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Understanding the 107 R form is essential for Army Reserve families seeking support and engagement with Family Programs. This critical document, formally known as the Family Information Data Worksheet, is designed to collect vital information about soldiers and their families. It serves multiple purposes, from helping to develop effective activities and services to identifying family members eligible for participation in these programs. The information collected is kept strictly for official use within Army Reserve Family Programs, adhering to the regulations established by the Privacy Act of 1974, ensuring that personal data is never shared with outside organizations. The form includes sections for soldier information, primary and secondary points of contact, and details about children and special family concerns. By providing this information, families can receive updates on essential military unit activities and upcoming services, particularly during times of separation. Participation is voluntary, yet withholding consent may limit communication opportunities, making it harder to stay informed and connected. Ultimately, the 107 R form acts as a bridge between the Army Reserve community and the families it serves, facilitating a support network that thrives on connection and awareness.

107 R Example

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

Form Characteristics

Fact Name Detail
Form Title Family Information Data Worksheet
Governing Regulations USAR Reg 608-1
Authority Title 10 U.S. Code, Sections 3012 and 3013
Privacy Protection Information is protected by the Privacy Act of 1974 (5 USC 552A)
Principal Purpose To gather data for Family Programs activities and services.
Voluntary Disclosure Providing information is optional and can affect communication.
Date of Last Revision Form last updated on May 15, 2010
Contact Information Includes sections for primary and secondary points of contact.

Guidelines on Utilizing 107 R

Filling out the 107 R form is an important step for soldiers and their families involved in Army Reserve Family Programs. After submitting this form, Family Programs staff can reach out to the designated contacts and provide necessary information and resources. Below are clear steps to help you complete this form accurately.

  1. Start with Section I by entering the soldier's last name, first name, and middle initial. Fill in the rank and date of birth.
  2. Provide the date of mobilization and length of tour in days.
  3. Complete the mailing address, including street, apartment number (if applicable), city, state, ZIP code, and country.
  4. List the primary and secondary phone numbers and both primary and secondary email addresses.
  5. Fill in the primary unit and major command details, as well as reassigned unit and major command if applicable.
  6. Indicate marital status by selecting Single, Married, or Divorced.
  1. Move to Section II and provide the primary point of contact’s last name, first name, and middle initial. Include their relationship to the soldier.
  2. Specify the primary language spoken by this contact.
  3. Enter their mailing address, phone numbers, and email addresses as you did for the soldier.
  1. In Section III, initial where indicated to consent to share information with Family Readiness Group volunteers. Print your name and provide your signature along with the date.
  1. Proceed to Section IV. Enter the secondary point of contact information just like you did for the primary contact, including their relationship to the soldier.
  1. In Section V, indicate if you have children by answering “Yes” or “No.” If yes, list the last name, first name, middle initial, gender, and date of birth of each child. Provide any different mailing addresses as necessary.
  1. Go to Section VI to address any family concerns or special needs. Select “Yes” or “No” and provide an explanation if necessary.
  1. Use Section VII for family programs staff. Leave this section blank as it will be filled out by the Family Programs office.

After completing all sections, double-check your entries for accuracy. Submit the form as directed to ensure the information is processed without delay.

What You Should Know About This Form

What is the purpose of the 107 R form?

The 107 R form, also known as the Family Information Data Worksheet, is designed to gather essential information that will help in offering support and services to military families. It allows the Army Reserve Family Programs to connect families with relevant activities, support networks, and resources. This ensures that families receive timely and useful information related to military unit activities and available programs. However, it’s important to note that the information is strictly for official use within the Department of Defense and will not be shared with any outside organizations or businesses.

Is participation in providing information through the 107 R form mandatory?

Participation in providing information on the 107 R form is voluntary. While you are not required to fill out the form, withholding your consent may lead to difficulties in communication. If the form is not completed, Family Programs may be unable to reach you during periods of military separation or keep you updated about activities and resources that could be beneficial for you and your family. Hence, it is often in your best interest to participate.

