Home : Staff : Office of Army Reserve Affairs-Japan : Forms

Army Reserve Forms

Please use the following links to ensure you download the latest versions of the applicable forms
DA Forms http://www.apd.army.mil/Forms/browse_forms.asp
DD Forms http://www.dtic.mil/whs/directives/infomgt/forms/formsprogram.htm
DA Publications http://www.army.mil/usapa/epubs/index.html

1. Request for Annual Training Orders
DA Form 1058-R   - Application for Active Duty for Training for U.S. Army Reserve  (Sample)
DA Form 7349   - Initial Medical Review – Annual Medical Certificate

- These forms must be submitted timely such that the RC Office has sufficient opportunity to submit the Request for Orders to HRC at least 30 days prior to the requested report date. The 1058 must be signed in blocks 21 and 23. In block 23, you should indicate what, if any, IDT dates you will perform in conjunction with your AT.

FCC Form 507   - Functional Capacity Certificate Form 507

- If you have any medical issues to declare, you must also complete and submit this form to the RC Office with a physician's signature such that we may pursue any necessary military profiles with MEDDAC-J on your behalf.

2. IN-Processing
*All documents are required for the initial IN-processing.
*Please submit forms only when you need to update information.
In-Processing Checklist and Sample USARJ Reserve Components In-processing Checklist
SF Form 1199A Direct Deposit Sign-Up Form
DA Form 5960 Authorization to Start, Stop, or Change BAQ and/or VHA
SGLV Form 8286 Servicemembers' Group Life Insurance (SGLI)
SGLV Form 8286A SGLI Family Coverage Election
*Please update W-4 and DD Form 2058 through DFAS MYPAY Online: https://mypay.dfas.mil/mypay.html
W-4 Employee's Withholding Allowance Certificate
DD Form 2058 State of Legal Residence Certificate

3. OUT-Processing
*Please refer to sample forms linked below and submit forms to our office when you finish your training.
AHRC Form 3924
(Sample 1)
(Sample 2)
Certificate of Performance
Follow Sample 1 if you perform AT only and no IDT.
If you perform AT and IDT, please submit two AHRC 3924's: one each according to Sample 1 and Sample 2.

DA Form 1380
( Sample)
Certificate of Completion for Inactive Duty for Training (IDT)
*Please refer to the sample form and submit Travel Voucher to DFAS.
DD Form 1351-2
 (Sample )
Travel Voucher or Subvoucher
Smart Voucher: http://www.dfas.mil/tdytravel/smartvoucher.html
*Please update DD Form 93.
DD Form 93 Record of Emergency Data
*Please submit these forms as soon as you take PT Test.
DA Form 5500-R Body Fat Content Worksheet (Male)
DA Form 5501-R Body Fat Content Worksheet (Female)

4. Evaluation Forms
*Please be sure to coordinate with your rater to ensure that they have all necessary documentation in order to prepare your annual evaluation in a timely manner.
DA Form 67-10-1 Company Grade and WO1-WO2 Officer Evaluation Report
DA Form 67-10-1A Officer Evaluation Report Support Form
DA Form 67-10-2 MAJ - LTC and WO3-5 Officer Evaluation Report
DA Form 2166-8 NCO Evaluation Report
DA Form 2166-8-1 NCO Counseling and Support Form (for end dates of 31 December 2015 or earlier)
DA Form 2166-9-1A NCO Evaluation Report Support Form (for end dates of 1 January 2016 and later)

5. Assignment Forms
DA Form 4651
 (Sample)
Request for Reserve Component Assignment or Attachment

6. Other Useful Forms
DA Form 2173 Statement of Medical Examination and Duty Status
DA Form 2813 DoD Active Duty/Reserve/Guard/Civilian Forces Dental Examination
DA Form 4187 Personnel Action
DA Form 4787 Reassignment Processing
DA Form 5888 Family Member Deployment Screening Sheet

NOTE: These resources are in Acrobat .pdf, Word .doc format and Excel .xls format. If you do not have these applications installed, free viewers are available (Adobe Reader | Microsoft Word viewer | Microsoft Excel viewer).