Free Da 2823 Form in PDF

Free Da 2823 Form in PDF

The DA Form 2823 is designated for the documentation of sworn statements within the U.S. Army, serving a critical role in the investigation of complaints and incidents aimed at maintaining discipline, law, and order. It is governed by specific regulations and protocols to ensure integrity in the process of recording potential criminal activity and other relevant matters. For those required to complete this form, detailed and accurate completion is essential to support the investigative and administrative processes. To begin filling out the DA Form 2823, please click the button below.

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The DA Form 2823, known as a Sworn Statement, plays a critical role within the U.S. Army’s framework for documenting potential criminal activity and maintaining discipline, law, and order through the thorough investigation of complaints and incidents. Authorized under Title 10, USC Section 301; Title 5, USC Section 2951; and Executive Order 9397, which necessitates the disclosure of Social Security Numbers (SSN), this form serves several principal purposes. It is designed not only to facilitate documentation and investigation processes but also to uphold stringent standards of transparency and accountability within Army operations. The information collected through this form can be shared with an array of entities, including federal, state, local, and foreign law enforcement agencies, courts, child protective services, and more, underlining its utility in broader legal and administrative contexts. Furthermore, the DA Form 2823 underscores the importance of voluntary disclosure while detailing the procedures for making a statement, including the requirement for the statement to be made under oath, thereby ensuring the integrity and reliability of the information provided. Its structured format, which includes sections for personal identification, statement content, and verification by oath, ensures that all necessary details are captured systematically.

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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Document Specs

Fact Name Description
Form Purpose DA Form 2823 is used to document potential criminal activity involving the U.S. Army, assisting officials in maintaining discipline, law, and order through the investigation of complaints and incidents.
Authority The form is authorized under Title 10, USC Section 301; Title 5, USC Section 2951; and Executive Order 9397. These authorities allow for the collection of social security numbers and other personal information for investigation purposes.
Routine Uses Information from DA Form 2823 may be disclosed to various agencies, including federal, state, local, and foreign law enforcement, for further investigation, judicial or non-judicial punishment, security clearances, and other personnel actions.
Disclosure Disclosure of personal information, including social security numbers, on the form is voluntary, but essential for documentation and investigation processes related to maintaining discipline within the Army.

Instructions on Writing Da 2823

Successfully completing the DA Form 2823, a sworn statement, requires careful attention to detail and accuracy. This form plays a crucial role in documenting potential criminal activity within the U.S. Army, facilitating investigations to maintain discipline, law, and order. Here's a clear, step-by-step guide on how to fill out this form. Ensuring each part is completed correctly is vital for the form's effectiveness in any subsequent investigations or proceedings.

  1. Begin with the Location where the statement is being made. This should include specifics like the base or office where the form is being filled out.
  2. Enter the Date in the format YYYYMMDD. This ensures clarity and avoids any confusion over international date formats.
  3. Record the Time the statement is being made, using the 24-hour clock to avoid ambiguity between AM and PM times.
  4. Fill in the File Number, if applicable. This could be a case number or any other identifier used by your office or the investigation.
  5. For the section requiring the name, input the Last Name, First Name, Middle Name of the person making the statement clearly.
  6. Enter the SSN (Social Security Number). Remember, providing your SSN is voluntary but can be crucial for accurately identifying individuals.
  7. Specify the Grade/Status of the individual making the statement. This includes ranks and positions within the Army.
  8. Add the Organization or Address related to the person making the statement. This could be a unit designation or home address.
  9. For the section beginning with "I, ________," clearly print the name of the person making the statement again and proceed to document the statement under the oath in the field provided. If more space is needed, continue the statement on additional pages.
  10. Every page after the first that contains continued text from the statement must have the heading "Statement of ______ taken at ______ dated ______". Fill in these blanks accordingly.
  11. Ensure Initials of Person Making Statement are placed at the bottom of each page, indicating they have reviewed and agree with the content on each page.
  12. On the final page, the person making the statement must affirm the accuracy and truthfulness of the information by signing under the "Affidavit" section. They must state they have made this statement freely and understand its content fully.
  13. Witnesses to the statement should provide their details and signatures in the designated section. This verifies the statement was properly observed.
  14. Ensure the Signature of Person Administering Oath section is completed by a duly authorized individual. This authenticates the sworn nature of the statement.
  15. Last, double-check the form for completeness and accuracy before submitting or retaining it as required. Misinformation or errors could affect investigations or proceedings related to the statement.

This comprehensive approach to filling out the DA Form 2823 ensures that the information is accurately documented, upholding the integrity of the investigative process and ensuring that all participants are appropriately recognized and held accountable.

