Da 2823 PDF Form Customize Form Here

Da 2823 PDF Form

The DA Form 2823 is a sworn statement used by the United States Army. It serves to document potential criminal activity and helps maintain discipline, law, and order through the investigation of complaints and incidents. This form outlines the authority, the principal purpose, routine uses of the information provided, and how it's disclosed, playing a vital role in various administrative and disciplinary actions within the Army.

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Overview

The DA Form 2823, titled "Sworn Statement," serves a crucial role within the United States Army's legal and disciplinary framework. As stipulated by Army Regulation 190-45, this document is designed to record testimonies or statements related to potential criminal activities or incidents that demand investigation within the Army context. Originating under the authority of Title 10, United States Code Section 301, and other relevant statutes, the form underscores the importance of gathering reliable testimony to maintain discipline, law, and order within the Army. Importantly, it furnishes a structured means for documenting the statements of individuals under oath, thereby ensuring that the information collected is both accountable and actionable. The form is meticulously designed to include essential details such as the location, date, time, and identification of the individual providing the statement, thus enhancing the integrity and utility of the information collected. Furthermore, the DA Form 2823 outlines the procedural norms regarding the voluntary disclosure of personal and sensitive information, including Social Security Numbers, highlighting the balance between operational necessity and privacy concerns. The stipulated use of this form extends beyond mere documentation, as the information garnered may be shared with a range of entities including federal, state, and foreign law enforcement agencies, courts, and even child protective services, underlining its significance in a wide array of legal and administrative actions. Clearly, the DA Form 2823 is an essential tool in the U.S. Army's effort to document investigations thoroughly, uphold justice, and ensure a disciplined and lawful operational environment.

Preview - Da 2823 Form

 

 

 

 

 

 

SWORN STATEMENT

 

 

 

 

 

 

 

 

For use of this form, see AR 190-45; the proponent agency is PMG.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PRIVACY ACT STATEMENT

 

 

 

 

 

 

AUTHORITY:

Title 10, USC Section 301; Title 5, USC Section 2951; E.O. 9397 Social Security Number (SSN).

 

 

 

PRINCIPAL PURPOSE:

To document potential criminal activity involving the U.S. Army, and to allow Army officials to maintain discipline,

 

 

 

 

 

law and order through investigation of complaints and incidents.

 

 

 

 

 

ROUTINE USES:

Information provided may be further disclosed to federal, state, local, and foreign government law enforcement

 

 

 

 

 

agencies, prosecutors, courts, child protective services, victims, witnesses, the Department of Veterans Affairs, and

 

 

 

 

 

the Office of Personnel Management. Information provided may be used for determinations regarding judicial or

 

 

 

 

 

non-judicial punishment, other administrative disciplinary actions, security clearances, recruitment, retention,

 

 

 

 

 

placement, and other personnel actions.

 

 

 

 

 

 

DISCLOSURE:

Disclosure of your SSN and other information is voluntary.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

LOCATION

 

 

2. DATE (YYYYMMDD)

 

3. TIME

 

4. FILE NUMBER

 

 

 

 

 

 

 

 

 

 

 

5.

LAST NAME, FIRST NAME, MIDDLE NAME

 

 

6. SSN

 

 

7. GRADE/STATUS

 

 

 

 

 

 

 

 

 

 

 

8.

ORGANIZATION OR ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9.

I,

 

 

, WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH:

 

 

 

 

10. EXHIBIT

11. INITIALS OF PERSON MAKING STATEMENT

Page 1 of 3

ADDITIONAL PAGES MUST CONTAIN THE HEADING "STATEMENT OF TAKEN AT DATED

THE BOTTOM OF EACH ADDITIONAL PAGE MUST BEAR THE INITIALS OF THE PERSON MAKING THE STATEMENT, AND PAGE NUMBER MUST BE INDICATED.

DA FORM 2823, NOV 2006

PREVIOUS EDITIONS ARE OBSOLETE.

APD AEM v1.04ES

 

 

USE THIS PAGE IF NEEDED. IF THIS PAGE IS NOT NEEDED, PLEASE PROCEED TO FINAL PAGE OF THIS FORM.

