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Click ‘Get Form’ to open DA Form 5840 in the editor.
Begin by entering the names and ages of the family members you will be responsible for in the designated fields. Ensure accuracy as this information is crucial for your Family Care Plan.
In the section labeled 'Typed or Printed Name of Guardian', clearly write your name. This identifies you as the guardian or escort.
Sign the form in the signature field, confirming your agreement to accept responsibility for the listed family members.
Fill in your address, including ZIP code, telephone number, and email address to ensure proper communication regarding any necessary updates or inquiries.
Complete the notary section by providing details such as state and county, and have a notary public acknowledge your signature on the specified date.
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DA FORM 5841-R, APR 1999. USAPA V1.00. SPECIAL INSTRUCTIONS RELATED TO EXECUTION OF POWERS OF ATTORNEY. The DA Form 5841-R is a special power of attorney (POA)Read more
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