DA Form 5118 Reassignment Status and Election Statement

What Is DA Form 5118?

DA Form 5158, Reassignment Status and Election Statement is a form used at the beginning of the Soldier’s reassignment cycle or as a basis for initiating specific assignment processing. This specific assignment processing includes deletion, deferments, additional service and any other special processing.

The latest version of the form - sometimes incorrectly referred to as the DD Form 5118 - was released by the Department of the Army (DA) in October 2012 with all previous editions being obsolete. An up-to-date DA Form 5118 fillable version is available for download and online filing below or can be found through the Army Publishing Directorate website.

The DA 5118 is used to conduct the initial pre-reassignment screening to determine the Soldier’s eligibility to comply. Disclosure of any personal information is voluntary, but failing to file will result in unnecessary delays in reassignment.

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REASSIGNMENT STATUS AND ELECTION STATEMENT
For use of this form, see AR 600-8-11; the proponent agency is DCS, G-1.
PRIVACY ACT STATEMENT
Authority:
Title 10, USC, Sections 3010, 8012 and 5031, and Title 5, USC, Section 301 and E.O. 9397 (SSN).
Principal
(1) To conduct initial screening of reassignment cycle to determine Soldier's eligibility to comply; and (2) basis for
Purpose:
initiating specific assignment processing (deletion/deferments; additional service; or any other special processing required).
Routine Uses:
The "Blanket Routine uses" set forth at the beginning of the Army's Compilation of Systems of Records Notices also
applies to this system.
Disclosure:
Disclosure of information is voluntary. However, failure to disclose this data may result in unnecessary hardship on the
Soldier and/or Family members. Failure to disclose data will not automatically exempt Soldier from selected reassignment.
PART I - MILITARY PERSONNEL DIVISION/PERSONNEL SERVICE COMPANY
INSTRUCTIONS: The Military Personnel Division/Personnel Service Company will answer all the questions in Part I (Sections A, B, and C) after
comparing the EDAS Cycle with the Personnel Qualification Record (DA Form 2-1) of the Soldier. A checkmark in any of the "Yes" blocks will require a
comment in the "Remarks" block indicating the reason for further action, review, or possible removal from this assignment. If a question does not apply,
check the "N/A" block. This form pertains to enlisted Soldiers only.
1. NAME
2. SSN
3. GRADE
4. PMOS
5. ASI
6. CONTROL LANGUAGE
7. CURRENT UNIT
8. CURRENT UPC
9. GAINING UNIT
10. EDAS CYCLE NO.
11. TODAY'S DATE (YYYYMMDD)
12. ARRIVAL DATE (YYYYMMDD)
13. AI MOS
14. AI ASI
15. AI LANGUAGE
Section A - Special Management Command Status
YES
NO
N/A
16. Is the Soldier being assigned to a special management command (table 2-5)?
Section B - General Eligibility Status
17. Is the Soldier currently assigned to another installation?
18. Has the Soldier already received assignment instructions from which he/she has not been officially deleted?
19. Does the Soldier have less than 120 days notice to prepare for this assignment?
20. Will the Soldier be reassigned during the same fiscal year of his/her last "cost" PCS?
21. Will the Soldier be reassigned before completing at least 12 months at his/her current duty station?
22. Will the Soldier's stabilization period terminate after the assignment arrival date?
23. Does the Soldier's PULHES contain a "3" or "4"?
24. Does the Soldier's PMOS differ from the assignment MOS?
25. Are the special qualifications required for this assignment different from those currently possessed by the Soldier?
26.
Are the prerequisites for TDY schooling or training required for this assignment different from those currently
possessed by the Soldier?
27.
Are the PRP requirements for this assignment different from those currently possessed by the Soldier?
Section C - Time in Service Requirements Status
28.
Will the Soldier who is being reassigned from CONUS to CONUS have less than 24 months service remaining (as of
the last day of the arrival month) until his/her ETS?
29.
Will the initial term Soldier have insufficient service remaining (as of the last day of the arrival month) to complete
at least the "all others" tour prior to ETS upon arrival in the gaining overseas area?
30.
Will the career Soldier have sufficient service remaining (as of the last day of the arrival month) until his/her ETS to
serve the "all others tour" for the overseas area?
31.
Will the Soldier who is being reassigned from OCONUS (long tour area) to CONUS have less than 13 months
service remaining from his/her DEROS until his/her ETS?
32.
Will the Soldier who is being reassigned from OCONUS (short tour area) to CONUS have less than 7 months service
remaining from his/her DEROS until his/her ETS (less Johnston Island and Enewetak.)?
33.
Will the Soldier be reassigned prior to the completion of his/her Foreign Service Tour Extension (FSTE)?
34.
Is the Soldier's DEROS after the assignment arrival date?
DA FORM 5118, OCT 2012
Page 1 of 5
PREVIOUS EDITIONS ARE OBSOLETE.
APD LC v1.00ES
REASSIGNMENT STATUS AND ELECTION STATEMENT
For use of this form, see AR 600-8-11; the proponent agency is DCS, G-1.
PRIVACY ACT STATEMENT
Authority:
Title 10, USC, Sections 3010, 8012 and 5031, and Title 5, USC, Section 301 and E.O. 9397 (SSN).
Principal
(1) To conduct initial screening of reassignment cycle to determine Soldier's eligibility to comply; and (2) basis for