What types of information are collected on the 107 R form?

The 107 R form collects various details, including the soldier's personal information such as their name, rank, and unit, as well as contact information for family members and points of contact. This includes their names, relationships to the soldier, addresses, and phone numbers. The form also requests information about the soldier's marital status, children, and any special family concerns, enabling the Family Programs staff to tailor their services to the unique needs of each family.

How is the information on the 107 R form protected?

To safeguard your privacy, the information provided on the 107 R form is subject to the Privacy Act of 1974. This law ensures that personal data is used solely for official purposes and not disclosed to unauthorized entities. The Army Reserve Family Programs Directorate keeps this information confidential and employs strict measures to protect it from misuse. By filling out the form, you can be assured that your details will remain within the appropriate military channels and contribute solely to enhancing family support efforts.

Common mistakes

Filling out the 107 R form can be a straightforward process, but mistakes can occur, leading to complications. One common mistake is providing incomplete information in Section I, particularly with regard to personal details such as the soldier's rank and DOB. Omitting details like these may result in delays or the rejection of the form. It is essential to ensure that all fields are fully completed, so that the Family Programs Office has a clear understanding of who they are assisting.

Another frequent error involves not including accurate contact information. Missing or incorrect phone numbers and email addresses can hinder communication between families and the Family Programs staff. If a family member cannot be reached during critical times, such as military separations or emergencies, this could create unnecessary distress. Double-checking these entries can save a lot of trouble later on.

A third common mistake relates to the consent section. People often neglect to initial or sign where required, which can render the entire form invalid. The consent for sharing information with Family Readiness Group (FRG) volunteers is crucial to maintaining a support network. No consent means no outreach, which might impede the flow of important updates or benefits.

Finally, families frequently overlook Section V regarding children. Failing to indicate whether there are children, or not providing their details, can limit access to family-specific resources. Providing this information is vital for developing tailored programs that meet the unique needs of each family. Ensuring this section is completed accurately can enhance the overall support received.

Documents used along the form

The USAR Form 107-R, also known as the Family Information Data Worksheet, is essential for gathering information to assist military families. However, several other forms and documents often accompany it to ensure a comprehensive understanding of a soldier's family situation. Below are five key documents that frequently complement the 107-R form.

  • USAR Form 27-R: This form, officially called the Family Readiness Group (FRG) Enrollment Form, captures information about the family members involved in the FRG. It helps leaders understand who is participating and allows for better communication about events and support services.
  • USAR Form 600-1: The Family Support Needs Assessment is used to identify the specific needs and concerns of military families. This helps the Family Programs Office to tailor resources and support based on the unique circumstances of soldiers and their families.
  • DA Form 7599: Known as the Personnel Evaluation, this form provides insights into a soldier's overall performance and readiness. While it focuses on the service member, the context can help Family Programs personnel understand stressors impacting family dynamics.
  • DA Form 5305: The Survivor Benefit Plan Election form is vital for families to make decisions about financial security. It ensures families are informed about options regarding benefits, especially important during transitions or separations.
  • DA Form 4787: The Reenlistment / Extension Application is significant for soldiers considering extending their service. This form impacts family decisions, and understanding a soldier's future commitments can guide family program planning and services.

Each of these forms serves a unique purpose and enhances the support network available to military families. By utilizing the 107-R form alongside these documents, Family Programs can more effectively address the diverse needs of service members and their loved ones.

