107 R Fillable PDF Details

The 107 R form, also known as the Family Information Data Worksheet, serves a vital function within the Army Reserve Family Programs. Its primary use, under the regulations stipulated by USAR Reg 608-1 and backed by the authority of Title 10 U.S. Code, Sections 3012 and 3013, is to collect essential data to support the development of Family Programs activities and services. These programs are designed to support the families of service members by ensuring they have access to necessary information, especially during times of military separation. The worksheet facilitates the identification of individuals eligible for participation in Family Programs and aims to foster a community of support through the sharing of contact information among participants. This sharing intends to help in building a supportive network and enhancing communication among families facing similar challenges. The form emphasizes voluntary participation, highlighting that withholding consent may limit the ability of Family Programs participants to reach out with valuable updates related to military unit family activities, services, and programs. With sections dedicated to soldier information, primary and secondary points of contact, children, special family concerns, and official use by Family Programs staff, the 107 R form embodies a comprehensive approach to gathering information. It serves as an enduring reminder of the Army Reserve's commitment to the wellbeing of service members' families, guided by the principles laid out in the Privacy Act of 1974.

QuestionAnswer
Form Name 107 R Fillable
Form Length 2 pages
Fillable? No
Fillable fields 0
Avg. time to fill out 30 sec
Other names usar forms, r usar form, 107r form, usar form 37 r

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ROUTINE USES:

Family Information Data Worksheet

[For use of this form see USAR Reg 608-1; the proponent agency is the USAR Family Programs Directorate.]

The information on this worksheet is for official use only within Army Reserve Family Programs and will not be furnished to any commercial enterprise, company, representative, organization or agency outside the Department of Defense, as established by the Privacy Act of 1974 (5 USC 552A and AR 340-21).

PRIVACY ACT ADVISORY STATEMENT

AUTHORITY: Title 10 U.S. Code, Sections 3012 and 3013. PRINCIPAL PURPOSE: To gather data that will assist in the development of appropriate Family Programs activities and services to servicemembers' families, identify individuals eligible to participate in the Family Programs and receive information.

Information provided (specifically, name, address, and telephone number) may be listed and distributed to other participants to enable development of a communication and support network. EFFECT OF WITHHOLDING CONSENT: Voluntary disclosure. Failure to provide information may prevent the Family Programs participants from contacting you, especially during periods of military separation, or being able to provide you updated information on military unit related family activities, programs, and services available.

SECTION I - SOLDIER INFORMATION

LAST NAME

 

 

 

 

 

 

FIRST NAME

 

 

 

 

 

 

 

MI

 

RANK

 

DOB

MOB DATE

TOUR LENGTH

 

 

 

 

 

 

 

 

 

(MM/DD/YYYY)

 

 

(MM/DD/YYYY)

 

 

 

 

 

 

(# of DAYS)

MAILING ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREET

 

 

 

 

 

 

 

 

APT. #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

 

 

 

 

 

STATE

 

ZIP CODE

 

 

COUNTRY

PRIMARY PHONE

 

 

 

SECONDARY PHONE

 

PRIMARY E-MAIL

 

 

 

 

SECONDARY E-MAIL

 

PRIMARY UNIT

 

 

 

 

 

 

MAJOR COMMAND

 

 

 

REASSIGNED UNIT

 

 

 

 

 

MAJOR COMMAND

 

MARITAL STATUS:

Single

Married

Divorced

SECTION II - PRIMARY POINT OF CONTACT

LAST NAME

 

 

 

FIRST NAME

 

 

 

 

 

MI

 

 

 

 

RELATIONSHIP TO SOLDIER

 

 

 

PRIMARY LANGUAGE

 

 

 

 

 

 

 

 

 

 

MAILING ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREET

 

 

 

 

 

 

 

 

 

 

APT. #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

 

 

 

 

 

 

 

STATE

 

ZIP CODE

 

COUNTRY

 

 

 

PRIMARY PHONE

 

 

SECONDARY PHONE

 

 

 

 

 

 

 

 

 

 

PRIMARY E-MAIL

 

 

 

SECONDARY E-MAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION III - CONSENT

 

 

 

 

 

 

 

 

 

Your Primary Point of Contact will be contacted by the Family Programs Office staff. Please initial to release this information to FRG volunteers.

