DA Form 7666 Parental Consent

What Is DA Form 7666?

DA Form 7666, Parental Consent is a form used to obtain the agreement of both parents on the custodial arrangements expressed on their Family Care Plan. The form is a necessary part of the Family Care plan paperwork and allows a partner or other individual to act as temporary guardian of any dependents while the servicemember is performing their military duties.

The newest version of the form - often incorrectly referred to as the DD Form 7666 - was released by the Department of the Army in September 2009. An up-to-date DA Form 7666 fillable version is available for digital filing and download below or can be supplied through the APD Forms website.

The Family Care Plan - or FCP - is a tool used for designating a guardian that takes care of a servicemember's dependent child or children while they are away. The FCP is applicable only to single soldiers with kids, dual military members and parents with a separation agreement, not for soldiers married to civilians or soldiers without kids.

PARENTAL CONSENT
For use of this form, see AR 600-20; the proponent agency is DCS, G-1.
PRIVACY ACT STATEMENT
10 U.S.C. Section 3013, Secretary of the Army: Army Regulation 600-20, Army Command Policy.
AUTHORITY:
To record the agreement of both parents with their child's custodial arrangement as documented in the Family
PRINCIPAL PURPOSE:
Care Plan.
None.
ROUTINE USES:
DISCLOSURE:
Mandatory; failure to maintain a Family Care Plan could subject you to separation, administrative action, or
disciplinary action under the UCMJ.
In accordance with this agreement the parties confirm the following stipulations of fact and terms of agreement:
,
are the parents of
a member of the United States Army, (hereinafter "the Soldier"), and
(hereinafter "the child"), date of birth
, born in
.
The child currently resides primarily with
at
.
As a function of performing military duties, the Soldier may have to perform temporary duty, be deployed, or otherwise not be available to care
a.
for the minor child.
b.
The Soldier has been notified that he or she is to be temporarily deployed. The time period of deployment has been estimated to be
in length. As a matter of military necessity, the minor child will not be able to reside with, or exercise access to the
Soldier during this time. (Initial appropriate paragraph)
The parties agree that each has reviewed the attached Family Care Plan as set forth in Form DA 5305, which indicates that for the time period that the
Soldier is absent,
is to serve as the minor child's temporary physical guardian.
The parties agree that during this period the minor child will reside at
.
The parties agree that each will cooperate with the execution of any additional documentation as may be necessary to facilitate the designation of
physical custody to the temporary guardian and effectuate this consent.
By the signatures below, each party indicates their consent to the arrangements outlined in the attached Family Care Plan and this agreement.
(SOLDIER'S SIGNATURE)
STATE OF
COUNTY OF
Acknowledged before me this
day of
,
.
(NOTARY PUBLIC)
My commission expires:
(OTHER PARENT'S SIGNATURE)
STATE OF
COUNTY OF
Acknowledged before me this
day of
,
.
(NOTARY PUBLIC)
My commission expires:
APD LC v1.01
DA FORM 7666, SEP 2009

Download DA Form 7666 Parental Consent

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How to Fill Out DA Form 7666?

An overview of the form and all applicable filing guidelines can be found in the Army Regulation 600–20, Army Command Policy, released in November 2014. DA Form 7666 instructions are as follows:

  1. First, the soldier has to enter their name in the first line of the form, then provide the name of the second parent, then the name of the child and their date and place of birth.
  2. The next several lines are meant for providing information on where and with whom the child currently primarily resides.
  3. Lines (a) and (b) provide information on the soldier’s deployment period.
  4. The next line requires the name of the person who will serve as the child’s temporary physical guardian while the soldier is performing their duties.
  5. The DA 7666 is then signed by the servicemember and certified by a notary public and then by the other parent, who must also have their signature notarized.

DA 7666 Related Forms

  1. DA Form 5304, Family Care Plan Counseling Checklist, is a related form that must be signed by the Commanding Officer or the Commander;
  2. DA Form 5305, Family Care Plan, is a form filed by soldiers seeking assistance with child care while they are on active duty trips.
  3. DA Form 5840, Certificate of Acceptance as Guardian or Escort, is a form made for each guardian - whether temporary or long-term - and certified by a private notary;
  4. DA Form 5841, Power of Attorney, is a form used to designate a guardian for child care during a soldier’s absence.
  5. DD Form 1172, Application for Uniformed Service Identification Cards/DEERS Enrollment, is a form used for enrolling in the Defense Enrollment Eligibility Reporting System for certain benefits and privileges.
  6. DD Form 2558, Authorization to Start, Stop, or Change Allotment, is a form used for maintaining a record of all allotments and ensuring that any starts, changes, and stops are in keeping with the wishes of the servicemember.