DA Form 5121 Oversea Tour Election Statement

What Is DA Form 5121?

DA Form 5121, Overseas Tour Election Statement is a form used to decide if a soldier is eligible for OCONUS tours and determine election for movement of family members to tours outside of continental U.S. territories.

An up-to-date version of the statement – sometimes incorrectly referred to as the DD Form 5121 – was released by the Department of the Army in March 2007. The newest DA Form 5121 fillable version is available for digital filing and download below or can be found through the APD website.

The DA 5121 is a required form for all overseas assignments along with the DA Form 4036, Medical Dental Preparation for Overseas Movement and DA Form 4787, Reassignment Processing. The information provided within the form can be used as the basis for initiating specific assignment processing like additional service, deletion or deferments.

ADVERTISEMENT

OVERSEAS TOUR ELECTION STATEMENT
For use of this form, see AR 600-8-11; the proponent agency is DCS, G-1.
PRIVACY ACT STATEMENT
Title 10, USC, Sections 3010, 8012 and 5031, and Title 5, USC, Section 301.
Authority:
For personnel service support.
Principal Purpose:
(1) To conduct initial screening of reassignment cycle to determine soldier's eligibility to comply; and (2) basis
Routine Uses:
for initiating specific assignment processing (deletion/deferments; additional service; or any other special
processing required).
Disclosure of information is voluntary. However, failure to disclose this data may result in unnecessary hardship
Disclosure:
on the soldier and/or family members. Failure to disclose data will not automatically exempt soldier from
selected reassigment.
INSTRUCTIONS: Prepare this form in two copies. Place the original in the Action Pending section of the soldier's MPRJ and place the
copy in the soldier's Reassignment File.
1. NAME
2. SSN
3. GRADE/RANK
4. FOR ALL SOLDIERS
Having been advised that I am scheduled for a permanent change of station assignment to
, I understand that I must elect to serve either an "all others" or a "with
dependents" tour.
If I elect to serve the "all others" tour, I understand that Government transportation of my family members to or from my
overseas duty station will not be authorized during the tour. I also understand that if my family members travel at their own
expense to reside at or near the area of my assignment (except for a visit for a period not exceeding 3 continuous months),
I will no longer be entitled to Family Separation Allowance. I also understand that under this tour election, I am authorized
movement of my family members to a designated location at Government expense. However, after my family members
make a move to a designated location at Government expense, I cannot request to change my tour to the "with dependents"
tour in order to request movement of my family members to my overseas area unless extreme personal problems arise
which are fully documented.
AND
If I elect to serve the "with dependents" tour, I understand I am not authorized to move my family members and/or household
goods to a designated location in CONUS. I understand that I must apply promptly for concurrent travel of my family
members in order to receive Family Separation Allowance in the event concurrent travel is not approved. I understand that,
if concurrent/deferred travel is not approved, I may apply for nonconcurrent travel for my family members after I arrive in my
overseas area, if I am able to obtain suitable quarters, or I may elect to have my family members remain in CONUS. I
understand I must have sufficient remaining service to complete the "with dependents" tour length requirements upon my
arrival in the overseas area. If not, I will be required to serve an "all others" tour and will not be entitled to Government
transportation of my family members to my overseas duty station.
5. FOR INVOLUNTARY EXTENSION
I further understand that I will be involuntarily extended in the overseas command if:
I am an obligated volunteer officer (OBV) and do not wish to extend my Active Duty Service Obligation (ADSO) and the
end date of my ADSO follows my date eligible for return from overseas (DEROS) within 11 months (long tour area) or six
months (short tour area).
I will be returned to the continental U.S. (CONUS) transition point in sufficient time to process my separation. To be
reassigned to CONUS at my normal DEROS, I must be eligible for and take action to acquire sufficient service to have the
required months remaining at DEROS.
6. FOR ALL ARMY SOLDIERS MARRIED TO OTHER ARMY SOLDIERS
I have been briefed and understand the joint domicile requirements.
7. FOR USAR OBV OFFICERS
I understand that if I currently have insufficient remaining service to complete the "with dependents" tour, that by electing the
"with dependents" option below, I am concurrently volunteering herewith to extend my ADSO until completion of the
prescribed tour.
8. FOR ALL SOLDIERS
Regarding my option to elect either the "all others" or the "with dependents" tour, I choose the following actions, to include
any additional involuntary extended time in the overseas command.
a.
I elect to serve a tour for a period of
months in an "all others" status.
b.
I elect to serve a tour for a period of
months in an "with dependents" status.
9. SIGNATURE OF SOLDIER
10A. SIGNATURE OF WITNESS
B. DATE (YYYYMMDD)
DA FORM 5121, MAR 2007
PREVIOUS EDITIONS ARE OBSOLETE
APD LC v1.01ES

Download DA Form 5121 Oversea Tour Election Statement

679 times
Rate
4.6(4.6 / 5) 54 votes

ADVERTISEMENT

How to Fill Out DA Form 5121?

An overview of the form and filing guidelines can be found in the Army Regulation 600–8–11, Reassignment, released in May 2007. DA Form 5121 instructions are as follows:

  1. Before interviewing a soldier, the Personnel Reassignment Work Center conducts a reassignment briefing.
  2. After that, a pre-move (overseas orientation) briefing is scheduled. It is conducted within 30 calendar days of EDAS cycle date. The person authorized to direct the utmost support of all activities included in the reassignment process is the garrison or division commander.
  3. The Personnel Reassignment Work Center is responsible for organizing and planning the soldier’s leave, travel time, TDY en-route, determining the anticipated date of loss, requesting an HRC deletion via EDAS (if applicable), sending a notification to the installation retention and verifying the medical readiness classification (MRC).
  4. The soldier will need to complete the DA Form 5121 during the interviews. This form should be prepared in two copies. The original is placed in the Action Pending section of the soldier’s MPRJ and a copy is placed in the soldier’s reassignment file. 
  5. The DA 5121 requires the soldier’s personal data – their name, SSN, grade and rank – for identification purposes in Items 1 through 3. Item 4 is mandatory to file under any conditions. It requires specifying the soldiers' reassignment location. Items 5 through 7 are applicable under special conditions and contain information for the soldier to read and accept. Item 8 is for the soldier's duty status and the length of tour in months.
  6. The completed form has to be dated and signed by a soldier and certified by a witness.