Blank Da 2823 PDF Form

Blank Da 2823 PDF Form

The DA Form 2823 is a sworn statement used by the U.S. Army to document potential criminal activity and maintain order within its ranks. This form allows individuals to provide important information under oath, which may be used in various legal and administrative proceedings. If you need to make a statement, please fill out the form by clicking the button below.

The DA Form 2823, also known as the Sworn Statement form, plays a crucial role in documenting potential criminal activities involving the U.S. Army. This form is essential for maintaining discipline and law and order within the military community. It allows Army officials to investigate complaints and incidents effectively. The form requires specific information such as the date, time, and location of the statement, along with the individual's name, Social Security Number (SSN), grade or status, and organization. It is important to note that while providing the SSN and other personal details is voluntary, the information gathered may be shared with various law enforcement agencies and other governmental bodies for purposes including judicial or non-judicial punishment and personnel actions. The DA 2823 form also includes a section where individuals can affirm the accuracy of their statements, ensuring that the information provided is truthful and made without coercion. This process underscores the commitment to transparency and accountability within the Army, reinforcing the importance of each individual's contribution to upholding military integrity.

Document Sample

 

 

 

 

 

 

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

APD AEM v1.04ES

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

APD AEM v1.04ES

File Specifics

Fact Name Details
Form Purpose The DA 2823 form is used to document potential criminal activity involving the U.S. Army.
Governing Regulations This form is governed by AR 190-45.
Privacy Act Authority It is authorized under Title 10, USC Section 301 and Title 5, USC Section 2951.
Voluntary Disclosure Disclosure of your Social Security Number (SSN) and other information is voluntary.
Routine Uses Information may be shared with various law enforcement agencies and related entities.
Required Information The form requires details such as location, date, time, and personal identification information.
Statement Under Oath The individual making the statement must do so under oath, affirming its truthfulness.
Witness Requirement The statement must be subscribed and sworn before an authorized individual.
Page Instructions Additional pages must include specific headings and the initials of the person making the statement.

How to Use Da 2823

Filling out the DA 2823 form is an important step in documenting a statement under oath. This form is used to report potential criminal activity involving the U.S. Army. Properly completing the form ensures that your statement is clear and can be effectively used in any necessary investigations.

  1. Location: Write the location where the statement is being made.
  2. Date: Enter the date in the format YYYYMMDD.
  3. Time: Fill in the time when the statement is taken.
  4. File Number: Provide the file number if applicable.
  5. Last Name, First Name, Middle Name: Write your full name as it appears on official documents.
  6. Social Security Number (SSN): Enter your SSN. Disclosure is voluntary.
  7. Grade/Status: Indicate your military grade or status.
  8. Organization or Address: Provide your current organization or address.
  9. Statement: Clearly write your statement under oath, beginning with “I, [Your Name], want to make the following statement under oath:”
  10. Exhibit: If you have any supporting documents, indicate them here.
  11. Initials: Sign your initials at the bottom of the page to confirm the statement.

For any additional pages, include the heading "Statement of Taken At" along with the date. Remember to initial each page and indicate the page number. Once completed, ensure that you sign and date the affidavit section to finalize your statement.

Your Questions, Answered

What is the purpose of the DA 2823 form?

The DA 2823 form, also known as the Sworn Statement, is primarily used to document potential criminal activity involving the U.S. Army. It allows Army officials to maintain discipline and law and order by facilitating the investigation of complaints and incidents. The information collected can be shared with various law enforcement agencies and may be used for disciplinary actions, security clearances, and personnel decisions.

Who is required to fill out the DA 2823 form?

Any individual who wishes to make a sworn statement regarding an incident or complaint related to the U.S. Army can fill out the DA 2823 form. This includes military personnel, civilians, and witnesses. It is important for the person making the statement to provide accurate and truthful information, as the form serves as a legal document.

What information is needed to complete the DA 2823 form?

To complete the DA 2823 form, the following information is typically required:

  1. Location of the incident
  2. Date (in YYYYMMDD format)
  3. Time of the incident
  4. File number (if applicable)
  5. Full name (last name, first name, middle name)
  6. Social Security Number (SSN)
  7. Grade or status
  8. Organization or address
  9. The statement itself
  10. Exhibits or additional evidence, if any

It is also necessary for the individual to initial each page of the statement and to sign it in the presence of a person authorized to administer oaths.