STATEMENT OF

 

TAKEN AT

 

DATED

9.STATEMENT (Continued)

INITIALS OF PERSON MAKING STATEMENT

Page 2 of 3

DA FORM 2823, NOV 2006

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STATEMENT OF

 

 

TAKEN AT

DATED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AFFIDAVIT

 

 

 

I,

 

 

, HAVE READ OR HAVE HAD READ TO ME THIS STATEMENT WHICH BEGINS ON

PAGE 1, AND ENDS ON PAGE

3 . I FULLY UNDERSTAND THE CONTENTS OF THE ENTIRE STATEMENT MADE BY ME. THE

STATEMENT IS TRUE. I HAVE INITIALED ALL CORRECTIONS AND HAVE INITIALED THE BOTTOM OF EACH PAGE CONTAINING THE STATEMENT. I HAVE MADE THIS STATEMENT FREELY WITHOUT HOPE OF BENEFIT OR REWARD, WITHOUT THREAT OF PUNISHMENT, AND WITHOUT COERCION, UNLAWFUL INFLUENCE, OR UNLAWFUL INDUCEMENT.

 

 

 

 

 

 

(Signature of Person Making Statement)

 

 

 

WITNESSES:

Subscribed and sworn to before me, a person authorized by law to

 

 

administer oaths, this

 

day of

 

,

 

 

 

 

at

 

 

 

 

 

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ORGANIZATION OR ADDRESS

 

 

 

 

(Signature of Person Administering Oath)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Typed Name of Person Administering Oath)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ORGANIZATION OR ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Authority To Administer Oaths)

 

 

 

INITIALS OF PERSON MAKING STATEMENT

DA FORM 2823, NOV 2006

Page 3 of 3

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File Specs

Fact Name Description
Form Title SWORN STATEMENT
Authority for Use For use of this form, see AR 190-45; the proponent agency is PMG.
Privacy Act Statement Authority Title 10, USC Section 301; Title 5, USC Section 2951; E.O. 9397 Social Security Number (SSN).
Principal Purpose To document potential criminal activity involving the U.S. Army, and to allow Army officials to maintain discipline, law and order through investigation of complaints and incidents.
Routine Uses Information may be disclosed to various agencies and used for multiple administrative actions regarding personnel.
Disclosure Disclosure of SSN and other information is voluntary.

Detailed Instructions for Filling Out Da 2823

When it comes to documenting incidents or potential criminal activity involving the U.S. Army, one of the key tools at your disposal is the DA Form 2823, also known as the Sworn Statement. Completing this form accurately and thoroughly is crucial for ensuring that Army officials have all the information they need to maintain discipline, investigate complaints, and take appropriate actions. The process might seem daunting at first, but with a clear set of instructions, anyone can fill out this form correctly. Below are the steps you need to follow to complete the DA Form 2823.

  1. Start with the LOCATION of the incident. This should be as specific as possible, including the complete address or the precise location within a facility or area.
  2. Enter the DATE of the statement using the format YYYYMMDD.
  3. Fill in the TIME when the statement is being made. Ensure this is in 24-hour format to avoid any confusion.
  4. The FILE NUMBER section is next. If there is a specific file or case number associated with the investigation or incident, enter it here. If not, this can be left blank.
  5. Input the full name of the person making the statement in the LAST NAME, FIRST NAME, MIDDLE NAME section.
  6. The SSN field is for the Social Security Number of the individual making the statement. Remember, providing this information is voluntary, but it can assist in accurately identifying individuals.
  7. Specify the GRADE/STATUS of the individual. This could be their rank within the military or their civilian status.
  8. Enter the ORGANIZATION OR ADDRESS of the individual, which can help in further identifying them or their place within the Army.
  9. Under the section marked "I, , WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH:", the individual making the statement should write their account of the incident or information being reported. If additional space is required, use the provided extra pages and ensure that each page contains the necessary headings and page numbers.
  10. If there are any exhibits or additional documents referenced in the statement, list them in the EXHIBIT section.
  11. The INITIALS OF PERSON MAKING STATEMENT should be placed at the bottom of each page to authenticate the information provided on that page.
  12. Upon completion of the statement, the final section includes an affidavit where the individual attests that the information is truthful and accurate to the best of their knowledge. After reading or having the statement read back, the individual signs the form. Witnesses or an authorized individual must then also sign, verifying the oath was properly administered.

Following these steps ensures the DA Form 2823 is filled out accurately and completely. This document plays a vital role in the investigative processes within the Army, making the thoroughness and accuracy of the information provided extremely important.

More About Da 2823

  1. What is the purpose of the DA Form 2823?

    The DA Form 2823 is primarily used to document potential criminal activity involving the U.S. Army and helps Army officials to maintain discipline, law, and order through the investigation of complaints and incidents. It serves as an official record of statements related to these activities.

  2. Who can fill out a DA Form 2823?

    Any individual, whether they are a member of the Army or a civilian, who needs to provide a formal statement related to an investigation within the Army, can fill out a DA Form 2823. This includes witnesses, suspects, or victims of the incident under investigation.

