DA Form 5137 Application for Voluntary Mobilization Preassignment

DA Form 5137 - also known as the "Application For Voluntary Mobilization Preassignment" - is a United States Military form issued by the Department of the Army.

The form - often mistakenly referred to as the DD form 5137 - was last revised on March 1, 2009. Download an up-to-date fillable PDF version of the DA 5137 down below or look it up on the Army Publishing Directorate website.

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APPLICATION FOR VOLUNTARY MOBILIZATION PREASSIGNMENT
For use of this form, see AR 601-10; the proponent agency is DCS, G-1
DATA REQUIRED BY THE PRIVACY ACT OF 1974
10 USC 12301d and 688.
AUTHORITY:
Pertinent information concerning any discrepancies in individual's marital status, education, date of birth, and
PRINCIPAL PURPOSES:
social security number is obtained from the retiree to keep his/her master personnel file up to date.
Information is used to update the individual's personnel record to determine availability for mobilization in the
ROUTINE USE:
event of a national emergency.
Disclosure and effect on individual not providing information: The execution of this form is voluntary to retirees.
DISCLOSURE:
Failure to furnish information requested may result in denial of a voluntary preassignment.
Commander, HRC - St. Louis
ATTN: AHRC-PLM-P
1 Reserve Way
St. Louis, Missouri 63132-5200
I hereby volunteer for preassignment to (Installation or geographic area)
1.a.
I
will
will not accept an alternate assignment.
b.
I understand that I may withdraw this application at any time and that retirees meeting the recall age criteria
c.
may subsequently be involuntarily preassigned
2. APPLICANT INFORMATION (Please print or type all information provided in blocks 2a through m.)
a. NAME (Last, first, middle)
b. DATE OF BIRTH
c. ADDRESS (Include ZIP Code)
d.(1) HOME PHONE (Include area code)
d.(2) BUSINESS PHONE (Include area code)
(Check one)
e. RETIRED COMPONENT
RA
AUS
USAR
f. RETIRED GRADE
g. BRANCH (Officers only)
h. DATE PLACED IN RETIRED STATUS
i. MARITAL STATUS
j. NUMBER OF DEPENDENTS
k.(1) MOS/SSI/AOC
k.(2) SMOS/ASSI (Skill)
l. PHYSICAL STATUS (Self-assessment)
IF CURRENTLY PREASSIGNED, INCLUDE COPY OF ORDERS.
3. SIGNATURE
4. DATE
DA FORM 5137, MAR 2009
DA FORM 5137-R, JUL 1994 IS OBSOLETE.
APD LC v1.00ES
APPLICATION FOR VOLUNTARY MOBILIZATION PREASSIGNMENT
For use of this form, see AR 601-10; the proponent agency is DCS, G-1
DATA REQUIRED BY THE PRIVACY ACT OF 1974
10 USC 12301d and 688.
AUTHORITY:
Pertinent information concerning any discrepancies in individual's marital status, education, date of birth, and
PRINCIPAL PURPOSES:
social security number is obtained from the retiree to keep his/her master personnel file up to date.
Information is used to update the individual's personnel record to determine availability for mobilization in the
ROUTINE USE:
event of a national emergency.
Disclosure and effect on individual not providing information: The execution of this form is voluntary to retirees.
DISCLOSURE:
Failure to furnish information requested may result in denial of a voluntary preassignment.
Commander, HRC - St. Louis
ATTN: AHRC-PLM-P
1 Reserve Way
St. Louis, Missouri 63132-5200
I hereby volunteer for preassignment to (Installation or geographic area)
1.a.
I
will
will not accept an alternate assignment.
b.
I understand that I may withdraw this application at any time and that retirees meeting the recall age criteria
c.
may subsequently be involuntarily preassigned
2. APPLICANT INFORMATION (Please print or type all information provided in blocks 2a through m.)
a. NAME (Last, first, middle)
b. DATE OF BIRTH
c. ADDRESS (Include ZIP Code)
d.(1) HOME PHONE (Include area code)
d.(2) BUSINESS PHONE (Include area code)
(Check one)
e. RETIRED COMPONENT
RA
AUS
USAR
f. RETIRED GRADE
g. BRANCH (Officers only)
h. DATE PLACED IN RETIRED STATUS
i. MARITAL STATUS
j. NUMBER OF DEPENDENTS
k.(1) MOS/SSI/AOC
k.(2) SMOS/ASSI (Skill)
l. PHYSICAL STATUS (Self-assessment)
IF CURRENTLY PREASSIGNED, INCLUDE COPY OF ORDERS.
3. SIGNATURE
4. DATE
DA FORM 5137, MAR 2009
DA FORM 5137-R, JUL 1994 IS OBSOLETE.
APD LC v1.00ES

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