DA Form 5960 Authorization to Start, Stop or Change Basic Allowance for Quarters (BAQ), and/Or Variable Housing Allowance (VHA)

What Is DA Form 5960?

DA Form 5960, Authorization to Start, Stop, or Change Basic Allowance for Quarters (BAQ), and/or Variable Housing Allowance (VHA) is a United States Army form used to authorize military officials to begin or discontinue paying Basic Allowance for Quarters or Variable Housing Allowance During the financial portion of in-processing, each Soldier must re-certify entitlement to Basic Allowance for Housing (BAH) regardless of dependency status. This re-certification is done via the DA 5960 Form. The Soldier may provide proof of support or residence for their dependents to also be eligible for BAH.

The latest version of DA Form 5960 - often mistakenly referred to as the DD Form 5960 - was revised by the Department of the Army (DA) on September 1990. A fillable DA-issued DA Form 5960 is available for download below or can be found on the Army Publishing Directorate website.

ADVERTISEMENT
PRIVACY ACT STATEMENT
AUTHORIZATION TO START, STOP, OR CHANGE
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).
1.
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,
2.
SOCIAL SECURITY NUMBER
3.
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.
4.
TYPE OF ACTION
DISCLOSURE IS VOLUNTARY:
Nondisclosure may result in nonpayment of BAQ and/or
VHA. Disclosure of your SSN is voluntary. However, this
START
CANCEL
CHANGE
REPORT
form will not be processed without your SSN because
the Army identifies you for pay purposes by your SSN.
CORRECT
STOP
RECERTIFICATION
5.
DUTY LOCATION (Include Station, Name, City, State, and Zip Code)
6.
7.
BAQ TYPE
DATE/ACTION
(YYYYMMDD)
WITH DEPENDENTS
PARTIAL
WITHOUT DEPENDENTS
8.
MARITAL/DEPENDENCY STATUS
QUARTERS ASSIGNMENT/AVAILABILITY
9.
a.
SINGLE
b.
MARRIED
c.
a.
DIVORCED (see
ADEQUATE
b.
INADEQUATE
(see blocks (1), (2) & (3))
blocks (1), (2) & (3))
(see block (1))
(see blocks (1), (2) & (4))
d.
e.
c.
d.
NOT AVAILABLE
LEGALLY SEPARATED
DEPENDENT CHILD
TRANSIENT
(see blocks (1), (2) & (3))
(see blocks (4), (5) & (6))
(see block (3))
(1)
(2)
(3)
Spouse/Former
Spouse/Former
Date of Marriage,
(1)
(2)
QUARTERS
FAIR RENTAL
Spouse SSN
Spouse Duty Station
Divorce/Separation
VALUE $
NO.
(4)
Child in
(3)
FROM:
TO:
Member
Spouse
Former Spouse
Other
Custody of:
(4)
(5)
If you check "OTHER" above, prepare DD Form 137 to establish dependency.
MEMBER ELECTION
COMMANDER
(Member in 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.
a.
Monthly Expenses:
Member
Dependent
b.
Sharer/Lease Information
c.
Address Information
(1)
Rental/Residential Address:
(1)
Landlord's Name and Address:
(1)
Mortgage (PITI) or Rent
(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 LC v2.05ES
PRIVACY ACT STATEMENT
AUTHORIZATION TO START, STOP, OR CHANGE
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).
1.
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,
2.
SOCIAL SECURITY NUMBER
3.
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.
4.
TYPE OF ACTION
DISCLOSURE IS VOLUNTARY:
Nondisclosure may result in nonpayment of BAQ and/or
VHA. Disclosure of your SSN is voluntary. However, this
START
CANCEL
CHANGE
REPORT
form will not be processed without your SSN because
the Army identifies you for pay purposes by your SSN.
CORRECT
STOP
RECERTIFICATION
5.
DUTY LOCATION (Include Station, Name, City, State, and Zip Code)
6.
7.
BAQ TYPE
DATE/ACTION
(YYYYMMDD)
WITH DEPENDENTS
PARTIAL
WITHOUT DEPENDENTS
8.
MARITAL/DEPENDENCY STATUS
QUARTERS ASSIGNMENT/AVAILABILITY
9.
a.
SINGLE
b.
MARRIED
c.
a.
DIVORCED (see
ADEQUATE
b.
INADEQUATE
(see blocks (1), (2) & (3))
blocks (1), (2) & (3))
(see block (1))
(see blocks (1), (2) & (4))
d.
e.
c.
d.
NOT AVAILABLE
LEGALLY SEPARATED
DEPENDENT CHILD
TRANSIENT
(see blocks (1), (2) & (3))
(see blocks (4), (5) & (6))
(see block (3))
(1)
(2)
(3)
Spouse/Former
Spouse/Former
Date of Marriage,
(1)
(2)
QUARTERS
FAIR RENTAL
Spouse SSN
Spouse Duty Station
Divorce/Separation
VALUE $
NO.
(4)
Child in
(3)
FROM:
TO:
Member
Spouse
Former Spouse
Other
Custody of:
(4)
(5)
If you check "OTHER" above, prepare DD Form 137 to establish dependency.
MEMBER ELECTION
COMMANDER
(Member in 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.
a.
Monthly Expenses:
Member
Dependent
b.
Sharer/Lease Information
c.
Address Information
(1)
Rental/Residential Address:
(1)
Landlord's Name and Address:
(1)
Mortgage (PITI) or Rent
(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 LC v2.05ES
PRIVACY ACT STATEMENT
AUTHORIZATION TO START, STOP, OR CHANGE
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).
1.
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,
2.
SOCIAL SECURITY NUMBER
3.
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.