Purpose:
initiating specific assignment processing (deletion/deferments; additional service; or any other special processing required).
Routine Uses:
The "Blanket Routine uses" set forth at the beginning of the Army's Compilation of Systems of Records Notices also
applies to this system.
Disclosure:
Disclosure of information is voluntary. However, failure to disclose this data may result in unnecessary hardship on the
Soldier and/or Family members. Failure to disclose data will not automatically exempt Soldier from selected reassignment.
PART I - MILITARY PERSONNEL DIVISION/PERSONNEL SERVICE COMPANY
INSTRUCTIONS: The Military Personnel Division/Personnel Service Company will answer all the questions in Part I (Sections A, B, and C) after
comparing the EDAS Cycle with the Personnel Qualification Record (DA Form 2-1) of the Soldier. A checkmark in any of the "Yes" blocks will require a
comment in the "Remarks" block indicating the reason for further action, review, or possible removal from this assignment. If a question does not apply,
check the "N/A" block. This form pertains to enlisted Soldiers only.
1. NAME
2. SSN
3. GRADE
4. PMOS
5. ASI
6. CONTROL LANGUAGE
7. CURRENT UNIT
8. CURRENT UPC
9. GAINING UNIT
10. EDAS CYCLE NO.
11. TODAY'S DATE (YYYYMMDD)
12. ARRIVAL DATE (YYYYMMDD)
13. AI MOS
14. AI ASI
15. AI LANGUAGE
Section A - Special Management Command Status
YES
NO
N/A
16. Is the Soldier being assigned to a special management command (table 2-5)?
Section B - General Eligibility Status
17. Is the Soldier currently assigned to another installation?
18. Has the Soldier already received assignment instructions from which he/she has not been officially deleted?
19. Does the Soldier have less than 120 days notice to prepare for this assignment?
20. Will the Soldier be reassigned during the same fiscal year of his/her last "cost" PCS?
21. Will the Soldier be reassigned before completing at least 12 months at his/her current duty station?
22. Will the Soldier's stabilization period terminate after the assignment arrival date?
23. Does the Soldier's PULHES contain a "3" or "4"?
24. Does the Soldier's PMOS differ from the assignment MOS?
25. Are the special qualifications required for this assignment different from those currently possessed by the Soldier?
26.
Are the prerequisites for TDY schooling or training required for this assignment different from those currently
possessed by the Soldier?
27.
Are the PRP requirements for this assignment different from those currently possessed by the Soldier?
Section C - Time in Service Requirements Status
28.
Will the Soldier who is being reassigned from CONUS to CONUS have less than 24 months service remaining (as of
the last day of the arrival month) until his/her ETS?
29.
Will the initial term Soldier have insufficient service remaining (as of the last day of the arrival month) to complete
at least the "all others" tour prior to ETS upon arrival in the gaining overseas area?
30.
Will the career Soldier have sufficient service remaining (as of the last day of the arrival month) until his/her ETS to
serve the "all others tour" for the overseas area?
31.
Will the Soldier who is being reassigned from OCONUS (long tour area) to CONUS have less than 13 months
service remaining from his/her DEROS until his/her ETS?
32.
Will the Soldier who is being reassigned from OCONUS (short tour area) to CONUS have less than 7 months service
remaining from his/her DEROS until his/her ETS (less Johnston Island and Enewetak.)?
33.
Will the Soldier be reassigned prior to the completion of his/her Foreign Service Tour Extension (FSTE)?
34.
Is the Soldier's DEROS after the assignment arrival date?
DA FORM 5118, OCT 2012
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PREVIOUS EDITIONS ARE OBSOLETE.
APD LC v1.00ES
35. REMARKS (Annotate any additional information or discrepancies)
36a. REASSIGNMENT CLERK'S SIGNATURE
36b. DATE
(YYYYMMDD)
DA FORM 5118, OCT 2012
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APD LC v1.00ES
PART II - BATTALION STATUS
INSTRUCTIONS: The Battalion S1 will answer all the questions in Part II (Sections D and E). A checkmark in any of the "Yes" blocks will require a
comment in the "Remarks" block indicating the reason for further action, review, or possible removal from this assignment. If a question does not
apply, check the "N/A" block. The Battalion S1 must sign the completed statement and return it to the MPD/Personnel Service Company with the
completed Soldier Status and Election Statement attached.
1. NAME
2. SSN
3. GRADE
4. PMOS
5. ASI
6. CONTROL LANGUAGE
7. CURRENT UNIT
8. CURRENT UPC
9. GAINING UNIT
10. EDAS CYCLE NO.
11. TODAY'S DATE (YYYYMMDD)
12. ARRIVAL DATE (YYYYMMDD)
13. AI MOS
14. AI ASI
15. AI LANGUAGE
Section D - Duty Status
YES
NO
N/A
Is the Soldier currently attached to another installation for the purpose of processing a personnel action?
37.
Is the Soldier currently assigned to another unit?
38.
39.
Is the Soldier currently assigned to a unit scheduled for permanent overseas deployment (other than unit TDY
movement such as a REFORGER)?
40.
Is the Soldier in an AWOL status?
41.
Is the Soldier presently confined?
42.
Is the Soldier currently TDY from his/her home station and not scheduled to return at least 60 days prior to the first day
of the arrival month?
Is the Soldier presently undergoing any medical or dental treatment that would prevent this reassignment?
43.
44.
Is the Soldier awaiting court or trial appearance as a defendant?