PRINTED NAME

SIGNATURE

SOLDIER

DATE

FAMILY MEMBER

(MM/DD/YYYY)

USAR Form 107-R, 15 May 10

Previous edition is obsolete and will not be used.

Page 1 of 2

Family Information Data Worksheet (continuation)

SOLDIER'S LAST NAME

 

 

 

FIRST NAME

 

 

 

 

 

MI

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION IV - SECONDARY POINT OF CONTACT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LAST NAME

 

 

 

FIRST NAME

 

 

 

 

 

MI

 

 

RELATIONSHIP TO SOLDIER

 

 

 

PRIMARY LANGUAGE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MAILING ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREET

 

 

 

 

 

 

 

 

 

 

 

 

 

APT. #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

 

 

 

 

 

 

 

 

 

 

STATE

 

ZIP CODE

 

COUNTRY

PRIMARY PHONE

 

 

 

SECONDARY PHONE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PRIMARY E-MAIL

 

 

 

 

 

 

SECONDARY E-MAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION V - CHILD INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

CHILDREN

Yes

Last Name, First Name, MI

No

GUARDIAN

 

 

 

 

 

 

 

 

PHONE

 

 

 

 

 

E-MAIL

 

 

 

Gender

 

DOB

 

Mailing Address (If different from family address)

 

 

 

 

 

 

(MM/DD/YYYY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION VI - FAMILY CONCERNS

SPECIAL NEEDS OR FAMILY CONCERNS If "Yes," please explain:

Yes

No

DUAL MILITARY

Yes

No

SECTION VII - FAMILY PROGRAMS STAFF USE ONLY

SOLDIER'S SSN

 

DATE ENTERED IN PORTAL

(MM/DD/YYYY)

USAR Form 107-R, 15 May 10 (Reverse)

Page 2 of 2

How to Edit USAR Form 107-R Online for Free

Our top level developers worked hard to obtain the PDF editor we are now proud to deliver to you. The software will allow you to instantly complete army 107r and can save precious time. You just have to comply with this specific guideline.

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stage 1 to filling out 107 r army

Complete the RELATIONSHIP TO SOLDIER, PRIMARY LANGUAGE, MAILING ADDRESS, PRIMARY PHONE, PRIMARY EMAIL, STREET, CITY, SECONDARY PHONE, SECONDARY EMAIL, SECTION III CONSENT, APT, STATE, ZIP CODE, COUNTRY, and Your Primary Point of Contact will field using the data requested by the software.

107 r army RELATIONSHIP TO SOLDIER, PRIMARY LANGUAGE, MAILING ADDRESS, PRIMARY PHONE, PRIMARY EMAIL, STREET, CITY, SECONDARY PHONE, SECONDARY EMAIL, SECTION III  CONSENT, APT, STATE, ZIP CODE, COUNTRY, and Your Primary Point of Contact will blanks to insert

You'll have to provide specific particulars in the section Family Information Data Worksheet, SOLDIERS LAST NAME, FIRST NAME, SECTION IV SECONDARY POINT OF, LAST NAME, RELATIONSHIP TO SOLDIER, MAILING ADDRESS, PRIMARY PHONE, PRIMARY EMAIL, STREET, CITY, FIRST NAME, PRIMARY LANGUAGE, SECONDARY PHONE, and SECONDARY EMAIL.

Filling out 107 r army step 3

The space SPECIAL NEEDS OR FAMILY CONCERNS, Yes, DUAL MILITARY, Yes, If Yes please explain, SECTION VI FAMILY CONCERNS, and SECTION VII FAMILY PROGRAMS STAFF should be where you can add both parties' rights and responsibilities.

step 4 to completing 107 r army

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