DA Form 5304 is the Army Family Care Plan Counseling Checklist, required under Army Regulation 600-20 (Army Command Policy). It documents the counseling session in which a soldier and their chain of command establish a plan for the care of dependents if the soldier is deployed, reassigned, or otherwise unable to provide care.
The form covers key aspects of the Family Care Plan, including the identification of designated short-term and long-term caregivers, financial power of attorney arrangements, legal guardianship documentation, and emergency contact information. Soldiers with minor children, elderly dependents, or disabled family members must maintain an active Family Care Plan at all times.
Related documents frequently used alongside DA Form 5304 include DA Form 5305 (Family Care Plan) and DA Form 5305-R. Together, these forms ensure Army commands can account for all soldiers' family obligations when making deployment and assignment decisions.
| Question | Answer |
|---|---|
| Form Name | DA Form 5304 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Issuing Agency | U.S. Department of the Army |
| Regulation | AR 600-20 (Army Command Policy) |
| Other names | da 5304 fillable pdf, da 5304, da form 5304 fillable, da form 5304 jun 2010 word doc |