DA Form 3739 at a glance
What it is: APPLICATION FOR COMPASSIONATE ACTIONS: the principal purpose is to determine eligibility for compassionate action.
Where and when to file: Forward application to HRC (AHRC-EPO-A) and submit one copy only.
A filled-in DA Form 3739 example: a Soldier requests reassignment
How to fill out DA Form 3739, box by box
Tap a group of boxes to open it, and a picture to see it full size.
1. I request
In 1. I request, check the one box that applies and write on its line: a. reassignment to; b. deferment of, days from orders to; c. deletion from orders to; d. permissive attachment of, days at, effective.
Name, DOD ID number, rank, pro-pay category
Write the 2. name (Last, First, MI), 3. DOD ID number, 4. rank and 5. pro-pay category.
ENL commitment, PMOS, SMOS, latest PCS
Write the 6. ENL commitment, 7. PMOS, 8. SMOS and 9. latest PCS.
Current status (check only one)
In 10. current status (check only one), check the one box that applies: duty, ordinary leave, ATCH, emergency leave or DDALV; in 11a. write the ASG/ATCH unit and in 11b. the phone no.
DEROS, DROS
Write the 12. DEROS and the 13. DROS.
Name of spouse, age, present address of spouse
Write the 16a. name of spouse, the 16b. age and the 16c. present address of spouse.
BASD, PEBD, ETS, home phone no.
Write the 17. BASD, 18. PEBD, 19. ETS and 20. home phone no. (include area code).
Authorized family members, children or others authorized as family members IAW AR 600-8-14
In 21., write the authorized family members, children or others authorized as family members IAW AR 600-8-14, and for each the age, name, address and relationship.
22a. Parents/parents-in-law
In 22a. parents/parents-in-law (to be completed by all Soldiers; indicate if parents/parents-in-law are deceased.), write each parent's name, address, age, monthly income and health.
22b. This request is based on loco parentis
In 22b., if this request is based on loco parentis, write the persons under "I resided with the following persons from (month/year) to: (month/year)", and for each the name, age, address, monthly income and health.
Soldier's brothers and sisters
In 23., write the Soldier's brothers and sisters whether living at home or elsewhere and other members of family (include brothers/sisters-in-law, if request is based on in-law problems), and for each the name, age, relationship, address, occupation and monthly income.
Previous requests for compassionate action
In 24., check yes or no: has the Soldier submitted any previous requests for compassionate action? If yes, include date submitted, circumstances prompting the request, and final decision.
Reasons for requesting compassionate action
In 25., give reasons for requesting compassionate action (if illness or injury is involved, attach statement from attending physician, IAW AR 614-200, Chapter 5.).
Attempts made by Soldier to remedy the conditions
In 26., write what attempts have been made by Soldier to remedy the conditions other than applying for a compassionate action?
Remarks
Write remarks on the 27. remarks lines.
28a. Signature of applicant
In 28a., sign on the signature of applicant line.
I have been interviewed by a commissioned officer and have been advised that false statements on this application will constitute a violation of the UCMJ 1951 (as amended) and may subject me to a trial by court-martial.
29. Has been verified, recommend approval, recommend disapproval
In 29., the commander or authorized representative certifies that the information on the request for compassionate action contained herein, check has been verified, recommend approval or recommend disapproval, sign on the signature line and write the typed or printed name of commander/authorized representative.
More rules for DA Form 3739
DISCLOSURE: Voluntary; however, failure to furnish information requested may result in denial of request for compassionate action.
If submitted by Soldier on leave, DDALV or in attached status, a copy of DA Form 31 or orders must be included with this request.
The Soldier is advised that if this request for compassionate action is approved, he/she may be assigned to duties in other than PMOS; further, a waiver of any enlistment/reenlistment commitment must be accomplished (AR 601-210, chapter 8 and AR 601-280, chapter 4).
Common questions about DA Form 3739
Where do I file it?
Forward application to HRC (AHRC-EPO-A) and submit one copy only.
Sources
[1] DA Form 3739 (JUN 2025), Application for Compassionate Actions, DCS, G-1 (the Official source link on this page).