What are the privacy implications of submitting the DA 2823 form?

When submitting the DA 2823 form, individuals should be aware that their information, including their Social Security Number, may be disclosed to various entities such as law enforcement agencies, courts, and child protective services. However, the disclosure of this information is voluntary. It is crucial to understand that the information provided will be used for specific purposes related to investigations and disciplinary actions within the Army.

Common mistakes

  1. Missing Required Information: People often forget to fill out essential fields such as location, date, or time. These details are necessary for the statement to be complete and valid.

  2. Incorrect Name Order: Some individuals may write their name in the wrong order. The form requires the last name, followed by the first name and middle name. This can lead to confusion in identification.

  3. Improper Initialing: It is common for users to overlook the need to initial corrections. Each correction made on the form should be initialed by the person making the statement to validate the changes.

  4. Neglecting to Sign: Some may forget to sign the statement at the end. A signature is crucial as it confirms that the individual understands and agrees with the contents of the statement.

Documents used along the form

The DA Form 2823 is an important document used to record sworn statements regarding potential criminal activity within the U.S. Army. When completing this form, several other documents may also be required to support the process. Here’s a list of related forms and documents that are often used in conjunction with the DA Form 2823:

  • DA Form 4856: This is the Developmental Counseling Form. It is used by leaders to document counseling sessions with soldiers, addressing performance issues or behavioral concerns.
  • DA Form 15-6: This is the Investigation Report form. It is used to document the findings of an investigation, providing a comprehensive overview of the events and conclusions drawn.
  • DA Form 2701: This form is known as the Initial Information for Victims and Witnesses of Crime. It provides essential information to victims and witnesses about their rights and available resources.
  • DA Form 160: This is the Report of Investigation form. It details the findings of an investigation and is crucial for maintaining records of incidents.
  • DA Form 2028: This form is used for the Recommended Changes to Publications and Blank Forms. It allows individuals to suggest updates or corrections to existing documents.
  • DD Form 214: This is the Certificate of Release or Discharge from Active Duty. It summarizes a service member's military service and is often requested for various administrative purposes.
  • SF 180: This form is the Request Pertaining to Military Records. It is used to request copies of military service records, which can be relevant in investigations.
  • AF Form 1168: This is the Statement of Suspect/Witness/Complainant form. It is used to collect statements from individuals involved in an incident.
  • DA Form 1-9: This is the Personnel Action form. It is used to document various personnel actions, including disciplinary measures or administrative actions.
  • DA Form 31: This is the Request and Authority for Leave. It documents a service member’s request for leave, which may be relevant in certain investigations.

Understanding these forms and their purposes can help streamline the process when dealing with investigations and related matters in the U.S. Army. It’s essential to ensure that all necessary documentation is completed accurately and submitted in a timely manner to maintain compliance and support any ongoing inquiries.

Similar forms

The DA Form 2823, known as the Sworn Statement, shares similarities with an Affidavit. Both documents serve as written declarations made under oath, which means they carry legal weight. An affidavit is typically used in various legal contexts, such as court proceedings or administrative matters, to provide evidence or support claims. Like the DA Form 2823, an affidavit requires the individual to affirm that the information is true and correct, often in the presence of a notary public or another authorized official. This shared purpose of documenting truthful statements under oath underscores the importance of both forms in legal and military settings.

Another document comparable to the DA Form 2823 is a Witness Statement. This type of statement is often collected during investigations to gather firsthand accounts of events. Similar to the DA Form 2823, a witness statement aims to provide a clear record of what an individual observed or experienced. Both documents require the person making the statement to provide identifying information and details about the event in question. The main difference lies in the context; while the DA Form 2823 is specifically for military purposes, witness statements can be used in various legal situations, including civil and criminal cases.

The Incident Report is another document that bears resemblance to the DA Form 2823. Incident reports are used by law enforcement and military organizations to document specific events or occurrences, often involving potential criminal activity. Like the DA Form 2823, these reports include essential details such as the date, time, and location of the incident, as well as information about individuals involved. Both forms aim to create a factual record that can be used for further investigation or legal proceedings, emphasizing the importance of accurate documentation in maintaining order and accountability.

