Get the free da form 5475 r printable - armypubs army

COR/MAE SURVEILLANCE SCHEDULE DATE For use of this form, see DA PAM 520; the proponent agency is AC SIM. When completed stamp “FOR OFFICIAL USE ONLY SERVICE DATE DA FORM 5475, MAR 2008 PREVIOUS

How to fill out da form 5475 r

How to fill out DA Form 5475 R:

1. Start by downloading a blank copy of DA Form 5475 R from the official Army publications website or obtain a physical copy from your unit.
2. Begin filling out the form by providing your personal information in Section I. This includes your full name, rank, Social Security Number, and contact information.
3. In Section II, indicate the type of request you are making by selecting the appropriate box. This could be for a determination of eligibility, a review of an earlier determination, or an update to your records.
4. In Section III, provide details about the specific request or eligibility you are seeking. Be thorough and provide all necessary information and supporting documents, such as medical records or deployment orders.
5. In Section IV, certify your form by signing and dating it. You may also need to have a witness sign this section depending on your specific situation.
6. Once the form is completed, make copies for your records and submit the original to the designated authority or office as instructed.
7. If you have any questions or need assistance, refer to the instructions provided with the form or contact the appropriate office for guidance.

Who needs DA Form 5475 R?

1. Soldiers who require a determination of eligibility for certain benefits or entitlements may need to fill out DA Form 5475 R.
2. Individuals who need a review of an earlier eligibility determination or require an update to their records may also need to complete this form.
3. This form is often used by military personnel who are seeking medical waivers, temporary profile extensions, or requesting accommodations for specific conditions.
4. Additionally, individuals who are applying for or renewing certain Army schools or programs may be required to submit this form as part of their application process.
5. It is important to consult with your unit or chain of command to determine if you need to fill out DA Form 5475 R and to confirm the specific requirements and deadlines for submission.

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What is da form 5475 r?

Da Form 5475-R is a form used by the Department of the Army for reporting counterfeit electronic parts.

Who is required to file da form 5475 r?

All Department of the Army personnel and contractors who come across counterfeit electronic parts are required to file Da Form 5475-R.

How to fill out da form 5475 r?

Da Form 5475-R can be filled out by providing detailed information about the counterfeit electronic parts encountered, including source, quantity, and potential impact.

What is the purpose of da form 5475 r?

The purpose of Da Form 5475-R is to report and track instances of counterfeit electronic parts within the Department of the Army.

What information must be reported on da form 5475 r?

Information such as source of counterfeit parts, quantity, potential impact, and actions taken must be reported on Da Form 5475-R.