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PARENTAL CONSENT

For use of this form, see AR 600-20; the proponent agency is DCS, G-1.

AUTHORITY: PRINCIPAL PURPOSE:

ROUTINE USES:

DISCLOSURE:

PRIVACY ACT STATEMENT

10 U.S.C. Section 3013, Secretary of the Army: Army Regulation 600-20, Army Command Policy.

To record the agreement of both parents with their child's custodial arrangement as documented in the Family Care Plan.

None.

Mandatory; failure to maintain a Family Care Plan could subject you to separation, administrative action, or disciplinary action under the UCMJ.

In accordance with this agreement the parties confirm the following stipulations of fact and terms of agreement:

 

 

,

a member of the United States Army, (hereinafter "the Soldier"), and

 

 

 

 

 

are the parents of

 

(hereinafter "the child"), date of birth

, born in

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The child currently resides primarily with

 

 

 

at

 

 

.

 

a.As a function of performing military duties, the Soldier may have to perform temporary duty, be deployed, or otherwise not be available to care for the minor child.

b.The Soldier has been notified that he or she is to be temporarily deployed. The time period of deployment has been estimated to be

in length. As a matter of military necessity, the minor child will not be able to reside with, or exercise access to the Soldier during this time. (Initial appropriate paragraph)

The parties agree that each has reviewed the attached Family Care Plan as set forth in Form DA 5305, which indicates that for the time period that the

Soldier is absent,

 

is to serve as the minor child's temporary physical guardian.

 

The parties agree that during this period the minor child will reside at

 

.

The parties agree that each will cooperate with the execution of any additional documentation as may be necessary to facilitate the designation of physical custody to the temporary guardian and effectuate this consent.

By the signatures below, each party indicates their consent to the arrangements outlined in the attached Family Care Plan and this agreement.

 

(SOLDIER'S SIGNATURE)

 

 

 

 

 

STATE OF

 

 

 

 

 

 

COUNTY OF

 

 

 

 

 

 

 

 

 

 

Acknowledged before me this

 

day of

,

.

 

 

 

 

 

 

 

 

 

 

 

(NOTARY PUBLIC)

My commission expires:

(OTHER PARENT'S SIGNATURE)

 

 

 

 

 

STATE OF

 

 

 

 

 

 

COUNTY OF

 

 

 

 

 

 

 

 

 

 

Acknowledged before me this

 

day of

,

.

 

 

 

 

 

 

 

 

 

 

 

(NOTARY PUBLIC)

My commission expires:

DA FORM 7666, SEP 2009

APD LC v1.01

Document Information

Fact Name Description
Purpose The DA 7666 form is used for the application of a U.S. Army Reserve or Army National Guard member to request a waiver of certain eligibility requirements for a specific program.
Eligibility Only active members of the U.S. Army Reserve or Army National Guard can submit the DA 7666 form.
Governing Law This form is governed by the regulations outlined in Army Regulation 135-7.
Submission Process The completed DA 7666 form must be submitted through the appropriate chain of command for review and approval.

DA 7666 - Usage Guidelines

Filling out the DA 7666 form is an important step in a specific administrative process. To ensure accuracy and completeness, it's essential to follow each step carefully. Below are the instructions to guide you through the process.

  1. Begin by downloading the DA 7666 form from the official military website or obtaining a physical copy from the appropriate office.
  2. Carefully read the instructions provided with the form to understand the required information.
  3. In the top section, fill in your personal details, including your full name, rank, and social security number.
  4. Provide your current duty station and the date you are completing the form.
  5. In the next section, indicate the type of action you are requesting. Be specific and select the option that best fits your situation.
  6. Fill out the details regarding your previous assignments and any relevant dates. Accuracy is crucial in this section.
  7. Review the section that asks for your current contact information. Ensure that your phone number and email address are correct.
  8. If applicable, include any additional documentation that supports your request. This may include letters or forms that provide further context.
  9. Before submitting, double-check all entries for accuracy. A mistake could delay the processing of your request.
  10. Sign and date the form at the bottom. Your signature confirms that the information provided is true and complete.
  11. Submit the completed form to the designated office or individual as instructed in the guidelines.

Following these steps will help ensure that the DA 7666 form is filled out correctly and submitted in a timely manner. Each detail matters, so take your time and review your work before sending it off.

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Dos and Don'ts

When filling out the DA 7666 form, it’s important to follow certain guidelines to ensure accuracy and compliance. Here are five things you should and shouldn't do:

  • Do read the instructions carefully before starting the form.
  • Do provide accurate and complete information to avoid delays.
  • Do double-check all entries for errors before submission.
  • Do keep a copy of the completed form for your records.
  • Do ask for help if you have questions about any section.
  • Don't leave any required fields blank; this can result in rejection.
  • Don't use abbreviations or slang that may cause confusion.
  • Don't submit the form without reviewing it thoroughly.
  • Don't ignore deadlines; timely submission is crucial.
  • Don't hesitate to reach out to the appropriate office for clarification.

Common mistakes

  1. Incomplete Information: Many individuals fail to provide all required information on the DA 7666 form. This can include missing signatures, dates, or necessary identification details. Omitting any part of the form can lead to delays in processing.

  2. Incorrect Personal Details: Errors in personal information such as name, address, or Social Security number are common. These mistakes can cause complications in verifying identity and may result in rejection of the application.

  3. Failure to Follow Instructions: The form includes specific instructions that must be adhered to. Ignoring these guidelines, such as the order of sections or how to format answers, can lead to confusion and errors.

  4. Not Keeping Copies: Individuals often forget to make copies of the completed form before submission. Having a copy is essential for tracking the application status and for reference in case of any issues.

  5. Submitting Late: Some applicants overlook deadlines for submission. Late submissions can result in automatic disqualification or denial of the request, so it is crucial to be aware of and adhere to all timelines.

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