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DA 5960 Form

The DA 5960 form is a crucial document used by members of the U.S. Army to request a waiver for the repayment of certain educational benefits. This form helps service members navigate their financial obligations while pursuing their education. Understanding how to properly fill out and submit the DA 5960 can significantly impact a soldier's financial future.

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DA 5960 Sample

AUTHORIZATION TO START, STOP, OR CHANGE

PRIVACY ACT STATEMENT

BASIC ALLOWANCE FOR QUARTERS (BAQ),

AUTHORITY:

37 USC 403; Public Law 96-343; EO 9397.

AND/OR VARIABLE HOUSING ALLOWANCE (VHA)

PRINCIPLE PURPOSE:

To start, adjust or terminate military member's entitlement

For use of this form, see AR 37-104-4; the proponent agency is ASA(FM)

to basic allowance for quarters

(BAQ) and/or variable

housing allowance (VHA).

NAME

(Last, First, MI)

ROUTINE USE:

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 NUMBER

GRADE

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.

TYPE OF ACTION

DISCLOSURE IS VOLUNTARY: Nondisclosure may result in nonpayment of BAQ and/or

START

CANCEL

CHANGE

REPORT

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.

CORRECT

STOP

RECERTIFICATION

DUTY LOCATION (Include Station, Name, City, State, and Zip Code)

6. DATE/ACTION

BAQ TYPE

(YYYYMMDD)

WITH DEPENDENTS

PARTIAL

WITHOUT DEPENDENTS

MARITAL/DEPENDENCY STATUS

QUARTERS ASSIGNMENT/AVAILABILITY

SINGLE

b. MARRIED

c. DIVORCED (see

ADEQUATE

INADEQUATE

(see blocks (1), (2) & (3))

blocks (1), (2) & (3))

(see block (1))

(see blocks (1), (2) & (4))

LEGALLY SEPARATED

DEPENDENT CHILD

TRANSIENT

NOT AVAILABLE

(see blocks (1), (2) & (3))

(see blocks (4), (5) & (6))

(see block (3))

(1)

Spouse/Former

(2)

Spouse/Former

(3)

Date of Marriage,

(1)

QUARTERS

(2) FAIR RENTAL

Spouse SSN

Spouse Duty Station

Divorce/Separation

NO.

VALUE $

(4)

Child in

Member

Spouse

Former Spouse

Other

(3)

FROM:

TO:

Custody of:

(4)

(5)

If you check "OTHER" above, prepare DD Form 137 to establish dependency.

MEMBER ELECTION

COMMANDER

(Member

grade E7 and

DETERMINATION

(6)

If child support received from another military member, complete (1), (2) & (3).

above)

(Attached)

10.

DEPENDENTS/SHARERS (Continue on back if required)

NAME OF DEPENDENT/SHARER

COMPLETE CURRENT ADDRESS

(Include ZIP Code)

RELATIONSHIP

DOB OF CHILDREN

11.

CERTIFICATION OF DEPENDENT SUPPORT

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.

12.

EXPENSES, IF AUTHORIZED, I AM REQUESTING VHA BASED ON

My permanent duty station:

My dependent's location:

Both my permanent duty station and dependent's location.

Monthly Expenses:

Member

Dependent

Sharer/Lease Information

Address Information

(1)

Mortgage (PITI)

or Rent

(1)

Rental/Residential Address:

(1)

Landlord's Name and Address:

(2)

Insurance

(3)

Other

(2)

Effective Date:

(3)

Expiration Date:

(2)

Landlord's Phone No.

TOTALS

(4)

Number of Sharers

(show name(s) and address in block 10.)

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.

13.

MEMBER'S SIGNATURE

14. DATE

15.

