,
marriage, death, living in government quarters etc, which could affect by BAQ or VHA entitlement.
IMPORTANT: Making a false statement or claim against the US Government is punishable by courts-martial. The penalty for willfully making a false claim or a false
statement in connection with claims is a maximum fine of $10,000 or imprisonment for 5 years, or both.
PRIVACY ACT STATEMENT
AUTHORITY:
PRINCIPLE PURPOSE:
ROUTINE USE:
DISCLOSURE IS VOLUNTARY:
AUTHORIZATION TO START, STOP, OR CHANGE
BASIC ALLOWANCE FOR QUARTERS (BAQ),
AND/OR VARIABLE HOUSING ALLOWANCE (VHA)
For use of this form, see AR 37-104-4; the proponent agency is ASA (FM)
37 USC 403; Public Law 96-343; EO 9397.
To start, adjust or terminate military member's entitlement
to basic allowance for quarters (BAQ) and/or
variable housing allowance (VHA).
DATE 15.DATE 13.
Landlord's Name and Address: Rental/Residential Address:
(3)
MARITAL/DEPENDENCY STATUS
(2)
(4)
(2)
c. b. a.
(1)
(2)
(3)
(3)
(4)
(Member in grade E7 and
above)
(2) (1)
(3)(2)
(4)
(1)
(5)
(6)
c.
a.
d.
b. INADEQUATE
(see blocks (1), (2) & (4))
QUARTERS ASSIGNMENT/AVAILABILITY
e.
DEPENDENT CHILD
(see blocks (4), (5) & (6))
c. b.
d.
a.
DATE/ACTION
(YYYYMMDD)
9.
GRADE SOCIAL SECURITY NUMBER
4.
WITHOUT DEPENDENTS
If you check "OTHER" above, prepare DD Form 137 to establish dependency.
MEMBER'S SIGNATURE
EXPENSES, IF AUTHORIZED, I AM REQUESTING VHA BASED ON
If child support received from another military member, complete (1), (2) & (3).
CERTIFICATION OF DEPENDENT SUPPORT
BAQ TYPE
WITH DEPENDENTS PARTIAL
TRANSIENT
(see block (3))
ADEQUATE
(see block (1))
NOT AVAILABLE
QUARTERS
NO.
FAIR RENTAL
VALUE $
CERTIFYING OFFICER'S SIGNATURE
Sharer/Lease Information
Effective Date: Expiration Date: Landlord's Phone No.
My permanent duty station: My dependent's location: Both my permanent duty station and dependent's location.
DOB OF CHILDREN
DependentMember
TOTALS
Monthly Expenses:
Insurance
Other
RELATIONSHIPNAME OF DEPENDENT/SHARER
Spouse/Former
Spouse SSN
Child in
Custody of:
SINGLE
LEGALLY SEPARATED
Member Spouse Former Spouse Other
Spouse/Former
Spouse Duty Station
Date of Marriage,
Divorce/Separation
7.
8.
10.
COMMANDER
DETERMINATION
(Attached)
MEMBER ELECTION
12.
11.
Address Information
2.
TYPE OF ACTION
3.
FROM:
16.
(1)(1)
14.
DA FORM 5960, SEP 1990
REPLACES DA FORM 3298, JUL 80 AND DA FORM 5545, JUL 86 WHICH ARE OBSOLETE
1.
NAME (Last, First, MI)
(see blocks (1), (2) & (3))
DEPENDENTS/SHARERS (Continue on back if required)
Number of Sharers (show name(s) and address in block 10.)
Mortgage (PITI) or Rent
COMPLETE CURRENT ADDRESS
(Include ZIP Code)
DIVORCED (see
blocks (1), (2) & (3))
(see blocks (1), (2) & (3))
To adjust member's military pay record, information may
be disclosed to Army components, such as USAFAC,
major commands, and other Army installations; to other
DOD components; other federal agencies such as IRS,
Social Security Administration and VA, GAO, members
of Congress; State and local government; US and State
courts, and various law enforcement agencies. Social
Security Number (SSN) is used for positive identification.
Nondisclosure may result in nonpayment of BAQ and/or
VHA. Disclosure of your SSN is voluntary. However, this
form will not be processed without your SSN because
the Army identifies you for pay purposes by your SSN.
I certify that I provide, or am will to provide adequate support for the above named dependents. I am aware that failure to support the above named
dependents may result in stopping BAQ and recouping BAQ for any prior periods/nonsupport.
IAW service regulations, I certify that the dependency status of my primary dependents, on whose behalf I am receiving BAQ, has not changed so as to affect
my entitlement thereto for the period
TO:
MARRIED
APD AEM v2.06ES