Section E - Pending Action Status
45.
Is the Soldier pending an early release from active duty?
46.
Is the Soldier pending a Medical Evaluation Board (MMRB/PEB)?
47.
Is the Soldier pending a PMOS reclassification?
48.
Is the Soldier under suspension of favorable personnel actions (FLAGGED)?
49.
Is the Soldier enrolled in phase III of the Alcohol and Drug Abuse Prevention and Control Program (ADAPCP)?
50.
Is the Soldier scheduled for any schooling not in conjunction with this assignment?
51.
Has the Soldier applied for specialized training?
Is the Soldier being delayed from complying with these assignment instructions due to administrative processing
52.
errors?
Are there any circumstances not listed above that would preclude the Soldier from complying with these assignment
53.
instructions?
54.
Medical Readiness Code (MRC):
55a.
I am not
aware of any medical conditions that would prevent me from worldwide deployability.
I am
55b. Date (YYYYMMDD):
Initials:
56a.
DEPLOYABILITY CERTIFICATION: I certify that this Soldier's deployable status is:
Ready
Not Ready
56b.
Physician's Name and title or position:
56c.
Physician's Signature:
56d. DATE (YYYYMMDD)
57.
REMARKS (Annotate any additional information or discrepancies):
58a. BATTALION COMMANDER'S SIGNATURE
58b. DATE (YYYYMMDD)
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DA FORM 5118, OCT 2012
APD LC v1.00ES
PART III - SOLDIER STATUS AND ELECTION STATEMENT
INSTRUCTIONS: You will answer all the questions in Part III (Sections F and G). A checkmark in any of the "Yes" blocks will require a comment in the
"Remarks" block indicating the reason for further action, review, or possible removal from this assignment. If a question does not apply, check the "N/A"
block. You must sign the completed statement and return it to the Battalion S1.
1. NAME
2. SSN
3. GRADE
4. PMOS
5. ASI
6. CONTROL LANGUAGE
7. CURRENT UNIT
8. CURRENT UPC
11. TODAY'S DATE (YYYYMMDD)
9. GAINING UNIT
10. EDAS CYCLE NO.
12. ARRIVAL DATE (YYYYMMDD)
13. AI MOS
14. AI ASI
15. AI LANGUAGE
Section F - Personal Status
YES
NO
N/A
59.
Do you have an approved retirement date?
60.
If you are being assigned to an airborne position, do you wish to terminate your airborne status?
61.
Are you being assigned to a duty or an area for which you have a reassignment restriction for the reason of prior
sensitive duty assignment?
62.
Do you have an enlistment or reenlistment commitment for other than the areas of this assignment?
63.
Are you a pregnant Soldier?
64.
Are you a sole parent or married to an Army Soldier?
65.
Is your spouse pregnant?
Do you have an extreme Family situation that meets the requirements outlined in table 2-1, AR 600-8-11?
66.
Section G - To and From OCONUS Status
67.
Do you have any Family members with a physical, emotional, developmental or intellectual disorder who are not
enrolled in the Exceptional Family Member Program?
68.
Have you failed to complete initial entry training (12 weeks military training or its equivalent) required before your
overseas movement?
69.
If you have received assignment instructions to Turkey, are you or your spouse a Turkish or dual U.S.-Turkish
national?
70.
Are you being assigned overseas to a country where you committed a crime that resulted in civil or military
imprisonment or conviction by a foreign tribunal?
71.
Are you being involuntarily reassigned to an unaccompanied short tour area following 12 cumulative months TDY
during a 24-month period?
72.
Do you desire to report in early to the gaining oversea command?
73.
If you have received assignment instructions to a dependent restricted area (short tour area), do you want to
participate in the Homebase Assignment Program?
74.
If you have received assignment instructions to a dependent restricted area (short tour area), do you want to
participate in the Advanced Assignment Program?
75. REMARKS (Annotate any additional information or discrepancies.)
76a. SOLDIER'S SIGNATURE
76b. DATE (YYYYMMDD)
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DA FORM 5118, OCT 2012
APD LC v1.00ES
PART IV - WARTIME STATUS
INSTRUCTIONS: You will answer all the questions in Part IV (Section H). A checkmark in any of the "Yes" blocks will require a comment in the
"Remarks" block indicating the reason for further action, review, or possible removal from this assignment. If a question does not apply, check the "N/
A" block. You must sign the completed statement and return it to the Battalion S1.
1. NAME
2. SSN
3. GRADE
4. PMOS
5. ASI
6. CONTROL LANGUAGE
8. CURRENT UPC
7. CURRENT UNIT
9. GAINING UNIT
10. EDAS CYCLE NO.
11. TODAY'S DATE (YYYYMMDD)
12. ARRIVAL DATE (YYYYMMDD)
13. AI MOS
14. AI ASI
15. AI LANGUAGE
Section H - Personal Status
YES
NO
N/A
77.
Have you applied for Conscientious Objector status?
78.
Are you a sole surviving son or daughter?
79.
Are you being reassigned to a hostile fire area and have immediate Family members whose service in that area
resulted in death, disability, missing in action, or prisoner of war status?
80.
Are you a former Peace Corps member being reassigned to the country in which you have served?
81.
Are you a former Prisoner of War or Hostage being reassigned to the country where you were held captive?
82.
Have you been hospitalized at least 30 days outside a hostile fire area due to a wound received in that area?
83. REMARKS (Annotate any additional information or discrepancies.)
84a. SOLDIER'S SIGNATURE
84b. DATE (YYYYMMDD)
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DA FORM 5118, OCT 2012
APD LC v1.00ES