CERTIFYING OFFICER'S SIGNATURE

16. DATE

DA FORM 5960, SEP 1990

REPLACES DA FORM 3298, JUL 80 AND DA FORM 5545, JUL 86 WHICH ARE OBSOLETE

APD AEM v2.06ES

AUTHORIZATION TO START, STOP, OR CHANGE

PRIVACY ACT STATEMENT

BASIC ALLOWANCE FOR QUARTERS

(BAQ),

AUTHORITY:

37 USC 403; Public Law 96-343; EO 9397.

AND/OR VARIABLE HOUSING ALLOWANCE (VHA)

PRINCIPLE PURPOSE:

To start, adjust or terminate military member's entitlement

For use of this form, see AR 37-104-4; the proponent agency is ASA (FM)

to basic allowance for quarters (BAQ) and/or

variable housing allowance

(VHA).

NAME

(Last, First, MI)

ROUTINE USE:

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 NUMBER

GRADE

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.

TYPE OF ACTION

DISCLOSURE IS VOLUNTARY: Nondisclosure may result in nonpayment of BAQ and/or

START

CANCEL

CHANGE

REPORT

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.

CORRECT

STOP

RECERTIFICATION

DUTY LOCATION (Include Station, Name, City, State, and Zip Code)

6. DATE/ACTION

BAQ TYPE

(YYYYMMDD)

WITH DEPENDENTS

PARTIAL

WITHOUT DEPENDENTS

MARITAL/DEPENDENCY STATUS

QUARTERS ASSIGNMENT/AVAILABILITY

SINGLE

b. MARRIED

c. DIVORCED (see

ADEQUATE

INADEQUATE

(see blocks (1), (2) & (3))

blocks (1), (2) & (3))

(see block (1))

(see blocks (1), (2) & (4))

LEGALLY SEPARATED

DEPENDENT CHILD

TRANSIENT

NOT AVAILABLE

(see blocks (1), (2) & (3))

(see blocks (4), (5) & (6))

(see block (3))

(1)

Spouse/Former

(2)

Spouse/Former

(3)

Date of Marriage,

(1)

QUARTERS

(2)

FAIR RENTAL

Spouse SSN

Spouse Duty Station

Divorce/Separation

NO.

VALUE $

(4)

Child in

Member

Spouse

Former Spouse

Other

(3)

FROM:

TO:

Custody of:

(4)

(5)

If you check "OTHER" above, prepare DD Form 137 to establish dependency.

MEMBER ELECTION

COMMANDER

(Member

grade E7 and

DETERMINATION

(6)

If child support received from another military member, complete (1), (2) & (3).

above)

(Attached)

10.

DEPENDENTS/SHARERS (Continue on back if required)

NAME OF DEPENDENT/SHARER

COMPLETE CURRENT ADDRESS

(Include ZIP Code)

RELATIONSHIP

DOB OF CHILDREN

11.

CERTIFICATION OF DEPENDENT SUPPORT

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

12.

EXPENSES, IF AUTHORIZED, I AM REQUESTING VHA BASED ON

My permanent duty station:

My dependent's location:

Both my permanent duty station and dependent's location.

Monthly Expenses:

Member

Dependent

Sharer/Lease Information

Address Information

(1)

Mortgage (PITI)

or Rent

(1)

Rental/Residential Address:

(1)

Landlord's Name and Address:

(2)

Insurance

(3)

Other

(2)

Effective Date:

(3)

Expiration Date:

(2)

Landlord's Phone No.

TOTALS

(4)

Number of Sharers

(show name(s) and address in block 10.)

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.

13.

MEMBER'S SIGNATURE

14. DATE

15.

CERTIFYING OFFICER'S SIGNATURE

16. DATE

DA FORM 5960, SEP 1990

REPLACES DA FORM 3298, JUL 80 AND DA FORM 5545, JUL 86 WHICH ARE OBSOLETE

APD AEM v2.06ES

AUTHORIZATION TO START, STOP, OR CHANGE

PRIVACY ACT STATEMENT

BASIC ALLOWANCE FOR QUARTERS

(BAQ),

AUTHORITY:

37 USC 403; Public Law 96-343; EO 9397.

AND/OR VARIABLE HOUSING ALLOWANCE (VHA)

PRINCIPLE PURPOSE:

To start, adjust or terminate military member's entitlement

For use of this form, see AR 37-104-4; the proponent agency is ASA (FM)

to basic allowance for quarters (BAQ) and/or

variable housing allowance

(VHA).

