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Da 4187 Cola Dependent Change Example


DA 4187 COLA Dependent Change Example




DA Form 4187 is a Personnel Action form that can be used to request or record various personnel actions for or by soldiers in accordance with DA PAM 600-8. One of the possible actions that can be requested using this form is a change in Cost of Living Allowance (COLA) due to a change in dependent status. COLA is a supplemental allowance that compensates for variations in purchasing power between different locations. It is based on factors such as the number of dependents, the location of the duty station, and the location of the dependents.


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A change in dependent status can occur due to various reasons, such as marriage, divorce, birth, adoption, death, or relocation of dependents. When a change in dependent status occurs, the soldier must report it to their finance office within 30 days and submit a DA Form 4187 to request a change in COLA. The form must include the following information:



  • The soldier's name, rank, social security number, and unit.



  • The type of personnel action requested (in this case, COLA change).



  • The effective date and reason for the change in dependent status.



  • The name, relationship, and location of each dependent.



  • The signature of the soldier and the endorsement of their commander.



  • Any supporting documents, such as marriage certificate, divorce decree, birth certificate, death certificate, etc.




An example of a DA Form 4187 requesting a COLA change due to a dependent relocation is shown below:




PERSONNEL ACTION


For use of this form, see PAM 600-8; the proponent agency is DCS, G-1.




DATA REQUIRED BY THE PRIVACY ACT OF 1974




AUTHORITY: Title 10, USC, Section 3013, E.O. 9397 (SSN), as amendedPRINCIPAL PURPOSE: To request or record personnel actions for or by Soldiers in accordance with DA PAM 600-8.ROUTINE USES: The DoD Blanket Routine Uses that appear at the beginning of the Army's compilation of systems of records may apply to this system.DISCLOSURE: Voluntary; however failure to provide Social Security Number may result in a delay or error in processing the request for personnel action.




SECTION I - PERSONAL IDENTIFICATION


SECTION II - DUTY STATUS CHANGE (AR 600-8-6)




A. NAME (Last, First, MI)B. RANKC. SSND. BRANCH




Smith, John A.E-5123-45-6789Army




E. UNIT OR ACTIVITY (Include ZIP Code)F. PREVIOUS STATUSG. NEW STATUSH. EFFECTIVE DATE/TIME (YYYYMMDD)




1st Battalion, 10th Infantry Regiment12345 APO AE 09876N/AN/AN/A



SECTION III - REQUEST FOR PERSONNEL ACTION


I request the following action: (check as appropriate)


Change in COLA due to dependent relocation


J. REASON FOR REQUEST:


My spouse has relocated from Germany to CONUS on 20230901 due to personal reasons.


K. REMARKS:


Please update my COLA entitlements accordingly. My dependents are as follows:


Name: Smith, Jane B.Relationship: SpouseLocation: 123 Main Street, Anytown, USA 12345


L. SIGNATURE OF SOLDIER


___________________________


M. DATE (YYYYMMDD)


20230905


SECTION IV - ENDORSEMENT BY COMMANDER OR AUTHORIZED REPRESENTATIVE


N. RECOMMEND APPROVAL RECOMMEND DISAPPROVAL


O. SIGNATURE OF COMMANDER OR AUTHORIZED REPRESENTATIVE


___________________________


P. DATE (YYYYMMDD)


20230906


Q. IS APPROVED IS DISAPPROVED


R. SIGNATURE OF APPROVING AUTHORITY


___________________________


S. DATE (YYYYMMDD)


20230907



This is just one example of how a DA Form 4187 can be used to request a COLA change due to a dependent change. Other situations may require different information and documentation. For more information on how to fill out a DA Form 4187, please refer to the [instructions] provided by the New York State Division of Military and Naval Affairs. For more information on COLA and other allowances, please refer to the [Defense Travel Management Office website].


I hope this article was helpful and informative. Thank you for reading.


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