Form Da 5425 – Fill Out and Use This PDF

The DA Form 5425, known as the Applicant/Nominee Personal Financial Statement, is a document used within the United States Army. It serves to verify that individuals meet specific financial criteria, ensuring their suitability for selection and assignment, particularly for recruiting duty. For those interested in filling out this form, you can do so by clicking the button below.

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Form Da 5425 PDF Details

Understanding the significance of the DA Form 5425, or the Applicant/Nominee Personal Financial Statement, proves essential in gauging the financial suitability of individuals for specific roles within the U.S. Army, particularly for those being considered for recruiting duty. Governed by certain regulations and the Secretary of the Army's directives, this form serves as a comprehensive tool for verifying that an individual meets the financial criteria set forth for selection. It covers a broad spectrum of financial information, from basic income and expenditures to assets like savings accounts, stocks, real estate, and personal liabilities such as loans and credit card debts. Individuals are questioned about their bankruptcy history and other potential financial red flags, aiming to ensure their stability and reliability. The completion of this form, which is a prerequisite during the inprocessing at the Army Recruiter Course, is voluntary. However, non-disclosure or partial disclosure can affect an individual’s candidacy, overlooking their financial status in decision-making. Its structured format seeks to paint a clear picture of an applicant's financial health, impacting selections and assignments significantly. Through this preview, we delve into the intricacies and requirements of the DA Form 5425, shedding light on its critical role within the recruitment and positioning process in the Army.

Question	Answer
Form Name	Form Da 5425
Form Length	3 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	45 sec
Other names	da 31, dgp da 12 formato pdf, da 5425 r, form 5425

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APPLICANT/NOMINEE PERSONAL FINANCIAL STATEMENT

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

AUTHORITY:

PRINCIPAL PURPOSES:

ROUTINE USES:

DISCLOSURE:

PRIVACY ACT STATEMENT

5 U.S.C. 301, Departmental Regulation; 10 U.S.C. 3013, Secretary of the Army; AR 601-1, Assignment of Enlisted Personnel to the US Army Recruiting Command.

To verify that the individual meets financial criteria and is suitable for selection and assignment for recruiting duty. This form will be used during inprocessing at the Army Recruiter Course to confirm continued eligibility

None. The "Blanket Routine Uses" set forth at the beginning of the Army's Compilations of System of Records Notices apply to this system.

Voluntary. However, failure to provide the requested information may result in selection and assignment made without consideration of your financial status.

1.NAME (Last, First, Middle)

2. GRADE

3. Are you now or have you ever filed for bankruptcy?	(If yes, state when, where, and why.)	YES	NO
		YES	NO

Have you ever received a letter(s) of indebtedness? (If yes, enter month and year below.)

MONTH

YEAR

MONTH

YEAR

MONTHLY INCOME

AMOUNT

TOTAL

a. Basic Pay

b. Separate Rations

c. Clothing Allowance

d. Total Military Income Before Taxes (Total of a thru c above)

e. Subtract FICA and Income Taxes

(Subject)

f. Total After Tax Income

(Equal)

g. Any other Monthly Income (Do not include Spouse's income)

(Add)

TOTAL MONTHLY SPENDABLE INCOME

(Equal)

ADDITIONAL INFORMATION OR REMARKS

DA FORM 5425, SEP 2010

PREVIOUS EDITIONS ARE OBSOLETE.

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6. ASSETS

YES

AMOUNT

a. Do you have a savings account? (Enter approximate balance)

b. Do you own stocks, bonds, or benefit from a trust? (Enter approximate value)

c. Do you own (with no payments):

(1)

Vehicles

MAKE

MODEL

YEAR

(Enter total estimated value)

(2)

Home

Trailer

("x" one)

(Enter total estimated value)

(3)

Furniture (Enter estimated value)

(4)

Land (Enter estimated value)

TOTAL ASSETS

7. MONTHLY EXPENDITURES/LIABILITIES

MONTHLY PAYMENT

a. Cost of food (Include meals eaten out, school lunches, etc.)

b. Clothing (Dry cleaning/laundry)

c. Medical (Doctor, orthodontist, special medications, special schooling or treatment for handicapped

family member)

d. Insurance (Life, auto, homeowner, other)

e. Vehicle expenses

(1)

MAKE

MODEL

YEAR

(Enter total estimated value)

(2)

Gas, Oil, maintenance

f. List charge cards or credit cards for which you have an outstanding balance:

BALANCE OWED

NAME

DA FORM 5425, SEP 2010

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7. MONTHLY EXPENDITURES/LIABILITIES (Continued)

BALANCE OWED

MONTHLY PAYMENT

g.List finance companies, banks, credit unions, or other institutions where you have an outstanding loan:

NAME

h. Alimony or child support.

i.Any allotments for purposes not listed above?

(If yes, state for what purpose.)

YES

j. Any other indebtedness or financial obligation not listed above? (Use

remarks section to explain if necessary.)

TOTAL MONTHLY EXPENDITURES/LIABILITIES

REMARKS

8. SIGNATURE OF VOLUNTEER/NOMINEE

DA FORM 5425, SEP 2010

9. DATE

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APD PE v1.00ES

Form Da 5425 – Fill Out and Use This PDF

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