NAME

(Last, First, MI)

ROUTINE USE:

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 NUMBER

GRADE

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.

TYPE OF ACTION

DISCLOSURE IS VOLUNTARY: Nondisclosure may result in nonpayment of BAQ and/or

START

CANCEL

CHANGE

REPORT

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.

CORRECT

STOP

RECERTIFICATION

DUTY LOCATION (Include Station, Name, City, State, and Zip Code)

6. DATE/ACTION

BAQ TYPE

(YYYYMMDD)

WITH DEPENDENTS

PARTIAL

WITHOUT DEPENDENTS

MARITAL/DEPENDENCY STATUS

QUARTERS ASSIGNMENT/AVAILABILITY

SINGLE

b. MARRIED

c. DIVORCED (see

ADEQUATE

INADEQUATE

(see blocks (1), (2) & (3))

blocks (1), (2) & (3))

(see block (1))

(see blocks (1), (2) & (4))

LEGALLY SEPARATED

DEPENDENT CHILD

TRANSIENT

NOT AVAILABLE

(see blocks (1), (2) & (3))

(see blocks (4), (5) & (6))

(see block (3))

(1)

Spouse/Former

(2)

Spouse/Former

(3)

Date of Marriage,

(1)

QUARTERS

(2)

FAIR RENTAL

Spouse SSN

Spouse Duty Station

Divorce/Separation

NO.

VALUE $

(4)

Child in

Member

Spouse

Former Spouse

Other

(3)

FROM:

TO:

Custody of:

(4)

(5)

If you check "OTHER" above, prepare DD Form 137 to establish dependency.

MEMBER ELECTION

COMMANDER

(Member

grade E7 and

DETERMINATION

(6)

If child support received from another military member, complete (1), (2) & (3).

above)

(Attached)

10.

DEPENDENTS/SHARERS (Continue on back if required)

NAME OF DEPENDENT/SHARER

COMPLETE CURRENT ADDRESS

(Include ZIP Code)

RELATIONSHIP

DOB OF CHILDREN

11.

CERTIFICATION OF DEPENDENT SUPPORT

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

12.

EXPENSES, IF AUTHORIZED, I AM REQUESTING VHA BASED ON

My permanent duty station:

My dependent's location:

Both my permanent duty station and dependent's location.

Monthly Expenses:

Member

Dependent

Sharer/Lease Information

Address Information

(1)

Mortgage (PITI)

or Rent

(1)

Rental/Residential Address:

(1)

Landlord's Name and Address:

(2)

Insurance

(3)

Other

(2)

Effective Date:

(3)

Expiration Date:

(2)

Landlord's Phone No.

TOTALS

(4)

Number of Sharers

(show name(s) and address in block 10.)

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.

13.

MEMBER'S SIGNATURE

14. DATE

15.

CERTIFYING OFFICER'S SIGNATURE

16. DATE

DA FORM 5960, SEP 1990

REPLACES DA FORM 3298, JUL 80 AND DA FORM 5545, JUL 86 WHICH ARE OBSOLETE

APD AEM v2.06ES

⇓ PDF File

Instructions on Utilizing DA 5960

Filling out the DA 5960 form is an important step in managing certain military benefits. Make sure you have all necessary information ready before you begin. This will help ensure a smooth process.

