DD Form 137-5 Dependency Statement - Incapacitated Child Over Age 21

DD Form 137-5 Dependency Statement - Incapacitated Child Over Age 21

What Is DD Form 137-5?

This is a form that was released by the U.S. Department of Defense (DoD) on March 1, 2018. The form, often mistakenly referred to as the DA Form 137-5 , is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DoD.

Form Details:

  • A 5-page document available for download in PDF;
  • The latest version available from the Executive Services Directorate;
  • Additional instructions and information can be found on page 1 of the document;
  • Editable, printable, and free to use;

Download an up-to-date fillable DD Form 137-5 down below in PDF format or browse hundreds of other DoD Forms compiled in our online library.

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DD Form 137-5 Instructions

The DD Form 137-5 contains fifteen sections overall and must be completed entirely: if any questions are not applicable to a particular situation, write NOT APPLICABLE (or N/A) in that block. No fields should be left blank - incomplete forms will take longer to process.

  1. Section 1 describes the requested entitlements and information about previous applications for benefits.
  2. Section 2, Member Information, contains 9 Boxes in total. The information required within these boxes includes the name, DoD ID number, rank, and status of the applicant, their home and military addresses, phone numbers, email address and marital status.
  3. Section 3 is only for the information about the child being claimed. The applicant must provide the name, DoD ID and date of birth of the child, their relationship to the applicant, their complete address and marital status.
  4. Section 4 is for providing information about the other parent. Boxes 4c and 4d must be filed for military parents in any branch of service including Reserve and National Guard.
  5. Section 5 is self-explanatory - it specifies the child's current living conditions and the amount of time living at the listed address.
  6. Section 6 is filed only if the child is currently in a hospital or institution. Section 8 must be left blank if the child resides at the facility full time. If the child is staying at the facility part-time, both Sections 6 and 8 must be filled out. The Army requires an official letter from the institution or facility with a run-down of all costs and expenses. All information must be correct and provided in full - forms are regularly rejected because of incorrect or incomplete information in this section.
  7. Section 7 is self-explanatory and is meant for listing the people sharing a household with the child. The list should include everyone including the applicant filing the DD 137-5. This section cannot be left blank even if the service member and their child are the only people living in the household.
  8. Section 8 is for providing a detailed list of household expenses for all people living in the household.
  9. Section 9 is for describing the child's personal expenses regardless of who pays for them.
  10. Section 10 has lines for specifying the gross income made by or on behalf of the child, whether taxable or not. The personal income of the service member should not be included.
  11. Section 11 is filed in cases if the claimed child had been employed within the last 12 months.
  12. Section 12, Child's School Attendance is for describing the child's educational career. Include all schooling even if it is a vocational or a degree-seeking program.
  13. Section 13 is for listing all contributions made towards caring for the child over the last 12 months. Proof of support is required for BAH.
  14. Section 14 is for additional remarks and Section 15 is for the signatures and certification. All signature and dates must be notarized.

DD 137-5 Related Forms:

Download DD Form 137-5 Dependency Statement - Incapacitated Child Over Age 21

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