Understanding Da 2823

What is the purpose of the DA Form 2823?

The DA Form 2823, also known as a Sworn Statement, serves a crucial role in documenting potential criminal activities concerning the U.S. Army. It facilitates Army officials in maintaining discipline, law, and order by enabling the thorough investigation of complaints and incidents. This form acts as an official record that may be used in legal, administrative, and disciplinary actions within the military context.

Who is authorized to administer an oath for the DA Form 2823?

An oath on the DA Form 2823 must be administered by someone legally authorized to do so. This often includes military officers and other designated personnel within the Department of Defense who have the authority to administer oaths according to military regulations and federal law. The name, rank, and organization of the person administering the oath will be recorded on the form to ensure the statement's validity.

Is providing my Social Security Number (SSN) required on the DA Form 2823?

Disclosure of your Social Security Number (SSN) on the DA Form 2823 is voluntary. However, the SSN is used to ensure accurate identification and record-keeping within the Army's system. While not mandatorily required, providing your SSN can facilitate a smoother process in linking the statement to the correct individual, especially in cases that may lead to judicial, non-judicial, or administrative actions.

Can the information on the DA Form 2823 be disclosed to other agencies or organizations?

Yes, information provided on the DA Form 2823 can 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. Such disclosures are made for routine uses, including but not limited to, investigations, legal proceedings, and other personnel actions. The form is designed to allow for the wide sharing of information as necessary to uphold law, discipline, and order within and beyond the Army.

Common mistakes

Filling out the DA Form 2823, the Sworn Statement, can be daunting. Many people, aiming to document an incident accurately and truthfully, still find themselves making common mistakes. First and foremost, a frequent error is the omission of details such as the location, date, and time at the beginning of the form. These specifics are crucial as they contextualize the statement, adding to its credibility and relevance.

Another common pitfall is not including a file number when applicable. The file number serves as a unique identifier, ensuring that the statement can be accurately matched to the corresponding case or incident being reported or investigated. Without it, the document could easily become misplaced or misattribated, potentially compromising the integrity of the investigation.

Perhaps one of the most critical sections that is often neglected is the personal information section, including the SSN and grade/status. While disclosure of the SSN is voluntary, providing it, along with accurate grade or status information, can significantly aid in the identification process within the military's administrative and judicial context. Furthermore, failure to accurately complete the organization or address section can lead to confusion about the origin of the statement or the specific unit concerned.

When making the statement, individuals frequently forget to clearly articulate their account, leaving out essential details or not fully explaining the context of the incident. A well-documented account should include all relevant information, facilitating a thorough understanding of the events that transpired.

Moreover, the importance of initials on each page, including those containing amendments to the statement, cannot be overstated. These initials are a personal verification of the statement's accuracy on a page-by-page basis and lend authenticity to the document.

The signing of the affidavit and ensuring the presence of a witness are steps that are too often overlooked. This oversight can significantly impact the document's legal standing. The affidavit's signature validates the truthfulness of the statement, while a witness's signature provides an additional layer of verification and formality to the process.

Last but not least, many fail to recognize the gravity of the statement they're making. Filling out the form in haste, without fully understanding the implications or ensuring the complete and accurate representation of events, can lead to unintended consequences. It is not just a formality but a crucial part of a legal process that demands attention to detail and care.

Documents used along the form

Completing a DA Form 2823, Sworn Statement, is often just one step in the process when dealing with incidents or investigations within the U.S. Army. To provide a clear and comprehensive overview of a situation, this form may be used together with various other documents and forms, each serving a distinct function to ensure thorough documentation and compliance with procedures. Understanding these associated documents can be immensely helpful.

  • DA Form 4856: This form is a developmental counseling form used by the U.S. Army to document counseling sessions between leaders and their subordinates. It often complements the DA Form 2823 when the situation involves counseling for behavior or incidents related to the statement.
  • DA Form 638: An award recommendation form used to recommend military personnel for awards. In instances where the sworn statement involves acts of heroism or meritorious service, this form may accompany the DA Form 2823.
  • DA Form 4187: Personnel action request form that is used to request changes in personnel status, such as duty reassignments or special programs. It may be pertinent if the sworn statement impacts the individual's personnel status.
  • DD Form 214: Certificate of Release or Discharge from Active Duty, which could be relevant if the sworn statement pertains to events leading up to or influencing a service member's discharge.
  • DA Form 31: Request and Authority for Leave, which might be used alongside the DA Form 2823 if the incidents relate to leave status or requests.
  • DD Form 93: Record of Emergency Data form, which provides emergency contact information and beneficiary details. It may be relevant in situations where the sworn statement involves incidents that affect the service member’s personal record or emergency information.
  • DA Form 2828: Consent/Release form, which might be necessary if the sworn statement involves the release of personal or sensitive information requiring consent.
  • DA Form 5500: Body Fat Content Worksheet, potentially relevant if the sworn statement is related to the physical condition or fitness level of personnel.
  • DA Form 6: Duty Roster form, which could be important when the sworn statement involves issues or incidents relating to duty assignments or scheduling.