  3. Is it mandatory to provide a Social Security Number (SSN) on the DA Form 2823?

    While the form requests a SSN, disclosure of this information is voluntary. The SSN is used for identification purposes and to ensure records are accurately filed and retrieved. However, refusing to provide a SSN may not preclude the processing of the form but could potentially delay or complicate the investigation process.

  4. Can the information provided on the DA Form 2823 be disclosed to other agencies?

    Yes, the information provided may be disclosed to federal, state, local, and foreign government law enforcement agencies, prosecutors, courts, child protective services, victims, witnesses, the Department of Veterans Affairs, and the Office of Personnel Management. This is for the purposes of further investigation, judicial or non-judicial punishment, and other personnel administrative actions.

  5. What happens if there are mistakes in the statement provided on the DA Form 2823?

    Any corrections in the statement must be initialed by the person making the statement. This is an important step to ensure the accuracy and authenticity of the statement. If you notice a mistake after submitting the form, it is essential to notify the relevant authorities immediately to correct it as per the official procedures.

  6. Is it necessary to sign the DA Form 2823 in front of a witness?

    Yes, the individual making the statement on the DA Form 2823 must sign the affidavit in the presence of a person authorized by law to administer oaths. This witness must also sign the form, verifying that the statement was duly sworn before them. This procedure helps ensure the legality and veracity of the statement.

  7. What should be done if additional space is needed for the statement?

    If more space is required to complete the statement, additional pages can be attached. These pages must contain the heading "Statement of (Name) taken at (Location) dated (Date)," and the bottom of each page must bear the initials of the person making the statement along with the page number. This ensures all parts of the statement are properly linked and maintained.

  8. How is the DA Form 2823 submitted?

    The completed DA Form 2823 should be submitted to the requesting or investigating authority within the Army. The submission procedures may vary depending on the specifics of the investigation and the unit's protocols. Always follow up to ensure your statement has been received and correctly filed.

  9. What are the possible consequences of providing false information on the DA Form 2823?

    Providing false information on the DA Form 2823 is a serious matter that can lead to disciplinary action or legal consequences. It is essential to provide truthful and accurate information to the best of your knowledge and belief, under the penalty of perjury.

  10. Can a DA Form 2823 be withdrawn or amended after submission?

    Once a DA Form 2823 is submitted, it becomes a part of an official record. If there is a need to amend the statement or if new information becomes available, it is critical to contact the investigating authority immediately. However, the original statement cannot be withdrawn but can be supplemented with additional information or clarification.

Common mistakes

One common mistake that individuals make when completing the DA 2823 form, the sworn statement for use in situations involving potential criminal activity within the U.S. Army, is not providing a clear and specific location where the incident occurred. By not detailing the exact location, the effectiveness of the investigation might be compromised. Mentioning the specific place where the incident happened, whether it's a building, an area within the base, or any other identifiable location, could significantly enhance the clarity and usefulness of the statement for investigative purposes.

Another error frequently encountered is inaccurately or incompletely filling in the date and time of the event in question. The DA 2823 form requires the date to be in the YYYYMMDD format, ensuring uniformity and preventing any confusion about when the described events took place. Similarly, being precise about the time of the event helps in corroborating the statement with other pieces of evidence or witness accounts which may critically affect the outcome of the investigation.

Additionally, a number of people often overlook the importance of initialed corrections on the DA 2823 form. Any alterations made to the statement after the initial documentation should be initialed by the person making the statement. This step is crucial to maintaining the document's integrity and confirming that the changes were recognized and approved by the individual providing the statement. Neglecting this requirement might cast doubts on the statement's accuracy and veracity.

Lastly, a critical mistake is not ensuring the statement's conclusion on the form is acknowledged with a signature. The person making the statement is expected to sign at the bottom of the form, affirming that they have read or have had the statement read to them, understand its contents, and declare it to be true. This affirmation, alongside the signatures of witnesses and the individual administering the oath, legally validates the statement. Failure to include these signatures renders the document incomplete and might limit its legal standing and usefulness in subsequent investigations or proceedings.

Documents used along the form

When dealing with official military documents, it's important to understand not only the primary form you're working with but also other related forms or documents that might be used in conjunction. The DA Form 2823, the sworn statement form, is one such document often supplemented by other forms. These complementing documents help in ensuring that all aspects of an incident or statement are comprehensively covered, providing a more complete picture of the situation at hand.

