DA Form 3739 at a glance
What it is: DA Form 3739 is the Application for Compassionate Actions (AR 614-200).
Who signs: Sign at SIGNATURE OF APPLICANT and enter the DATE (YYYYMMDD). The COMMANDER/ AUTHORIZED REPRESENTATIVE enters the TYPED OR PRINTED NAME, signs at SIGNATURE and enters the DATE (YYYYMMDD).
The application is signed at SIGNATURE OF APPLICANT.
A filled-in DA Form 3739 example: a Soldier requests reassignment
How to fill out DA Form 3739, box by box
1. I request: reassignment, deferment, deletion or permissive attachment
Under 1. I REQUEST, the lines are a. REASSIGNMENT TO, b. DEFERMENT OF, c. DELETION FROM ORDERS TO and d. PERMISSIVE ATTACHMENT OF; the form also prints DAYS FROM ORDERS TO, DAYS AT and EFFECTIVE.
Boxes 2 to 9: name, DOD ID number, rank, PMOS and SMOS
Enter 2. NAME (Last, First, MI), 3. DOD ID NUMBER, 4. RANK, 5. PRO-PAY CATEGORY, 6. ENL COMMITMENT, 7. PMOS, 8. SMOS and 9. LATEST PCS.
Boxes 10 to 13: current status, unit, DEROS and DROS
10. Current status (check only one): duty, ordinary leave, ATCH, emergency leave or DDALV. Also enter 11a. ASG/ATCH UNIT, 11b. PHONE NO., 12. DEROS and 13. DROS.
Boxes 14 to 20: marital status, spouse, BASD, PEBD and ETS
Enter 14. MARITAL STATUS and 15. DATE OF MARRIAGE (YYYYMMDD), then 16a. NAME OF SPOUSE, 16b. AGE and 16c. PRESENT ADDRESS OF SPOUSE.
Enter 17. BASD, 18. PEBD, 19. ETS and 20. HOME PHONE NO. (Include area code).
21. Authorized family members, children or others
In 21. AUTHORIZED FAMILY MEMBERS, CHILDREN OR OTHERS AUTHORIZED AS FAMILY MEMBERS IAW AR 600-8-14, enter NAME, AGE, RELATIONSHIP and ADDRESS.
22a. Parents and parents-in-law
22a. PARENTS/PARENTS-IN-LAW is to be completed by all Soldiers; indicate if parents/parents-in-law are deceased. Enter NAME, ADDRESS, AGE, MONTHLY INCOME and HEALTH.
22b. Request based on loco parentis
22b. This request is based on loco parentis. I resided with persons from (Month/Year) to: (Month/Year); enter name, age, monthly income, health and address.
23. Soldier's brothers and sisters and other members of family
23. 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. Enter name, age, relationship, address, occupation and monthly income.
24. Previous requests for compassionate action
24. Has Soldier submitted any previous requests for compassionate action? Mark NO or YES; if yes, include date submitted, circumstances prompting the request, and final decision.
Boxes 25 to 27: reasons, attempts and remarks
25. GIVE REASONS FOR REQUESTING COMPASSIONATE ACTION. If illness or injury is involved, attach statement from attending physician, IAW AR 614-200, Chapter 5.
26. What attempts have been made by Soldier to remedy the conditions other than applying for a compassionate action?
Use 27. REMARKS.
28. Applicant statement and signature
28a. 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.
Sign at SIGNATURE OF APPLICANT and enter the DATE (YYYYMMDD).
29. Commander or authorized representative
29a. Signing certifies that the information on the request for compassionate action contained herein has been verified, and recommend approval or recommend disapproval is marked.
Enter the TYPED OR PRINTED NAME OF COMMANDER/ AUTHORIZED REPRESENTATIVE, sign at SIGNATURE and enter the DATE (YYYYMMDD).
Common questions about DA Form 3739
Where do I file it?
Forward the application to HRC (AHRC-EPO-A). Submit one copy only. 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). 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.
Sources
[1] DA Form 3739 (JUN 2025), Application for Compassionate Actions, U.S. Army (the Official source link on this page).