Da Form 4474 PDF Details

In the arena of military benefits and financial assistance, forms and paperwork serve as critical tools to ensure personnel receive the resources and support they ought to. Among the myriad of forms the United States Armed Forces uses, the DA Form 4474, titled "Request for Accelerated Payment of SRB - Hardship or Compassionate," plays a unique role. Formulated under the guidance provided by AR 601-280, and overseen by the agency DCS, G-1, this document is rooted in the legislation of the Armed Forces Enlisted Personnel Bonus Act of 1974. Its primary objective is to gather necessary data about a service member's financial condition to support a request for an accelerated payment of the Selective Reenlistment Bonus (SRB). The form requires comprehensive information, including personal, financial, and service details from the requesting enlisted member, to be thoroughly evaluated by a personnel manager. The considerations for accelerated SRB payments are based upon instances of hardship or compassionate grounds, highlighting the form’s function as a bridge between immediate financial relief and the serving members in their times of need. As an essential piece of documentation, DA Form 4474 underscores the military's commitment to providing for its personnel, signified through its detailed sections requesting financial disclosures, dependents’ information, and specific purposes for the advanced payment request. It's an illustrative example of how procedural documentation intersects with compassionate consideration within military administration.

QuestionAnswer
Form NameDa Form 4474
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesform 4474, VHA, 1974, atf form 4474

Form Preview Example

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REQUEST FOR ACCELERATED PAYMENT OF SRB - HARDSHIP OR COMPASSIONATE

For use of this form, see AR 601-280; the proponent agency is DCS, G-1.

DATA REQUIRED BY THE PRIVACY ACT

PRINCIPAL PURPOSE:

ROUTINE USES:

Section 308, Title 37, US code, as amended by public law 93-277. Armed Forces Enlisted Personnel Bonus Act of 1974, 10 May 1974.

To obtain data on service member's financial condition.

As a source document for the personnel manager to determine propriety of accelerated payment of Selective Reenlistment Bonus (SRB ) to enlisted applicants.

DISCLOSURE:

Voluntary. However, failure to provide any or all of the requested information may result in the personal manager not

 

having sufficient information on which to base an approval of the enlisted member's request.

 

 

SECTION A - (To be completed by requestor)

1.

NAME (Last, First, MI)

2. GRADE

3. MOS

4. DATE

 

 

 

 

5.

DATE AND LENGTH OF REENLISTMENT

6. NUMBER OF DEPENDENTS

7. UNIT AUTOVON NO.

8. HAVE YOU SUBMITTED ANY PREVIOUS REQUESTS FOR ACCELERATED SRB

YES

IF SO, WHAT ACTION WAS TAKEN ON YOUR REQUEST?

APPROVED

DISAPPROVED

NO

RETURNED WITHOUT ACTION

9. INDIVIDUAL/FAMILY INCOME

 

AMOUNT

 

 

10. COLLECTIONS (Ref Col 8. LES)

 

AMOUNT

(Ref Col 5. LES)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

a

 

 

b

 

 

 

 

 

a

 

 

 

 

 

 

 

b

a. BASIC PAY

 

 

 

 

a. FEDERAL INCOME TAX

 

 

 

 

 

 

 

 

b. QUARTERS ALLOWANCE

 

 

 

 

b. FICA

 

 

 

 

 

 

 

 

 

 

 

c. RATIONS/VHA

 

 

 

 

c. SOLDIER'S HOME/SGLI

 

 

 

 

 

 

 

 

d. PRO PAY

 

 

 

 

d. AER/CFC CONTRIBUTIONS

 

 

 

 

 

 

 

 

e. SPOUSE'S MONTHLY INCOME

 

 

 

 

e. INSURANCE (COL 7, LES)

 

 

 

 

 

 

 

 

 

TOTAL

 

 

 

 

 

 

 

 

TOTAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11. ALLOTMENTS, ADVANCE

 

PURPOSE

 

BALANCE

 

MONTHLY

 

 

DATE

 

DATE TO LIQUIDATE

PAY (s) & EXPENDITURE (s)

 

 

 

 

REMAINING

 

PAYMENT

INCURRED

 

 

 

 

a

 

b

 

 

c

 

 

d

 

 

e

 

 

f

a. RENT/HOME PAYMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b. FOOD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

c. AUTO UPKEEP/FUEL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

d. AUTO INSURANCE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

e. OTHER INSURANCE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

f. UTILITIES (including phone)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

g.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

h.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

i.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

j.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

k.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I,

 

 

 

 

 

, REQUEST IMMEDIATE PAYMENT OF

 

 

 

 

 

 

 

 

(SIGNATURE)

 

 

 

 

 

 

 

 

 

(NUMBER)

ACCELERATED INSTALLMENT (S) OF MY REMAINING SRB/VRB. A TOTAL OF $

 

 

 

 

 

TO BE USED FOR THE FOLLOWING

PURPOSE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION B - (To be completed by servicing FAO)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A REVIEW OF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PERSONAL FINANCE

RECORD REVEALS THE FOLLOWING INFORMATION: GROSS SRB/ENTITLEMENT

 

 

 

 

 

 

 

 

 

 

 

AMOUNT PAID EM $

 

 

BALANCE DUE EM $

 

 

SRB/DESIGNATOR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TYPED NAME/SIGNATURE

 

 

 

 

 

 

 

 

 

 

DATE

 

 

 

DA FORM 4474, AUG 2010

PREVIOUS EDITIONS ARE OBSOLETE.

APD LC v1.00ES

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Filling in section 1 in VRB

2. Soon after performing the previous step, go on to the next step and enter the necessary particulars in all these blanks - TOTAL, SIGNATURE, REQUEST IMMEDIATE PAYMENT OF, NUMBER, ACCELERATED INSTALLMENT S OF MY, TO BE USED FOR THE FOLLOWING, A REVIEW OF, SECTION B To be completed by, PERSONAL FINANCE, RECORD REVEALS THE FOLLOWING, AMOUNT PAID EM, BALANCE DUE EM, SRBDESIGNATOR, TYPED NAMESIGNATURE, and DATE.

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