DA Form 1058 – Army Pubs DA 1058 Fillable – Military Instructional Training (DA Form 1058), Active Duty for Special Work (DA Form 1058), Temporary Tour of Active Duty (DA Form 1058), Annual Training (DA Form 1058), and Temporary Tour of Active Duty (DA Form 1058) for Soldiers of the Army National Guard and United States Army Reserve are all forms issued by the Department of the Army (DA). Below is a link to the most recent version of the DA Form 1058 fillable form.
The form is used to determine eligibility for Active Duty and to schedule troops from the Army National Guard and the United States Army Reserve for Special Work, Temporary Tours, and Annual Training on the dates that have been requested by the commanding officer. Incorrectly referred to as the “DD Form 1058” or the “DA Form 1058-R,” the application was last amended on October 1, 2020, rendering all prior iterations null and void, as of that date.
Instructions for DA Form 1058
A segment or part of the DA Form 1058 is divided into two parts or sections: Applicants who served in the military should complete Part I. This section of the form must be signed by the soldier himself or herself; unit officials are not permitted to sign the form on the soldiers’ behalf. The custodian of records is responsible for filing Part II.
- Each of the boxes 1 through 4 contains information on the soldier, including their name, home address, business telephone numbers, and the address from which the soldier will report to duty. Those troops whose Home of Record (HOR) is more than a half-hour drive away from their duty site must complete the last section.
- Boxes 5, 6, and 7 include information about the unit of assignments, the grade, and the branch.
- Sex, height, weight, date of birth, marital status, main SSI and duty SSI, as well as the total amount of time spent in active federal service, are all described inside boxes 8 to 17.
- Individual mobilization augmentees are the only ones that need to submit a box 18.
- For each type of Active Duty for Special Work (ADSW), Temporary Tour of Active Duty (TTAD), Active Duty Training (ADT), or Annual Training (AT) request, Box 19 lists the dates and locations of the Active Duty for Special Work (ADSW), Temporary Tour Of Active Duty (TTAD), Active Duty for Training (ADT), or Annual Training (AT) requested.
- Medico-legal fitness is assessed in Box 20. A Soldier’s latest Periodic Health Assessment (PHA) exam must be recorded in Box 20a, and the location of the examination must be recorded in Box 20b.
- Boxes 21 and 22 of the form must be signed and dated by the soldier.
- In Box 23, Remarks, the soldier indicates his or her agreement to be released from active service after the tour for which they are applying.
- The records custodian is in charge of filling boxes 24 through 33.
- If Box 34 does not appear on your ORDERS QUERY printout, you are not required to complete it. SEE ORDERS QUERY should be the first line in Box 34a if everything has been completed correctly. Not all Title 10 tours are included on the ORDERS QUERY page; you must list them here if you do not have a state order covering that tour in the first instance.
- The custodian then signs the form in Box 35, certifying that the information on DA Form 1058 is true and that the soldier fulfills the medical standards for tour consideration as outlined in NGB PPOM 13-020 and that the soldier is eligible for tour consideration.
- The Army Regulation 135-200, Active Duty for Missions, Projects, and Training for Soldiers in the Reserve Component, contains further instructions and filing criteria.