Each document plays a crucial role in complementing the DA Form 2823 to provide a full picture of circumstances, decisions, or actions taken regarding personnel within the U.S. Army. Whether for awards, disciplinary records, personal status changes, or other purposes, understanding the function and proper use of these forms ensures accurate and effective documentation and compliance with Army regulations.

Similar forms

The DA Form 2823 is closely related to the FD-395, Witness Statement Form used by the Federal Bureau of Investigation (FBI). The FD-395 is a document where individuals provide a formal account of what they witnessed or know about an incident, often in relation to federal investigations or crimes. Both forms serve as official records of statements made by individuals and are used to support investigations. They require the person making the statement to acknowledge the truthfulness of their testimony, typically before an authorized official.

Similar to the DA Form 2823, the SF-86, Questionnaire for National Security Positions, is another document used within government operations. Although used for a different purpose -- to evaluate individuals applying for security clearances -- it collects detailed personal information and requires attestation to the veracity of the information provided. Both forms collect sensitive information, including social security numbers, and emphasize the importance of honesty in providing information.

The I-9 Employment Eligibility Verification form, mandated by the U.S. Citizenship and Immigration Services, is another document that shares similarities with the DA Form 2823. It verifies the identity and employment authorization of individuals hired for employment in the United States. Like the DA Form 2823, the I-9 includes sections for personal information, attestation by the individual, and verification by an authorized representative, underlining the significance of truthful statements.

The Miranda Warning Form, used by law enforcement before questioning a detained suspect, also parallels the DA Form 2823 in its formal acknowledgment of rights and responsibilities. Both documents involve the administration of rights under specific circumstances — the Miranda Warning for suspects in custody and the DA Form 2823 for individuals providing sworn statements related to military investigations. Each requires official witness signatures to validate the process.

The Incident Report Forms, commonly used across various sectors such as healthcare, public safety, and education, document details of unusual or unexpected events. Similar to DA Form 2823, these forms record factual accounts of incidents to initiate investigations or action. Both forms are pivotal in documenting events accurately and may include personal testimonies, whereby the authenticity of information provided is crucial for further actions.

The IRS Form 4506-T, Request for Transcript of Tax Return, shares the aspect of formal documentation of personal information with the purpose of verification, akin to the DA Form 2823. Though the 4506-T is specifically for tax purposes — allowing individuals or entities to request previous tax returns — it emphasizes the importance of accurate, truthful information provided under penalty of perjury, similar to the statement verification aspect of the DA Form 2823.

Lastly, the Consent to Release Information Form, used in various contexts like medical, educational, and employment fields, requires individuals to provide authorization for the disclosure of personal information. This form, akin to the DA Form 2823, involves a formal agreement, the provision of personal details, and, often, an understanding of the confidentiality and use of the provided information. Both forms deal with sensitive information and have implications for privacy and legal matters, underscoring the importance of conscious and truthful participation.

Dos and Don'ts

When it comes to handling the DA Form 2823, which is a Sworn Statement, it's critical to approach this document with the utmost care and attention to detail. This form plays a key role in documenting potential criminal activity within the U.S. Army and assists officials in maintaining discipline, law, and order. Below are some core do's and don'ts to keep in mind when filling out this form.

What you should do:

  • Ensure all information is accurate: Double-check every detail you enter, especially your Social Security Number (SSN) and personal information. Mistakes can complicate or delay investigations.
  • Follow instructions carefully: Each section of the form serves a specific purpose, so it's vital to answer each part as instructed to avoid confusion or errors.
  • Use additional pages if necessary: If your statement does not fit in the space provided on the first page, continue onto additional pages, ensuring you adhere to the format required for those continuations.
  • Initial all corrections: If you need to make changes to any of the information you've entered, be sure to initial beside each correction. This verifies that you've acknowledged and approved the changes.