4.
TYPE OF ACTION
DISCLOSURE IS VOLUNTARY:
Nondisclosure may result in nonpayment of BAQ and/or
VHA. Disclosure of your SSN is voluntary. However, this
START
CANCEL
CHANGE
REPORT
form will not be processed without your SSN because
the Army identifies you for pay purposes by your SSN.
CORRECT
STOP
RECERTIFICATION
5.
DUTY LOCATION (Include Station, Name, City, State, and Zip Code)
6.
7.
BAQ TYPE
DATE/ACTION
(YYYYMMDD)
WITH DEPENDENTS
PARTIAL
WITHOUT DEPENDENTS
8.
MARITAL/DEPENDENCY STATUS
QUARTERS ASSIGNMENT/AVAILABILITY
9.
a.
SINGLE
b.
MARRIED
c.
a.
DIVORCED (see
ADEQUATE
b.
INADEQUATE
(see blocks (1), (2) & (3))
blocks (1), (2) & (3))
(see block (1))
(see blocks (1), (2) & (4))
d.
e.
c.
d.
NOT AVAILABLE
LEGALLY SEPARATED
DEPENDENT CHILD
TRANSIENT
(see blocks (1), (2) & (3))
(see blocks (4), (5) & (6))
(see block (3))
(1)
(2)
(3)
Spouse/Former
Spouse/Former
Date of Marriage,
(1)
(2)
QUARTERS
FAIR RENTAL
Spouse SSN
Spouse Duty Station
Divorce/Separation
VALUE $
NO.
(4)
Child in
(3)
FROM:
TO:
Member
Spouse
Former Spouse
Other
Custody of:
(4)
(5)
If you check "OTHER" above, prepare DD Form 137 to establish dependency.
MEMBER ELECTION
COMMANDER
(Member in 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.
a.
Monthly Expenses:
Member
Dependent
b.
Sharer/Lease Information
c.
Address Information
(1)
Rental/Residential Address:
(1)
Landlord's Name and Address:
(1)
Mortgage (PITI) or Rent
(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 LC v2.05ES
PRIVACY ACT STATEMENT
AUTHORIZATION TO START, STOP, OR CHANGE
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).
1.
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,
2.
SOCIAL SECURITY NUMBER
3.
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.
4.
TYPE OF ACTION
DISCLOSURE IS VOLUNTARY:
Nondisclosure may result in nonpayment of BAQ and/or
VHA. Disclosure of your SSN is voluntary. However, this
START
CANCEL
CHANGE
REPORT
form will not be processed without your SSN because
the Army identifies you for pay purposes by your SSN.
CORRECT
STOP
RECERTIFICATION
5.
DUTY LOCATION (Include Station, Name, City, State, and Zip Code)
6.
7.
BAQ TYPE
DATE/ACTION
(YYYYMMDD)
WITH DEPENDENTS
PARTIAL
WITHOUT DEPENDENTS
8.
MARITAL/DEPENDENCY STATUS
QUARTERS ASSIGNMENT/AVAILABILITY
9.
a.
SINGLE
b.
MARRIED
c.
a.
DIVORCED (see
ADEQUATE
b.
INADEQUATE
(see blocks (1), (2) & (3))
blocks (1), (2) & (3))
(see block (1))
(see blocks (1), (2) & (4))
d.
e.
c.
d.
NOT AVAILABLE
LEGALLY SEPARATED
DEPENDENT CHILD
TRANSIENT
(see blocks (1), (2) & (3))
(see blocks (4), (5) & (6))
(see block (3))
(1)
(2)
(3)
Spouse/Former
Spouse/Former
Date of Marriage,
(1)
(2)
QUARTERS
FAIR RENTAL
Spouse SSN
Spouse Duty Station
Divorce/Separation
VALUE $
NO.
(4)
Child in
(3)
FROM:
TO:
Member
Spouse
Former Spouse
Other
Custody of:
(4)
(5)
If you check "OTHER" above, prepare DD Form 137 to establish dependency.
MEMBER ELECTION
COMMANDER
(Member in 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.
a.
Monthly Expenses:
Member
Dependent
b.
Sharer/Lease Information
c.
Address Information
(1)
Rental/Residential Address:
(1)
Landlord's Name and Address:
(1)
Mortgage (PITI) or Rent
(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 LC v2.05ES

Download DA Form 5960 Authorization to Start, Stop or Change Basic Allowance for Quarters (BAQ), and/Or Variable Housing Allowance (VHA)

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DA Form 5960 Instructions

  1. Supply your identifying information in Boxes 1 through 3. This includes your name, rank, and SSN.
  2. Indicate the type of action you are using the form for in Box 4.
  3. Enter your duty location, date and type of quarters in Box 5.
  4. Identify your marital and dependency status in Boxes 7 and 8.
  5. Identify the type of quarters you will be moving into in Box 9.
  6. Provide the information on any dependents that will be sharing your quarters in Box 10.
  7. For Box 12, enter the information about your monthly expenses and similar accounting information of any dependents not currently living with you. Include your mortgage payments, insurance, and any other regular obligations.
  8. Sign and date the form and hand it over to the commanding officer for signing. Keep a copy of the DA 5960 form for future reference and send the original to the proper authority.

Every soldier needs to recertify their entitlement to Basic Allowance for Housing annually. The re-certification paperwork includes the DA Form 5960, DD Form 93 (Record of Emergency Data) and SGLV (Servicemembers' Group Life Insurance). All paperwork needs to be current and present in the iPERMS Record Review Tool during the Annual Personnel and Financial Record Reviews.

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