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Download DA 5960 Template

The DA 5960 form is a document used by the U.S. Army to request a waiver for certain educational benefits. This form plays a crucial role in ensuring service members can access the support they need for their education. Understanding its purpose and how to complete it can greatly benefit those seeking assistance.

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Content Overview

The DA 5960 form plays a crucial role in the military finance system, particularly for service members seeking to manage their housing allowances effectively. This form is primarily used to request a Basic Allowance for Housing (BAH) or to update existing information related to housing. It captures essential details such as the service member's duty station, marital status, and any dependents living in the household. By providing accurate information, service members ensure they receive the correct housing allowance, which can significantly impact their financial well-being. Additionally, the form facilitates the process of updating changes in living situations, such as a change in marital status or the arrival of a new dependent. Understanding the DA 5960 form is vital for service members to navigate their financial responsibilities and benefits efficiently.

Key takeaways

The DA 5960 form is an important document for military personnel seeking to apply for or update their Basic Allowance for Housing (BAH) based on dependency status. Here are some key takeaways to keep in mind when filling out and using this form:

Accurate Information: Ensure all personal details, including service member's information and dependent's information, are correct. Inaccuracies can lead to delays or denials.
Timely Submission: Submit the form as soon as there is a change in dependency status. This helps prevent any interruptions in BAH payments.
Documentation: Attach necessary supporting documents, such as marriage certificates or birth certificates, to verify dependency claims.
Review Process: Understand that the form will undergo a review process. Be prepared for potential follow-up questions or requests for additional information.

Guide to Writing DA 5960

Filling out the DA 5960 form is an essential step in managing certain benefits and entitlements. To ensure accuracy and completeness, follow these detailed steps carefully.

Begin 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, enter your personal information, including your name, rank, and Social Security number.
Fill in your unit information, including the unit name and address. This helps to identify your affiliation.
In the next section, provide details about your dependents. Include their names, relationship to you, and Social Security numbers.
Indicate the type of benefits you are applying for by checking the appropriate boxes. Ensure that you understand the implications of each option.
Review the section on eligibility. Confirm that you meet all requirements and provide any additional documentation if needed.
Sign and date the form at the bottom. Your signature indicates that the information provided is accurate and complete.
Finally, submit the completed form to your unit's administrative office or the appropriate office as instructed.

After submission, keep a copy of the form for your records. This will be important for tracking the status of your application and for any future reference.

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Identity Verification Form - The signer affirms the accuracy of their provided information.

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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

Documents used along the form

The DA 5960 form is an important document used by military personnel to request a basic allowance for housing (BAH) based on their dependent status. However, it is often accompanied by several other forms and documents that help to support the request and ensure that all necessary information is provided. Below is a list of additional forms and documents that are commonly used in conjunction with the DA 5960 form.

DD Form 1172-2: This is the application for a uniformed services identification card and DEERS enrollment. It verifies the eligibility of dependents for military benefits.
Texas Motor Vehicle Bill of Sale: This document is essential for the transfer of vehicle ownership, ensuring all details are documented accurately, as outlined in toptemplates.info/bill-of-sale/motor-vehicle-bill-of-sale/texas-motor-vehicle-bill-of-sale/.
DA Form 31: This form is used to request leave. When applying for BAH, service members may need to document their leave status, particularly if they are temporarily away from their duty station.
DA Form 4187: This is a personnel action form. It is often used to document changes in a service member’s status, such as a change in dependent status, which may affect BAH eligibility.
AF Form 594: This is the application for a dependent’s identification card. It is crucial for establishing that a service member’s dependents are eligible for certain military benefits, including housing allowances.
DD Form 214: This form is the Certificate of Release or Discharge from Active Duty. While it primarily serves as proof of service, it can also provide context for a service member’s housing allowance eligibility.
Rental Agreement or Lease: This document outlines the terms of a rental arrangement. Providing a copy can help substantiate the request for housing allowance based on actual living expenses.

These forms and documents collectively ensure that requests for housing allowances are processed accurately and efficiently. It is essential for military personnel to gather the necessary paperwork to support their application, as this can significantly impact their financial well-being and housing stability.