File Properties

Fact Name Description
Purpose The DA Form 5960 is used to request Basic Allowance for Housing (BAH) for service members.
Eligibility Active duty service members and certain reserve members may use this form to apply for BAH.
Governing Law BAH is governed by Title 37, United States Code, Section 403.
Submission Process The form must be submitted to the service member's commanding officer for approval.
Required Information Personal information, duty station, and housing details must be provided on the form.
Supporting Documents Service members may need to attach additional documentation, such as rental agreements.
Updates Changes in duty station or family status require a new DA Form 5960 to be submitted.
Processing Time Approval and processing times can vary based on the command's workload.
State-Specific Forms Some states may have additional forms or requirements; check local regulations.
Contact Information For questions, service members should contact their finance office for assistance.

Instructions on Utilizing DA 5960

Completing the DA 5960 form is essential for ensuring proper processing of your request. Follow the steps below carefully to fill out the form accurately.

  1. Obtain the DA 5960 form. You can find it online or request a copy from your unit's administrative office.
  2. Begin with the top section. Fill in your name, rank, and Social Security number in the designated fields.
  3. Provide your unit information, including your duty station and the date of the request.
  4. In the next section, indicate the type of request you are making. Be specific about the purpose of the form.
  5. Complete the financial information section. Include any relevant details about your pay and allowances.
  6. Review the declaration statement at the bottom of the form. Ensure you understand what you are certifying.
  7. Sign and date the form. This confirms that all information provided is accurate and complete.
  8. Submit the completed form to your designated authority for processing. Keep a copy for your records.

Important Facts about DA 5960

What is the DA 5960 form?

The DA 5960 form is used by the U.S. Army to request a waiver for certain educational benefits. This form is crucial for service members who need assistance in meeting educational requirements or who are seeking to extend their benefits. It helps streamline the process and ensures that all necessary information is collected for review.

Who needs to fill out the DA 5960 form?

Any active duty or reserve service member who is looking to apply for a waiver of educational benefits should complete the DA 5960 form. This includes individuals who may not meet standard eligibility criteria due to various circumstances. If you believe you qualify for a waiver, it is important to fill out this form accurately and submit it promptly.

How do I submit the DA 5960 form?

The completed DA 5960 form should be submitted to your unit’s educational services officer or the appropriate administrative office. Ensure that you have filled out all sections completely and have attached any necessary documentation that supports your request. Timely submission is key, as delays can affect your eligibility for benefits.

What happens after I submit the DA 5960 form?

After submission, your request will be reviewed by the appropriate authorities. You will receive a notification regarding the status of your waiver request. This process can take some time, so it is important to be patient. If additional information is needed, you may be contacted for clarification or further documentation.

Common mistakes

Filling out the DA 5960 form can be a straightforward process, but many people make common mistakes that can lead to delays or complications. One frequent error is not providing complete and accurate personal information. Ensure that your name, Social Security number, and other identifying details are correct. A simple typo can create issues down the line.

Another mistake often made is failing to include all required signatures. The form requires signatures from both the service member and their spouse or dependent. Omitting a signature can stall the processing of your request. Always double-check that everyone has signed where needed before submitting.

Many individuals overlook the importance of providing supporting documentation. The DA 5960 form may require additional documents to verify eligibility for certain benefits. Not including these documents can lead to a rejection of your application. Be thorough and attach all necessary paperwork to ensure a smooth process.

Some people also misinterpret the instructions regarding the effective date of the benefits. It’s crucial to understand when the changes will take effect and to fill out that section accurately. Incorrect dates can lead to confusion and potentially impact your benefits.

Another common pitfall is not keeping a copy of the completed form. Once submitted, it’s wise to retain a copy for your records. This can be helpful if any questions arise later about your application or if you need to reference it in future dealings.

Finally, many fail to submit the form in a timely manner. There are deadlines associated with benefits that can affect eligibility. Be proactive and submit the DA 5960 as soon as you have completed it. Waiting until the last minute can lead to unnecessary stress and complications.

Documents used along the form

The DA 5960 form is essential for military personnel seeking to request a Basic Allowance for Housing (BAH) or to make changes to their existing BAH status. It is often accompanied by other forms and documents that support the application process. Below are five commonly used forms and documents that may be required alongside the DA 5960.