Download DA Form 5118 Reassignment Status and Election Statement

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DA Form 5118 Instructions

The 5118 DA form consists of four main parts.

Part I (Military Personnel Division/Personnel Service Company) is filled after comparing the EDAS cycle with the Soldier’s Personal Qualification Record (DA Form 2-1).

The first section is unnamed and requires the Soldier to enter their name, social security number, grade, primary military occupational specialty (PMOS) code, additional skill identifier (ASI), and control language and provide information about their current unit, gaining unit, the Enlisted Distribution Assignment System (EDAS) cycle, the date of filling the form and the arrival date.

The rest of Part I is divided into Sections A through C filled by the Military Personnel Division or Personnel Service Company and certified by the reassignment clerk.

Part II (Battalion Status) is filled by the battalion commander's principal staff officer. The Soldier fills in only Items 1 through 15 and the officer fills in the entire Sections D and E. At the end of Part II, the battalion commander signs and dates the form before returning the form to the MPD or Personal Service Company with a completed Soldier Status and Election Statement attached.

Part III (Soldier Status and Election Statement) is filled in by the Soldier. Section F refers to the Soldier’s personal status, Section G requires information on the Soldier’s OCONUS (Outside the Continental United States) status. Each positive answer should be clarified in the Remarks box at the end of the form.

When Part III is complete, the Soldier signs and dates the section and continues to Part IV (Wartime Status).

The signed and completed DA 5118 Form is then handed in to the battalion S1.

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