PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
DA Form 5412
for the current year.
DA Form 5412 Waiver of Compensation Statement
What Is DA Form 5412?
This is a military form that was released by the U.S. Department of the Army (DA) on April 1, 1985. The form, often mistakenly referred to as the DD Form 5412, is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DA.
FAQ
Q: What is the DA Form 5412?
A: DA Form 5412 is a Waiver of Compensation Statement.
Q: What is the purpose of the DA Form 5412?
A: The purpose of the DA Form 5412 is to waive compensation for a specific period of time.
Q: Who is required to fill out the DA Form 5412?
A: Individuals who wish to waive their compensation for a specific period of time are required to fill out the DA Form 5412.
Q: Is the DA Form 5412 specific to the United States Army?
A: Yes, the DA Form 5412 is specific to the United States Army.
Form Details:
- A 1-page document available for download in PDF;
- The latest version available from the Army Publishing Directorate;
- Editable, free, and easy to use;
- Fill out the form in our online filing application.
Download an up-to-date fillable DA Form 5412 down below in PDF format or browse hundreds of other DA Forms stored in our online database.
