Every entry on DA Form 5220-R exists because a record system needs it in writing. The form's official title is CHILD DEVELOPMENT SERVICES (CDS) FAMILY CHILD CARE (FCC) PROVIDER BACKGROUND CLEARANCE REQUEST, and it is raised whenever an office must child development services (cds) family child care (fcc) provider background clearance request (lra) in a way that survives the departure of everyone involved. Memory does not transfer between assignments; a filed document does. The edition dated July 1989, status not stated, is what stands here, spread across 1 page(s) and about 143 fields — a count that reflects how much detail the receiving system requires, not how much the drafter wishes to give.
Behind any Army form sit two separate decisions. What the document asks is settled by ACSIM, which maintains and revises it. Whether you raise it, and where it goes once signed, is settled by AR 608-10. That division is the reason a form can outlive several changes in the process it serves.
Identification precedes substance for a structural reason. Name, identification number, organisation and date of preparation are how the finished document is located in a file or a database; the body of the form is what someone reads after the search has succeeded. Spell the name as official records spell it, since the search runs against those records and not against habit.
Much of the form's behaviour follows from its being a fixed page. Tab order was set at build time along the reading sequence, which is why tabbing catches boxes a pointer passes over. Exclusive groups release one choice when another is made because a record cannot carry two answers to a single question. Single-line fields refuse to wrap because every entry must print where the layout expects it — text beyond the width is lost at the margin, visible on screen to the end. That is what remarks areas and continuation sheets are for. Marking a field that does not apply matters for a related reason: emptiness is ambiguous, and a reviewer reading the file later cannot distinguish an omission from a decision.
A signature is what converts entries into a record, which is why it comes last and why an unsigned form remains a draft however complete it looks. Where a reviewing official, an approving authority or a witness also signs, each adds a distinct attestation, and each dates the day of signing rather than the day of preparation — the dates trace the sequence of responsibility. The recurring defects are worth knowing precisely because they defeat that purpose: an empty mandatory field leaves an obligation unmet, transposed identification digits attach the record to nobody, a date with day and month reversed puts events in the wrong order, and entries left in a reused working copy assert facts nobody intended.
Personal information may not be gathered silently, and the Privacy Act statement is how that obligation is met on paper: it names the collection authority, the purpose, the routine uses and whether disclosure is mandatory. Because it exists to inform a decision, it belongs before the fields it covers rather than after them. A filled copy then holds personal data and is stored and transmitted under the corresponding safeguards.
Download the form
Formats exist because completion happens under different conditions, not because anyone wanted variety. The published set is PDF, XFDL. A fillable pdf carries live entry objects, so typed text lands in fixed positions and stays legible whoever reads it later. A printable pdf drops those objects and leaves the page as an image, which is what an office needs where a screen is unavailable and a pen is not. The document itself is unchanged between them; what differs is the circumstance each anticipates.
Where a file opens matters more than it appears to. A browser will display a pdf, but browser viewers were built to read documents, and some accept keystrokes into fields they never intended to store — the entries are gone at tab close, without warning, because saving was never part of what that viewer does. A dedicated reader is built around the file's own structure and keeps what you enter. The xfdl file belongs to a different lineage entirely: IBM Lotus Forms, adopted across Army systems for the routing and signature handling built into it. That is why only the Lotus Forms Viewer reads it.
There is no charge and no sign-up. Published documents are distributed as published, without modification.
What the form asks for
- ADDA
- ADDB
- COMPETENCY
- ContentArea1
- DATE
- LINEA
- LINEB
- LINEC
- LINED
- NAA
- NAB
- NAC
- NAD
- NAE
- NAF
- NAG
- NAH
- NAI
- NAJ
- NAME
- NOA
- NOB
- NOC
- NOD
Disposition is prescribed, not chosen. AR 608-10 names the destination, whether that is a specific office, the unit administrative channel or the personal record, and the applicable records schedule governs how long it survives there. Both rules exist to keep the file consistent across offices with different habits. Take your copy before the document leaves, since it will not come back.
Series and number are how the DA series signals which documents belong together, and the grouping follows real process boundaries: a shared proponent or directive usually means a shared purpose. A form cited on the face of another is part of that same transaction, and continuation sheets, covers and transmittals complete it.
Editions change because the process changes, and the printed edition date is the only marker of which version a page belongs to. A copy saved locally cannot know it has been superseded, so the date on it is compared against the edition in force before reuse. Records already executed under an earlier edition are left alone — a document is read under the terms it was made, and reopening completed files to match a later form would falsify the account.
A word on where this page sits. These are reproductions of published Department of the Army documents, made available by an independent site with no official role and no authority to issue forms. The structure described above — proponent, prescribing directive, records schedule — exists apart from this site entirely, which is why nothing written here is legal advice and why acceptance by any office is not something that can be promised. Put questions of entry, requirement or eligibility to ACSIM or to the administrative office servicing your unit.
Questions and answers
- What is DA Form 5220-R?
- CHILD DEVELOPMENT SERVICES (CDS) FAMILY CHILD CARE (FCC) PROVIDER BACKGROUND CLEARANCE REQUEST
- Which edition is current?
- July 1989
- Who is responsible for this form?
- ACSIM
- In which formats can it be downloaded?
- PDF, XFDL