  • DA Form 268 (Report to Suspend Favorable Personnel Actions (Flag)): This form is used to temporarily suspend any favorable actions for a service member, such as promotions or re-enlistments, usually pending investigation. It might be filled out in response to information gathered from a DA Form 2823 sworn statement if it implicates the service member in misconduct.
  • DA Form 4856 (Developmental Counseling Form): Often, a DA Form 2823 sworn statement may indicate the need for corrective training or counseling. The DA Form 4856 is used by leaders to document counseling sessions with their subordinates, covering a wide range of topics, including any misconduct discussed in a sworn statement.
  • DA Form 31 (Request and Authority for Leave): This form is used by service members to request leave from their duties. While not directly linked to the incident documentation process, a DA Form 2823 could potentially mention circumstances or individuals that necessitate the review of past leave requests documented on a DA Form 31.
  • DD Form 214 (Certificate of Release or Discharge from Active Duty): In cases where a sworn statement (DA Form 2823) contributes to the decision-making process regarding a service member's separation from the military, the DD Form 214 is used to document the service member’s release or discharge. It includes information about the service member’s duty history and the reason for discharge, which could be related to the findings of an investigation involving a DA Form 2823.

These forms and documents serve to create a thorough administrative record, framing the context and consequences of the matters described in sworn statements. By understanding how these documents interact with each other, individuals can better navigate the administrative processes of the U.S. military and ensure that all necessary information is accurately recorded and appropriately acted upon.

Similar forms

  • Form I-9, Employment Eligibility Verification: Similar to DA Form 2823, Form I-9 is used for verification purposes, ensuring employees are legally authorized to work in the United States. Both forms serve to document key information and maintain compliance with regulations, though for different authorities and purposes.

  • Incident Report Forms used by police departments: These forms document the details of incidents similar to how DA Form 2823 records statements related to potential criminal activities. Both forms are instrumental in investigations and in maintaining discipline and order.

  • Form SF-86, Questionnaire for National Security Positions: This form collects personal information for background investigations, akin to DA Form 2823 documenting information for the purpose of maintaining security clearances and personnel actions within Army disciplines.

  • Victim Impact Statements: These statements, submitted by victims of crimes, bear resemblance to DA Form 2823, as both involve personal accounts meant to influence outcomes in legal and disciplinary actions.

  • Witness Statement Forms: Comparable to DA Form 2823, these are used to capture witnesses' accounts for use in legal proceedings and investigations. Both documents play a crucial role in the assembly of evidence and testimonial records.

  • Form W-4, Employee's Withholding Certificate: Similar in the aspect of documenting personal information for official purposes, Form W-4 is used by employers to determine the amount of federal income tax to withhold from employees' paychecks, mirroring the DA Form 2823's role in gathering information for administrative actions.

  • Medical Records Release Forms: These forms authorize the disclosure of an individual's health information. Like DA Form 2823, which may share information with various agencies, these forms facilitate the lawful sharing of sensitive information under specific circumstances.

  • Affidavit Forms: Affidavits are written statements confirmed by oath or affirmation for use as evidence in court. The DA Form 2823 serves a similar purpose in documenting sworn statements related to Army investigations, both binding the signer to the truth of their statements under penalty of perjury.

  • Insurance Claim Forms: These forms document details of incidents for claims processing, analogous to how DA Form 2823 records details pertinent to military discipline and law enforcement actions. Both sets of documents are essential in the assessment and decision-making processes within their respective frameworks.

  • Security Clearance Forms: Used to assess individuals' eligibility for access to classified information, these forms, like DA Form 2823, collect detailed personal information and statements to maintain national security and proper personnel placement within the military and government agencies.

Dos and Don'ts

When filling out the DA Form 2823, a sworn statement used in the context of U.S. Army investigations, it's crucial to follow guidelines that help ensure the information recorded is accurate, complete, and legally valid. Here are some recommended dos and don'ts:

Dos:

  1. Read the privacy act statement carefully before you start filling out the form to understand the purpose, use, and disclosure of your information.
  2. Use black or blue ink for clarity and to ensure that the document is legible and can be copied or scanned without issue.
  3. Be precise and thorough in your responses. Provide all relevant details when describing events or situations, including dates, times, locations, and the names of individuals involved.
  4. Initial any corrections you make. If you need to correct information after writing it, draw a single line through the error, write the correct information nearby, and then put your initials next to the change.
  5. Review the entire statement before signing. Once you've completed the form, carefully read through your statement to ensure accuracy and completeness. If it's read back to you, listen carefully to confirm every detail.
  6. Sign and date the affidavit section only after you've fully reviewed the statement and are certain it's true and correct to the best of your knowledge.

