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Get DA Form 7574, JULY 2005

E: This information will be used to determine eligibility for incapacitation pay. ROUTINE USES: None. The "Blanket Routine Uses" set forth at the beginning of the Army's Compilations of System of Records Notices apply to this system. DISCLOSURE: Voluntary. However, failure to provide all the requested information may delay or prevent the payment of compensation. 11. EXACT DATES OF INCAPACITATION (DAYS I WAS UNABLE TO WORK DURING THIS CALENDAR MONTH): YES 14a. I was employed (civilian job.

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