DA Form 5521 PDF Details

DA Form 5521 is the official Army document for Non-Appropriated Fund (NAF) employees to record emergency contact data and designate beneficiaries for any unpaid compensation upon their death. Required under AR 215-3 and the Privacy Act of 1974, this form ensures an employee's final wishes are legally documented and honored.

The form captures three key data categories: basic employee identification, emergency contact details, and explicit beneficiary designations. Each beneficiary entry must include their name, relationship to the employee, and their percentage share of any unpaid compensation. Failing to submit this form can delay estate payments or result in compensation going to unintended recipients.

Complete the form by entering your name, SSN, grade, and organization first. List emergency contacts and sign with a witness present. Submit the original to your NAF human resources office. For related Army employment documents, see the DA Form 87, DA Form 4856, and the life insurance beneficiary form.

QuestionAnswer
Form NameDA Form 5521
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesda form 5521 fillable, da data designation fillable, form 5521, da data designation