Don'ts:

  1. Don't leave any fields blank that are applicable to you. If a section does not apply, write "N/A" (not applicable) to show that you did not overlook the question.
  2. Don't guess dates or times. If you're unsure about certain details, it's better to state that you don't remember than to provide inaccurate information.
  3. Don't include secondhand information or hearsay unless it's directly relevant to your statement and you specify it as such. Focus on facts and firsthand observations.
  4. Don't overlook the need for witnesses when required. Ensure witnesses read your statement, if applicable, and sign the form in their designated sections.
  5. Don't forget to add your initials at the bottom of each additional page and all corrections. This step is crucial for the authentication of your statement.
  6. Don't submit the form without ensuring all sections, including the affidavit and organizational information, are fully and accurately completed.

Misconceptions

  • One common misconception is that the DA Form 2823 is only used by the Army. While primarily associated with the U.S. Army, this sworn statement form can also be disclosed and used by other branches of the military, federal, state, local, and foreign government law enforcement agencies, prosecutors, and courts for various purposes.

  • Many people believe that filling out the DA Form 2823 is mandatory. However, the Privacy Act Statement within the form specifies that providing your Social Security Number (SSN) and other information is voluntary, although crucial for documenting potential criminal activities and maintaining discipline.

  • There’s a misconception that the DA Form 2823 can only be used to document criminal activities. While its primary purpose is to document potential criminal activity involving the U.S. Army, it's also used for administrative purposes such as judicial or non-judicial punishment, security clearances, and personnel actions.

  • Some think that only the person making the statement can fill out the DA Form 2823. In reality, the statement can be recorded by another individual as long as the person making the statement reviews, confirms its accuracy, makes corrections, and initials any changes.

  • Many are under the impression that any military member can administer the oath on the DA Form 2823. The form clearly states that the oath must be subscribed and sworn before a person authorized by law to administer oaths, which includes specific roles within the military judicial system and other designated individuals.

  • Another misconception is that once the DA Form 2823 is filled out, it cannot be amended or corrected. Corrections are allowed and must be initialed by the person making the statement, ensuring the document’s accuracy and truthfulness.

  • Some believe that the information provided on the DA Form 2823 is only shared within the military. The form's routine uses section clarifies that information may be disclosed to a wide range of entities for lawful purposes, including law enforcement agencies, courts, and child protective services, among others.

  • There’s also a false assumption that the DA Form 2823 is a new requirement. The form has been in use for many years, with the version cited (NOV 2006) being an update to ensure compliance with current regulations, reflecting its longstanding importance in military procedures and legal processes.

Key takeaways

The DA Form 2823, commonly known as the Sworn Statement, serves a significant purpose in documenting potential criminal activity within the U.S. Army. Completing and utilizing this form properly is crucial for individuals involved in such processes. Here are key takeaways to consider:

  • The form is governed by the Army Regulation 190-45, with the Proponent Agency being the PMG, ensuring strict adherence to prescribed procedures.
  • Its primary purpose is to allow Army officials to maintain discipline, law, and order through the thorough investigation of complaints and incidents, highlighting its importance in military judicial processes.
  • Information provided on the DA Form 2823 might be disclosed to an array of agencies including federal, state, local, and even foreign law enforcement, underscoring the form’s scope beyond the immediate military environment.
  • Such disclosures extend to prosecutors, courts, and even child protective services, indicating the broad range of scenarios where the form's contents might be utilized.
  • The information could impact decisions related to judicial or non-judicial punishments, disciplinary actions, and even personnel actions like security clearances, emphasizing the form’s impact on an individual’s military career.
  • Voluntary disclosure of Social Security Numbers (SSN) and other personal information is required, signaling the importance of accuracy and honesty in filling out the form.
  • The form necessitates details such as location, date, time, and personal identification to ensure preciseness and accountability in the documentation process.
  • Sworn statements made on the form must be under oath, with the individual fully understanding the statements made, which ensures the reliability and integrity of the information provided.
  • All corrections and initials on the form, particularly on additional pages, must be made by the person making the statement, underscoring the personal responsibility in maintaining the document’s accuracy.
  • The final affirmation and signature, alongside a witness's verification, legally bind the statement, making it a potent tool in military legal proceedings.

Understanding and adhering to the specifications of the DA Form 2823 is essential for those involved in its completion and submission, given its influential role in military investigations and proceedings. The form not only serves as a means of documenting incidents but also as a foundational element in the administration of justice within the U.S. Army.

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