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This version of the form is not currently in use and is provided for reference only. Download this version of
DA Form 5840
for the current year.
DA Form 5840 Certificate of Acceptance as Guardian or Escort
What Is DA Form 5840?
DA Form 5840, Certificate of Acceptance as Guardian or Escort is a form that is filed by a guardian and signifies their agreement to care for a child or children in the absence of their parents.
The latest version of the form - sometimes incorrectly referred to as the DD Form 5840 and previously listed as DA Form 5840-R - was released by the Department of the Army (DA) on June 1, 2010 . An up-to-date DA Form 5840 fillable version is available for download and online filing below or can be found through the Army Publishing Directorate website.
The form is part of a series of Family Care-related paperwork. The document verifies that the guardian has been thoroughly briefed on all the responsibilities he will assume, the locations of pertinent documents and the procedures for accessing military and civilian facilities and services on behalf of the soldier's members of the family.
How to Fill Out DA Form 5840?
An overview of the purpose of the form and filing instructions are provided in the Army-issued AR 600-20, Army Command Policy, released in November 2014. The fillable DA Form 5840 form is designed as a letter and contains blank spaces that require the following information:
- The name of the guardian;
- The names and ages of the dependent family members that will be in the care of that guardian;
- The address, telephone, and e-mail of the guardian along with their signature and the date of signing.
The form is also filled out and verified by a Notary Public after all lines are completed by the guardian to-be.
DA 5840 Related Forms
The Army helps the soldiers in providing the necessary care for the dependent family members during periods of military-related absences. Family care paperwork includes the following forms:
- DA Form 5305, Family Care Plan - a form used to plan out the care that needs to be provided to the dependants and family members of a soldier during their absence;
- DA Form 5841, Power of Attorney;
- DD Form 2558, Authorization to Start, Stop, or Change an Allotment;
- DD Form 1172-2, Application for Identification Card/DEERS Enrollment. As a rule, this form is completed for each military family member.