What you shouldn't do:

  • Rush through the form: Taking your time to fill out the form carefully can prevent errors and ensure your statement is accurate and clear.
  • Leave sections blank: If a section does not apply to your situation, it's better to write "N/A" (not applicable) rather than leaving it empty, which could lead to misunderstandings.
  • Forget to initial every page: Beyond corrections, it's important to note that your initials need to be on every page of the statement. This requirement is part of certifying the document is entirely from you.
  • Sign without understanding: Before signing the affidavit at the end, ensure you fully understand your statement and its implications. If you have any doubts, asking questions before signing is crucial.

Misconceptions

There are several misconceptions surrounding the DA Form 2823, the sworn statement used within the U.S. Army. It is crucial for service members, as well as individuals involved with the military legal system, to have a clear understanding of this form. Below are explanations aimed at clarifying the most common misunderstandings.

  • Misconception 1:

    The DA Form 2823 is only for documenting criminal activities.

    While it is often used to document potential criminal activity, this form also plays a role in maintaining discipline, law, and order through the investigation of complaints and other incidents that may not necessarily be criminal.

  • Misconception 2:

    Information provided is solely for military use.

    The information recorded on a DA Form 2823 can be disclosed to a wide range of entities, including federal, state, and foreign law enforcement agencies, courts, and more, for various purposes beyond military discipline.

  • Misconception 3:

    Disclosure of Social Security Number (SSN) is mandatory.

    Although the form requests your SSN, providing it, along with other personal information, is voluntary. However, omitting your SSN might affect the form’s accuracy or efficiency in documentation.

  • Misconception 4:

    A DA Form 2823 is valid without a witness's signature.

    The final page of the form requires a witness - a person authorized by law to administer oaths - to sign, ensuring the statement was made under oath and verifying its authenticity.

  • Misconception 5:

    The form is complicated and cannot be corrected after it's signed.

    Corrections can be made on the DA Form 2823. The person making the statement must initial all corrections and initial the bottom of each page to validate these changes.

  • Misconception 6:

    There's no need to read the statement before signing if you're the one making it.

    Even if you are the person making the statement, it is crucial that the statement is read or read to you in its entirety before signing, to ensure it accurately reflects your testimony.

  • Misconception 7:

    The form can only be filled out by Army personnel.

    While predominantly used by the U.S. Army, the DA Form 2823 can be filled out by civilians or other service members as witnesses or when providing statements related to Army investigations.

  • Misconception 8:

    There is no way to continue a statement onto another page.

    Additional pages may be used if the space provided on the first page is insufficient. These pages must contain the proper headings, and each additional page must be initialed at the bottom by the person making the statement.

  • Misconception 9:

    The form once completed is final and cannot be revoked.

    If new information comes to light or if an error is discovered, additional statements can be made to supplement or correct the initial DA Form 2823. This process ensures that the most accurate information is recorded.

Understanding these points clarifies the purpose and procedures surrounding the DA Form 2823, ensuring that it is used correctly and effectively within the military legal framework.

Key takeaways

When dealing with the DA Form 2823, or the Sworn Statement, individuals must handle it with precision and integrity. This document serves as a crucial piece of evidence in documenting potential criminal activities involving the U.S. Army, making its correct use paramount. Here are key takeaways for filling out and using this form:

  • Understand the Purpose: The primary function of the DA Form 2823 is to document potential criminal activities and maintain discipline within the Army. It serves as a formal written record of statements related to investigations.
  • Accuracy is Key: When completing the form, every detail needs to be accurate. Misrepresentations or inaccuracies can undermine the investigation and potentially lead to legal complications.
  • Voluntary Disclosure: Providing your Social Security Number (SSN) and other personal information is voluntary but can be crucial for the investigation's thoroughness and accuracy.
  • Mandatory Fields: Certain fields on the form, such as location, date, and personal information, including last name and SSN, are essential for identifying the context and the individual making the statement.
  • Statement Under Oath: The declaration made on the DA Form 2823 is under oath. Individuals must comprehend the seriousness of making a statement under oath and the legal implications of perjury.
  • Witness and Oath Administration: The form must be signed in the presence of a person authorized to administer oaths, ensuring the statement's legality and veracity.
  • Initialing Corrections: If any information needs to be corrected during or after the initial statement, the individual making the statement must initial each correction, reinforcing the document's integrity.
  • Multiple Pages: Should the statement exceed one page, each additional page must contain the heading “Statement of Taken at Dated” and the individual's initials at the bottom. This ensures continuity and authentication across the document.

It is imperative for all parties involved in completing the DA Form 2823 to approach it with the gravity it demands. This form not only documents crucial information for internal investigations but also holds significant legal weight. Ensuring its correct and thoughtful completion is essential for maintaining the Army's standard of discipline, law, and order.

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