Download the form
DA Form 5304 exists to family care plan counseling checklist — that is the short version. Title of record: FAMILY CARE PLAN COUNSELING CHECKLIST. The page covers the download, the entries and the disposition, nothing else. Current here: edition 07/01/2020, status ACTIVE, 3 page(s), near 133 fields. Superseded edition. A newer one is out; stay here only for files already executed on this version.
Two references decide everything about your use of it: G-1 maintains the content, AR 600-20 sets the trigger and the routing. Consult the directive when your case is not routine; otherwise the printed blocks tell you enough. The person named in the entries fills it, or the administrative office holding the file does it for them.
The formats are PDF, XFDL, and the choice comes down to keyboard or pen. Fillable pdf for typing — live fields, tab order, saved entries. Printable pdf for handwriting — same page, no interactive objects, print it blank. Content is identical; only entry method differs.
Save the download and open it in a dedicated reader. That single step prevents the common failure: an in-browser viewer accepts your typing and discards it at tab close. Confirm with one field and one save cycle before committing the whole form. The xfdl copy needs the IBM Lotus Forms Viewer. That format runs in Army systems and nothing else reads it.
Nothing is charged and no sign-up applies. Files are served as published, without changes to the page image.
What the form asks for
- COMMANDR
- ContentArea1
- ContentArea2
- ContentArea3
- DATE_A
- DATE_B
- DATE_C
- DATE_D
- EMAIL_A
- EMAIL_B
- Page1
- Page2
- Page3
- R100
- R101
- R102
- R103
- R104
- R105
- R106
- R107
- R108
- R109
- R110
The heading entries carry more weight than the body. Name spelled as in official records, identification number, organisation, date prepared. Retrieval runs on those values, so a transposed digit or a casual spelling costs someone a file search. Fill them before anything else.
Move between fields with tab; the build-time order follows the page and misses nothing. Click check boxes and option buttons, and expect an exclusive group to release the old choice when you set a new one. The trap is field width. Single-line fields do not wrap, so an overlong entry displays complete on screen and prints cut at the margin — put it in remarks or on a continuation instead. Mark inapplicable fields rather than leaving them blank, since an empty box carries no information about whether the question was read.
Signature comes after every other entry — ink or an approved electronic means, and without it the document is a draft. Where reviewing, approving or witnessing signatures are called for, take them in printed block order, each dated on the day applied. Before release, one pass from the top. The defects worth hunting are always the same four: mandatory fields left empty, identification digits transposed, dates with day and month reversed, and stale data surviving in a copy reused in place of a blank form.
Privacy Act statement first, personal entries second. The notice covers who is authorised to collect, why, who else routinely sees it, and whether you must answer. After completion the file carries personal data and is stored and sent under the corresponding safeguards.
Send it where the directive says: the office it names, the unit administrative channel, or the individual's file. Take your copy before submission. How long the record is held comes from the schedule for the series, not from the office holding it.
Related forms are found by series and number. DA series documents under the same proponent or the same prescribing directive are commonly required as a set, and any form named on the face of this one goes forward with it. Assemble continuations, covers and transmittals before submitting, not after the query comes back.
Check the edition date before reusing a saved copy. Revisions come from the proponent without notice to you, and the printed date is the only version marker on the page. Already-submitted records under a superseded edition stand as filed; the change does not run backwards.
What is distributed here are reproductions of published Department of the Army documents. Independent site, no official standing, no forms of its own. Nothing on the page constitutes legal advice, and acceptance by any office is outside what can be stated. Put questions about entries, requirements or eligibility to G-1 or your servicing administrative office.
Questions and answers
- What is DA Form 5304?
- FAMILY CARE PLAN COUNSELING CHECKLIST
- Which edition is current?
- 07/01/2020
- Who is responsible for this form?
- G-1
- In which formats can it be downloaded?
- PDF, XFDL, PDF
Publisher notes
- 14-REQUIRES PRIVACY ACT STATEMENT (AR 340-21),