Similarly, the Statement of Facts is akin to the DA Form 2823. This document is often utilized in legal cases to outline the facts surrounding a particular situation. Like the sworn statement, a Statement of Facts requires clarity and precision in the information provided. Both documents serve the purpose of establishing a factual basis for legal arguments or decisions. The key distinction is that a Statement of Facts may not necessarily be made under oath, whereas the DA Form 2823 explicitly requires an oath, adding a layer of legal commitment to the information presented.

Finally, the Complaint Form is another document that parallels the DA Form 2823 in its function. A complaint form is used to report grievances or violations, often within organizational or legal frameworks. Both documents allow individuals to formally present their concerns, detailing the nature of the issue and any relevant facts. While the DA Form 2823 is specifically tailored for sworn statements regarding potential criminal activity in the military, a complaint form can be used in various contexts, including civil rights violations or workplace grievances, highlighting the need for formal channels to address concerns and uphold justice.

Dos and Don'ts

When filling out the DA 2823 form, it’s essential to be thorough and accurate. This form is a sworn statement used to document potential criminal activity involving the U.S. Army. Here are some important dos and don’ts to consider:

  • Do: Provide accurate and complete information. Ensure that all required fields, such as your name, date, and statement details, are filled out correctly.
  • Do: Sign and date the form. Your signature confirms that you understand the statement and that it is true to the best of your knowledge.
  • Do: Initial any corrections you make on the form. This shows that you acknowledge the changes and maintain the integrity of your statement.
  • Do: Include your Social Security Number (SSN) only if it is necessary and requested. Remember that disclosing your SSN is voluntary.
  • Don’t: Rush through the process. Take your time to ensure that all information is accurate and that your statement is clear.
  • Don’t: Leave any sections blank. If a section does not apply to you, indicate that clearly instead of leaving it empty.

By following these guidelines, you can help ensure that your DA 2823 form is filled out correctly and effectively. Remember, this document plays a critical role in maintaining discipline and order within the Army.

Misconceptions

Misconceptions about the DA 2823 form can lead to confusion and misinterpretation of its purpose. Here are nine common misconceptions, along with clarifications for each:

  1. It is only for serious criminal allegations.

    Many believe the DA 2823 form is reserved for serious crimes. In reality, it can document any potential criminal activity, regardless of severity, to maintain order within the Army.

  2. Completing the form is mandatory for all statements.

    Some think that every statement must be documented using this form. However, while it is recommended for formal statements, not all situations require it.

  3. Your Social Security Number (SSN) is mandatory.

    There is a misconception that providing your SSN is compulsory. In fact, disclosure of your SSN is voluntary, although it may help in identifying records.

  4. The form is only for Army personnel.

    Many assume that only Army members can use this form. In truth, it can be utilized by anyone involved in a situation related to Army activities.

  5. Once submitted, the statement cannot be changed.

    Some believe that after submitting the DA 2823, no alterations can be made. Corrections can be made as long as they are initialed by the person making the statement.

  6. The form guarantees anonymity.

    There is a belief that using this form will keep the identity of the person making the statement confidential. However, the information may be disclosed to various authorities as needed.

  7. Witness signatures are not necessary.

    Some think that witness signatures are optional. However, having witnesses can lend credibility to the statement and is often encouraged.

  8. Only one page is required for a statement.

    It's a common misconception that a single page suffices for all statements. Additional pages can be used if necessary, provided they are properly formatted.

  9. All statements will lead to investigations.

    Many fear that submitting a statement will automatically trigger an investigation. While the information may be reviewed, not every statement leads to formal action.

Key takeaways

Here are key takeaways for filling out and using the DA 2823 form:

  • Purpose: This form documents potential criminal activity involving the U.S. Army.
  • Voluntary Disclosure: Providing your Social Security Number (SSN) is optional.
  • Authority: The form is authorized under Title 10 and Title 5 of the U.S. Code.
  • Routine Uses: Information may be shared with various government agencies for investigations and disciplinary actions.
  • Initials Required: Initials of the person making the statement must appear at the bottom of each page.
  • Affidavit Section: The statement must be signed to confirm understanding and truthfulness.
  • Additional Pages: If more space is needed, label additional pages clearly and include initials.
  • Signature: A witness must sign and date the form to validate the statement.
  • Format: Fill in the required fields clearly, including location, date, and time.
  • Review: Always read the completed statement carefully before signing.