Similar forms

  • Family Information Data Worksheet: This form gathers essential details about a soldier's family to develop support programs and activities for them, similar to the 107 R form's purpose of collecting family data for Army Reserve programs.
  • Privacy Act Consent Form: Like the 107 R form, this document requests personal information while also ensuring that consent is obtained to share the information within the relevant agency, thereby prioritizing privacy and compliance.
  • Emergency Contact Information Form: This document serves a similar function by ensuring that vital contact information is available in case of emergencies, akin to the role of the primary point of contact section in the 107 R form.
  • Family Assistance Program Application: This application also collects family-related information to provide resources and support, much like the information sought in the 107 R form for family programs.
  • Dependent Verification Form: This form is used to confirm the identity and details of dependents, paralleling the requirement in the 107 R form to gather specific family information.
  • Benefit Eligibility Form: This document assesses eligibility for various benefits available to military families, which aligns with the 107 R's goal of identifying individuals who may qualify for Family Programs services.
  • Family Readiness Group Membership Form: Similar to the 107 R form, this form aims to facilitate communication and support networks among families, enhancing connection and resource sharing.
  • Child Information Form: This form collects data on dependent children, reflecting the section of the 107 R form that inquires about children and their associated details.

Dos and Don'ts

Filling out the 107-R form is a crucial step in ensuring that military families receive the support they need. Here’s a list of essential dos and don’ts to guide you:

  • Do read the instructions thoroughly before starting. Understanding the form's requirements can prevent mistakes.
  • Do provide accurate information. Double-check the spelling of names, addresses, and contact numbers.
  • Do ensure all sections are completed. Leaving sections blank can delay processing time.
  • Do ask for help if you’re unsure about any part of the form. Reach out to Family Programs staff or a knowledgeable contact within your unit.
  • Don’t share this form with unauthorized individuals. The information is for official use only and is protected under the Privacy Act.
  • Don’t use abbreviations unless specified. Clear and complete phrases are essential for accurate understanding.
  • Don’t forget to sign and date the form. An unsigned form cannot be processed.
  • Don’t wait until the last minute to submit the form. Allow ample time for submission and processing, especially during periods of heightened military activity.

Misconceptions

Here are seven common misconceptions about the 107 R form, along with clarifications to help you better understand its purpose and use.

  • Misconception 1: The 107 R form is only for soldiers.
  • This form is primarily designed for family members of soldiers too. It collects vital information that can help support military families.

  • Misconception 2: Information submitted on the form is shared publicly.
  • In reality, the information gathered is strictly for official use within Army Reserve Family Programs. It won't be shared with outside organizations due to privacy protections.

  • Misconception 3: Participation is mandatory.
  • Actually, providing information is voluntary. However, not participating might limit your access to family programs and services.

  • Misconception 4: The form targets only immediate family members.
  • This is not true. The form allows input for a Primary and a Secondary Point of Contact, which can include extended family or friends.

  • Misconception 5: The form is outdated and not in use.
  • The 107 R form is current and intended for ongoing use, with updates made to ensure it meets the needs of military families.

  • Misconception 6: Submitting the form puts your information at risk.
  • Privacy is a priority. The information shared is protected under the Privacy Act of 1974, ensuring it’s not accessible to unauthorized entities.

  • Misconception 7: You cannot update information once the form is submitted.
  • You can update the information as needed. Staying current is important for effective communication regarding family programs and services.

Key takeaways

Filling out the 107 R form accurately and completely is essential for ensuring that military families receive the support they need. Below are some key takeaways regarding the form's purpose, privacy considerations, and the importance of consent.

  • Purpose of the Form: The 107 R form, also known as the Family Information Data Worksheet, is designed to collect vital information regarding soldiers and their families. The data collected helps develop relevant family programs and services, ensuring that families of servicemembers are well-informed and supported.
  • Privacy Protection: Information submitted on the form is protected under the Privacy Act of 1974. This means that details such as names, addresses, and contact information are used solely within Army Reserve Family Programs and will not be shared with outside organizations.
  • Importance of Consent: When the soldier provides consent, their primary point of contact will be contacted by Family Programs staff. This is crucial for maintaining communication, especially during military separation periods. Without consent, families may miss important notifications about activities and services.
  • Completeness is Key: Each section of the form must be filled out thoroughly. Missing information can hinder contact with family members and limit access to available resources, impacting the overall support system provided to soldiers and their families.