  • DD Form 214: This form provides a summary of a service member's military service. It is crucial for verifying eligibility for benefits and housing allowances.
  • DA Form 31: This is a request for leave form used by service members. It may be necessary to submit this form if leave affects housing arrangements.
  • DA Form 1506: This document is used to verify active duty service. It can help confirm a service member's eligibility for certain allowances.
  • Lease Agreement: A copy of the lease may be required to validate the housing situation. It provides proof of residency and rental terms.
  • Supporting Documentation: This includes any additional paperwork that supports the claim for BAH, such as marriage certificates or dependent information.

Having these documents ready can streamline the process and ensure that all necessary information is available for review. Timely submission of the DA 5960 and its accompanying forms is critical for a smooth transition and approval of housing benefits.

Similar forms

  • DA Form 31: This form is used for requesting leave. Like the DA 5960, it is essential for managing personnel records and ensuring proper documentation within the military. Both forms require specific details about the service member's situation.
  • DA Form 2-1: This document serves as a personnel record. Similar to the DA 5960, it contains vital information about a soldier's career and status. Both forms help maintain accurate records and facilitate administrative processes.
  • DD Form 214: This form is issued upon a service member's separation from the military. It is comparable to the DA 5960 in that it provides crucial information about service history and entitlements, ensuring that benefits are correctly allocated.
  • DA Form 1506: Used for the adjustment of service dates, this form shares similarities with the DA 5960 in terms of documenting important changes in a soldier's record. Both forms play a role in maintaining accurate personnel data.
  • DA Form 4187: This is a request for personnel action. It is similar to the DA 5960 because both forms are used to initiate changes or requests related to a service member's status, ensuring that all actions are properly recorded.

Dos and Don'ts

When filling out the DA 5960 form, it's essential to approach the task with care to ensure accuracy and compliance. Here’s a list of things you should and shouldn't do:

  • Do read the instructions thoroughly before starting.
  • Do use black or blue ink for filling out the form.
  • Do double-check all personal information for accuracy.
  • Do sign and date the form where required.
  • Don't leave any mandatory fields blank.
  • Don't use correction fluid or tape on the form.
  • Don't submit the form without reviewing it for errors.
  • Don't forget to keep a copy of the completed form for your records.

Following these guidelines can help prevent delays and ensure that your form is processed smoothly.

Misconceptions

The DA 5960 form, known as the Authorization to Start, Stop, or Change Basic Allowance for Housing (BAH), is often misunderstood. Below are nine common misconceptions about this important form:

  1. It is only for active-duty service members. Many believe that only active-duty personnel can use the DA 5960 form. However, this form is also applicable to reservists and National Guard members when they are on active duty or in certain training statuses.
  2. Submitting the form guarantees an immediate change in BAH. Some individuals think that simply submitting the DA 5960 will instantly alter their housing allowance. In reality, the change may take time to process and is subject to verification and approval by the appropriate authorities.
  3. It can be submitted at any time without consequences. A misconception exists that there are no deadlines for submitting the DA 5960. In fact, timely submission is crucial, as delays can affect the amount of BAH received and may lead to financial discrepancies.
  4. Only one form is needed for multiple changes. Many people assume that one DA 5960 form can cover various changes in housing status. In actuality, a separate form is required for each distinct change to ensure accurate processing.
  5. It is not necessary to provide supporting documentation. Some believe that the DA 5960 can be submitted without any additional paperwork. However, supporting documents, such as lease agreements or orders, are often required to validate the request.
  6. The form is only relevant for those living off-base. There is a common belief that the DA 5960 is only applicable to service members living off-base. Conversely, it is also relevant for those residing in government quarters, especially when changes occur.
  7. Once submitted, the form cannot be amended. A misconception persists that after the DA 5960 is filed, it cannot be changed. In fact, if circumstances change, individuals can submit a new form to update their housing status.
  8. Only the service member can submit the form. Many think that only the service member can handle the submission of the DA 5960. Family members or authorized representatives can also submit the form on behalf of the service member in certain situations.
  9. There are no consequences for incorrect submissions. Some individuals believe that errors on the DA 5960 will not lead to any repercussions. Unfortunately, incorrect information can result in overpayments or underpayments, which may require repayment or lead to financial complications.

Understanding these misconceptions can help ensure that service members and their families navigate the process of managing their housing allowances more effectively.

Key takeaways

When filling out and using the DA 5960 form, keep the following key takeaways in mind:

  • Accuracy is essential: Ensure all information is filled out correctly to avoid delays in processing.
  • Review deadlines: Be aware of submission deadlines to ensure timely benefits.
  • Documentation matters: Attach all required supporting documents to validate your claims.
  • Keep copies: Always retain copies of the completed form and any correspondence for your records.