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Fill in a Valid DA 5960 Form

The DA 5960 form is a document used by the U.S. Army to request a waiver for the repayment of a bonus or other incentive. This form helps service members navigate financial obligations that may arise from their military service. Understanding its purpose and the process for submission is essential for those seeking assistance with their bonuses.

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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

Document Information

Fact Name	Description
Purpose	The DA Form 5960 is used to request Basic Allowance for Housing (BAH) for military personnel.
Eligibility	Active duty members of the military can use this form to apply for housing allowances.
Submission	Members must submit the form to their unit's finance office for processing.
Governing Law	The form is governed by the Department of Defense regulations regarding military housing allowances.
Updates	The DA Form 5960 is periodically updated to reflect changes in housing policies and allowances.

DA 5960 - Usage Guidelines

Filling out the DA 5960 form is an important step in ensuring that your request is processed accurately. Once completed, this form will be submitted to the appropriate military personnel office for review. Below are the steps to help you fill out the form correctly.

Begin by downloading the DA 5960 form from the official military website or obtaining a hard copy from your unit's administrative office.
Carefully read the instructions provided with the form to understand the requirements and any necessary documentation.
Fill in your personal information in the designated sections. This includes your name, rank, Social Security number, and unit information.
Provide details about your current living situation. Indicate whether you are living in government housing or off-base.
Complete the section regarding your dependents. List their names, relationship to you, and any other requested details.
Review the financial information section. Ensure you accurately report your income and any allowances you receive.
Sign and date the form at the bottom. Make sure to sign in the designated area to validate your request.
Gather any supporting documents that may be required, such as proof of dependency or housing agreements.
Submit the completed form and any supporting documents to your unit's administrative office. Keep a copy for your records.

Common PDF Forms

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Family Law Financial Affidavit (short Form Pdf) - This form must be updated if there are significant changes in a party’s financial situation before finalizing the divorce.

Dos and Don'ts

When filling out the DA 5960 form, it is important to follow specific guidelines to ensure accuracy and compliance. Here are five things you should and shouldn't do:

Do verify that all personal information is accurate, including name, Social Security number, and address.
Do ensure that you have the correct pay grade and duty station listed on the form.
Do double-check the calculation of your Basic Allowance for Housing (BAH) to avoid discrepancies.
Don't leave any required fields blank; incomplete forms can delay processing.
Don't submit the form without reviewing it for errors or inconsistencies.

Common mistakes

Incorrect Personal Information: Many individuals fail to double-check their name, Social Security number, and other personal details. This can lead to processing delays or rejections.
Missing Signatures: It’s common to forget to sign the form. Without the necessary signatures, the form cannot be processed.
Inaccurate Dates: Some people mistakenly enter the wrong dates for service or other important events. This can create confusion and complicate the approval process.
Failure to Include Required Documentation: Applicants often overlook the need to attach supporting documents. Missing documents can lead to delays or denials.
Not Following Instructions: Each section of the form has specific instructions. Ignoring these can result in incomplete or incorrect submissions.
Neglecting to Review Before Submission: Rushing through the form can lead to simple mistakes. Taking the time to review can prevent unnecessary issues.

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