R Usar Form Details

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QuestionAnswer
Form Name107 R Fillable
Form Length2 pages
Fillable?Yes
Fillable fields94
Avg. time to fill out19 min 22 sec
Other names107r fillable, 107r, army 107r, family information data worksheet 107 r

Form Preview Example

ROUTINE USES:

Family Information Data Worksheet

[For use of this form see USAR Reg 608-1; the proponent agency is the USAR Family Programs Directorate.]

The information on this worksheet is for official use only within Army Reserve Family Programs and will not be furnished to any commercial enterprise, company, representative, organization or agency outside the Department of Defense, as established by the Privacy Act of 1974 (5 USC 552A and AR 340-21).

PRIVACY ACT ADVISORY STATEMENT

AUTHORITY: Title 10 U.S. Code, Sections 3012 and 3013. PRINCIPAL PURPOSE: To gather data that will assist in the development of appropriate Family Programs activities and services to servicemembers' families, identify individuals eligible to participate in the Family Programs and receive information.

Information provided (specifically, name, address, and telephone number) may be listed and distributed to other participants to enable development of a communication and support network. EFFECT OF WITHHOLDING CONSENT: Voluntary disclosure. Failure to provide information may prevent the Family Programs participants from contacting you, especially during periods of military separation, or being able to provide you updated information on military unit related family activities, programs, and services available.

SECTION I - SOLDIER INFORMATION

LAST NAME

 

 

 

 

 

 

FIRST NAME

 

 

 

 

 

 

 

MI

 

RANK

 

DOB

MOB DATE

TOUR LENGTH

 

 

 

 

 

 

 

 

 

(MM/DD/YYYY)

 

 

(MM/DD/YYYY)

 

 

 

 

 

 

(# of DAYS)

MAILING ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREET

 

 

 

 

 

 

 

 

APT. #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

 

 

 

 

 

STATE

 

ZIP CODE

 

 

COUNTRY

PRIMARY PHONE

 

 

 

SECONDARY PHONE

 

PRIMARY E-MAIL

 

 

 

 

SECONDARY E-MAIL

 

PRIMARY UNIT

 

 

 

 

 

 

MAJOR COMMAND

 

 

 

REASSIGNED UNIT

 

 

 

 

 

MAJOR COMMAND

 

MARITAL STATUS:

Single

Married

Divorced

SECTION II - PRIMARY POINT OF CONTACT

LAST NAME

 

 

 

FIRST NAME

 

 

 

 

 

MI

 

 

 

 

RELATIONSHIP TO SOLDIER

 

 

 

PRIMARY LANGUAGE

 

 

 

 

 

 

 

 

 

 

MAILING ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREET

 

 

 

 

 

 

 

 

 

 

APT. #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

 

 

 

 

 

 

 

STATE

 

ZIP CODE

 

COUNTRY

 

 

 

PRIMARY PHONE

 

 

SECONDARY PHONE

 

 

 

 

 

 

 

 

 

 

PRIMARY E-MAIL

 

 

 

SECONDARY E-MAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION III - CONSENT

 

 

 

 

 

 

 

 

 

Your Primary Point of Contact will be contacted by the Family Programs Office staff. Please initial to release this information to FRG volunteers.

PRINTED NAME

SIGNATURE

SOLDIER

DATE

FAMILY MEMBER

(MM/DD/YYYY)

USAR Form 107-R, 15 May 10

Previous edition is obsolete and will not be used.

Page 1 of 2

Family Information Data Worksheet (continuation)

SOLDIER'S LAST NAME

 

 

 

FIRST NAME

 

 

 

 

 

MI

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION IV - SECONDARY POINT OF CONTACT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LAST NAME

 

 

 

FIRST NAME

 

 

 

 

 

MI

 

 

RELATIONSHIP TO SOLDIER

 

 

 

PRIMARY LANGUAGE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MAILING ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREET

 

 

 

 

 

 

 

 

 

 

 

 

 

APT. #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

 

 

 

 

 

 

 

 

 

 

STATE

 

ZIP CODE

 

COUNTRY

PRIMARY PHONE

 

 

 

SECONDARY PHONE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PRIMARY E-MAIL

 

 

 

 

 

 

SECONDARY E-MAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION V - CHILD INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

CHILDREN

Yes

Last Name, First Name, MI

No

GUARDIAN

 

 

 

 

 

 

 

 

PHONE

 

 

 

 

 

E-MAIL

 

 

 

Gender

 

DOB

 

Mailing Address (If different from family address)

 

 

 

 

 

 

(MM/DD/YYYY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION VI - FAMILY CONCERNS

SPECIAL NEEDS OR FAMILY CONCERNS If "Yes," please explain:

Yes

No

DUAL MILITARY

Yes

No

SECTION VII - FAMILY PROGRAMS STAFF USE ONLY

SOLDIER'S SSN

 

DATE ENTERED IN PORTAL

(MM/DD/YYYY)

USAR Form 107-R, 15 May 10 (Reverse)

Page 2 of 2

How to Edit 107 R Fillable

Filling in 107r form is simple. We created our tool to make it user friendly and allow you to complete any PDF online. Here are a couple steps that you need to go through:

Step 1: The page has an orange button stating "Get Form Now". Simply click it.

Step 2: The moment you get into the 107r form editing page, you will notice all the actions you may undertake about your document within the upper menu.

The next few parts are what you are going to complete to receive the ready PDF file.

step 1 to filling out 107 r army

Jot down the data in LAST NAME, FIRST NAME, RELATIONSHIP TO SOLDIER, PRIMARY LANGUAGE, MAILING ADDRESS, PRIMARY PHONE, PRIMARY E-MAIL, STREET, CITY, SECONDARY PHONE, SECONDARY E-MAIL, SECTION III - CONSENT, APT, STATE, ZIP CODE, COUNTRY, and Your Primary Point of Contact will.

Completing 107 r army part 2

You'll be asked to type in the information to let the program fill in the box SIGNATURE, DATE, (MM/DD/YYYY), USAR Form 107-R, Previous edition is obsolete and, and Page 1 of 2.

part 3 to finishing 107 r army

For part Family Information Data Worksheet, SOLDIER'S LAST NAME, FIRST NAME, SECTION IV - SECONDARY POINT OF, LAST NAME, RELATIONSHIP TO SOLDIER, MAILING ADDRESS, PRIMARY PHONE, PRIMARY E-MAIL, STREET, CITY, FIRST NAME, PRIMARY LANGUAGE, SECONDARY PHONE, SECONDARY E-MAIL, SECTION V - CHILD INFORMATION, APT, STATE, ZIP CODE, COUNTRY, CHILDREN, Yes, GUARDIAN, PHONE, and E-MAIL, indicate the rights and obligations.

part 4 to filling out 107 r army

Terminate by analyzing these areas and completing them accordingly: Last Name, Gender, DOB, (MM/DD/YYYY), Mailing Address, (If different from family address), SPECIAL NEEDS OR FAMILY CONCERNS, Yes, DUAL MILITARY, Yes, If "Yes, and SECTION VI - FAMILY CONCERNS.

part 5 to completing 107 r army

Step 3: After you press the Done button, your ready document can be easily transferred to all of your devices or to electronic mail stated by you.

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