Fillable Printable Sponsorship Program Counseling And Information Sheet
Fillable Printable Sponsorship Program Counseling And Information Sheet
Sponsorship Program Counseling And Information Sheet
SPONSORSHIP PROGRAM COUNSELING AND INFORMATION SHEET
For use of this form, see AR 600-8-8; the proponent agency is ACSIM.
PREVIOUS EDITIONS ARE OBSOLETE.
DA FORM 5434, DEC 2012
APD LC v1.02ES
DATA REQUIRED BY THE PRIVACY ACT OF 1974
NOTE: Soldiers/Family members/Civilians may retrieve information regarding their new assignment at Army Knowledge Online -
1.
I have been counseled on the
Total Army Sponsorship Program
Typed or Printed Name: Rank/Grade:
MOS/Branch/Civilian Occupational Series: Signature: Date:
FOR CIVILIAN EMPLOYEES ONLY:
I would like to have a sponsor assigned to me. (Complete remainder of form.)
I decline the offer of sponsorship. (Complete Section 1 only.)
AUTHORITY:
PRINCIPAL PURPOSE:
ROUTINE USES:
DISCLOSURE:
Title 5, USC Section 301.
Personnel service support. To counsel Soldier or civilian employee about sponsorship program entitlements, and provide information to gaining
battalion or activity of new members.
Mandatory for service members. Nondisclosure may prevent participation in the sponsorship program.
None. The DoD Blanket Routine Uses set forth at the beginning of the DoD's compilation of systems of records notices may apply to this system.
FAMILY CONSIDERATIONS: If additional space is necessary, please attach your documentation to the form)
5.
a.
Housing requirements (check one):
Off-post housing
Yes No
On-post housing
b.
Pets:
If yes, list pet and type:
c.
Child care requirements:
Yes No
d.
Spousal Employment info:
Yes No
If yes, list type of work:
e.
List of local schools:
Yes No
f.
Contact by Unit Family Readiness Group (FRG):
Yes No
If yes, list Email address:
Additional comments:
g.
Accompanied by Family members:
NAME AGE RELATIONSHIP
Married-unaccompanied Single-unaccompaniedMarried-accompanied Single-accompanied
SEX
a.
I
, am on assignment to (Gaining Installation):
and expect to arrive on/about (Month and Year):
b.
Soldier's/Civilian's contact information:
Current Unit/Activity Address:
DSN Phone number: Cell Phone number: Email address:
Leave Address and Phone number at this address until:
c.
Status
d.
Yes No
ARRIVAL INFORMATION TO ASSIST GAINING UNIT OR ACTIVITY: If additional space is necessary, please attach your documentation to the form)
2.
Yes No
Yes No
Yes No
Yes No
Other (i.e., Social Media):
Exceptional Family
Member Program (EFMP)
(Rank/Grade and Name):
(check one):
GAINING UNIT/ACTIVITY INFORMATION: If additional space is necessary, please attach your documentation to the form)
3.
a.
Gaining Unit/Activity:
b.
Unit CDR/Supervisor:
Phone number:
Email address:
c.
Unit sponsor:
Phone number:
Email address:
d.
Unit 1SG/Supervisor:
Phone number:
Email address:
e.
TASP Unit Coordinator:
Phone number:
Email address:
f.
Date of initial contact:
a.
Losing Unit/Activity:
b.
Unit CDR/Supervisor:
Phone number:
Email address:
c.
Unit 1SG/Supervisor:
Phone number:
Email address:
d.
TASP Unit Coordinator:
Phone number:
Email address:
LOSING UNIT/ACTIVITY INFORMATION: If additional space is necessary, please attach your documentation to the form)
4.
https://www.us.army.mil
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