Start by downloading the DA 5960 form from the official military website or obtain a hard copy from your unit's administrative office.
At the top of the form, fill in your personal information, including your name, rank, and Social Security number.
Provide your unit information. Include the unit name, address, and phone number.
Next, indicate the type of request you are making. Check the appropriate box that corresponds to your situation.
In the section for dependents, list the names, relationship to you, and Social Security numbers of each dependent.
Fill in the effective date of the request. This is the date when you want the benefits to start.
Sign and date the form at the bottom. Make sure your signature is clear and matches the name at the top of the form.
Submit the completed form to your unit's administrative office or the appropriate authority as instructed.

Once you have submitted the form, keep a copy for your records. This will help you track your request and ensure you receive the benefits you are entitled to.

Misconceptions

Misconception 1: The DA 5960 form is only for active duty service members.

This form is applicable not only to active duty personnel but also to reservists and National Guard members. It is used to request a basic allowance for housing (BAH) based on the member's duty status.

Misconception 2: Submitting the DA 5960 guarantees an increase in housing allowance.

Filing the DA 5960 does not automatically result in a higher allowance. The request must meet specific criteria and be supported by adequate documentation to be approved.

Misconception 3: The DA 5960 form is only needed once during a service member's career.

Service members may need to submit the form multiple times throughout their careers, especially when there are changes in duty stations, marital status, or dependents.

Misconception 4: The form can be submitted without any supporting documents.

Supporting documentation is often required to substantiate the claims made on the DA 5960. This may include proof of dependents or changes in living conditions.

Misconception 5: The DA 5960 form is only relevant for those living on base.

This form is relevant for all service members, regardless of whether they live on base or off base. It helps determine the appropriate housing allowance in various living situations.

Misconception 6: The approval process for the DA 5960 is quick and straightforward.

The approval process can vary significantly depending on the circumstances and the completeness of the submitted information. It may take time for the request to be reviewed and processed.

Misconception 7: Once approved, the housing allowance remains unchanged.

The housing allowance can change based on various factors, including changes in rank, duty station, or family status. Regular reviews may lead to adjustments in the allowance.

Documents used along the form

The DA 5960 form is essential for military personnel seeking to establish or modify their Basic Allowance for Housing (BAH). However, it is often accompanied by several other forms and documents that help streamline the process. Below is a list of common forms and documents that may be used alongside the DA 5960.

DA Form 31: This form is used to request leave from duty. It provides the necessary details regarding the leave period and is often required when a service member is moving to a new duty station or needs to take time off during a housing transition.
DD Form 214: This document serves as a record of military service. It includes information about the service member's discharge status and is crucial for verifying eligibility for various benefits, including housing allowances.
DA Form 1506: This form is used to verify service time for various purposes, including eligibility for certain benefits. It may be necessary when applying for housing allowances or other military-related benefits.
DA Form 4005: This form is utilized to request a change in a service member's address. It is important for updating records to ensure that housing allowances are sent to the correct location.
DA Form 5960-1: This is a supplemental form that provides additional information about the service member's housing situation. It may be required to support the DA 5960 form when applying for BAH.
SF 1199A: This form is used to authorize direct deposit for payments. Service members must complete this form to ensure their housing allowance is deposited directly into their bank accounts.
Lease Agreement: A copy of the lease is often required to verify the rental terms and conditions. This document confirms the service member's housing situation and is essential for BAH applications.
Utility Bills: Recent utility bills may be requested to demonstrate residency at a particular address. These documents help verify that the service member occupies the claimed residence.
Military Orders: Official orders can provide proof of the service member's duty station and the need for housing assistance. These documents are crucial for establishing eligibility for BAH.
Ohio Operating Agreement Form: To clearly define the management structure of your LLC, consider the customized Ohio Operating Agreement template resources that guide you through the essential legal frameworks.
Dependent Verification Documents: These may include birth certificates or marriage licenses to confirm dependents' eligibility for housing allowances. Such documents are essential for accurate BAH calculations.

Gathering these documents can significantly aid in the successful completion of the DA 5960 form process. Being well-prepared ensures that service members receive the housing allowances they are entitled to without unnecessary delays.