DA Form 5840 Certificate of Acceptance as Guardian or Escort

DA Form 5840 Certificate of Acceptance as Guardian or Escort

What Is DA Form 5840?

DA Form 5840, Certificate of Acceptance as Guardian or Escort, is a form that is filed by a guardian and signifies their agreement to care for a child or children in the absence of their parents.

The latest version of the form - sometimes incorrectly referred to as DD Form 5840 and previously listed as DA Form 5840-R - was released by the U.S. Department of the Army (DA) on . An up-to-date DA Form 5840 fillable version is available for download and online filing below or can be found through the Army Publishing Directorate website.

The form is part of a series of family care-related paperwork. The document verifies that the guardian has been thoroughly briefed on all the responsibilities he will assume, the locations of pertinent documents, and the procedures for accessing military and civilian facilities and services on behalf of the soldier's members of the family.

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How to Fill Out DA Form 5840?

An overview of the purpose of the form and filing instructions are provided in the Army-issued AR 600-20, Army Command Policy. The fillable DA Form 5840 form is designed as a letter and contains blank spaces that require the following information:

  1. The name of the guardian.
  2. The names and ages of the dependent family members that will be in the care of that guardian.
  3. The address, telephone, and e-mail of the guardian along with their signature and the date of signing.

The form is also filled out and verified by a Notary Public after all lines are completed by the guardian to-be.


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