Da 2823 Template

Da 2823 Template

The DA 2823 form is a sworn statement used within the U.S. Army to document potential criminal activity and maintain discipline through investigations of complaints. This form serves various routine purposes, including disclosures to law enforcement and considerations related to personnel actions. Understanding its significance and proper usage is essential for anyone involved in the military context.

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Content Overview

The DA Form 2823 is a Sworn Statement document essential for recording potential criminal activity associated with the U.S. Army. Intended for use by personnel and involved parties, the form serves multiple purposes, key among them being the documentation of complaints and incidents that require investigation. It facilitates Army officials in maintaining discipline and law and order, helping to ensure that concerns are adequately addressed. This form provides a structured method for individuals to present their statements, allowing for a clear articulation of facts under oath. Among the necessary elements included on this form are the individual's personal details, such as name, Social Security Number, and organization, along with a space for the detailed statement itself. The privacy of the information provided is paramount, as outlined in the Privacy Act Statement, which explains that data may be disclosed to various governmental entities for legal purposes. Furthermore, the form emphasizes that filling it out is a voluntary act, reassuring individuals that their participation in this process will not lead to unwanted repercussions. When completed, the form also requires the initials of the person making the statement to validate any corrections and to confirm understanding of the contents, ensuring clarity and accuracy throughout the documentation process.

Da 2823 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

Document Attributes

Fact Name Details
Form Purpose The DA 2823 form is used to document potential criminal activity involving the U.S. Army.
Governing Laws This form is governed by Title 10, USC Section 301; Title 5, USC Section 2951; and Executive Order 9397.
Information Disclosure Information may be shared with various law enforcement agencies and government entities.
Voluntary Disclosure Providing your Social Security Number and other information is voluntary.
Initials Requirement Each additional page must bear the initials of the person making the statement and indicate the page number.
Affidavit Statement The person making the statement must confirm its truthfulness and understanding before a witness authorized to administer oaths.

Da 2823: Usage Instruction

Filling out the DA 2823 form is an important process that requires accurate information and careful attention to detail. After completing the form, it will be used to collect and document your statement regarding an incident or complaint involving the U.S. Army. Once submitted, the information will aid in the investigation and help maintain order within the Army community.

  1. Locate the Form: Ensure you have a blank copy of the DA 2823 form.
  2. Fill Out the Location: In the first section, write the location where the statement is being taken.
  3. Enter the Date: Next, write today’s date in the format YYYYMMDD.
  4. Record the Time: Indicate the exact time when the statement is being taken.
  5. Provide Your File Number: Enter your file number if applicable.
  6. Complete Your Name: Fill in your last name, first name, and middle name.
  7. Enter Your Social Security Number: Write your SSN. Remember, this information is voluntary.
  8. List Your Grade/Status: Indicate your military grade or status.
  9. Provide Your Organization or Address: Fill in the organization name or your home address.
  10. Make Your Statement: In the next section, write your statement clearly, stating the facts as you perceive them.
  11. Attach Any Exhibits: If you have supporting documents or evidence, indicate them in the “Exhibit” section.
  12. Initial the Statement: At the end of your statement, provide your initials as verification of the statement’s contents.
  13. Additional Pages: If more space is needed, use additional pages but ensure they are properly labeled and initialed at the bottom.
  14. Final Review: Before signing, make sure to read through your statement to confirm its accuracy and completeness.
  15. Sign and Date: Sign the form, and provide the date of signing. This reinforces that you made the statement truthfully and under oath.
  16. Witness the Statement: Have a witness acknowledge your statement by providing their signature and organization information if required.

Frequently Asked Questions

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

    The DA Form 2823, also known as the Sworn Statement, is designed to document potential criminal activity involving the U.S. Army. It serves as a valuable tool for Army officials to maintain discipline and order through thorough investigations of complaints and incidents. By collecting statements under oath, the Army can gather accurate accounts of events that may require further action or inquiry.

  2. Who can use the DA Form 2823?

    This form can be utilized by anyone who wishes to report information regarding potential criminal activity within the Army. This includes soldiers, civilians, and witnesses to incidents. It is important to note that statements made on this form are provided under oath, adding a layer of seriousness to the information being shared.

  3. What information should I include when filling out the form?

    When completing the DA Form 2823, you will need to provide various details about yourself and the statement. Required information includes:

    • Location of the incident
    • Date and time
    • Your full name and Social Security Number (SSN)
    • Your grade or status in the Army
    • Your organization or address
    • The content of your statement

    Make sure to provide as much detail as possible to ensure a comprehensive understanding of the events being reported.

  4. What happens to my information once I submit the DA Form 2823?

    The information provided on the DA Form 2823 may be shared with various entities, including federal, state, and local law enforcement agencies, as well as courts and victim services. This sharing is meant to facilitate the investigation process and possibly inform decisions related to disciplinary actions, security clearances, or other personnel matters. Your privacy is taken seriously, and while disclosure of your SSN and other data is voluntary, providing accurate information is critical for the integrity of the investigation.

  5. Am I protected if I fill out this form?

    Yes, when you make a statement on the DA Form 2823, you are doing so under oath. You affirm that your statement is true, and you must acknowledge that it has been made freely and without any coercion or undue influence. This process offers some protection in terms of the seriousness of your testimony. However, it's crucial to understand that making false statements can lead to serious consequences. Always ensure that the information you provide is accurate to uphold the integrity of the investigation.

Common mistakes

Completing the DA 2823 form requires careful attention to detail. One common mistake is failing to include your Social Security Number (SSN). While disclosure is voluntary, omitting this information can delay processing or raise questions about the validity of the statement.

Another frequent error is not providing accurate dates and times. The directive is clear: all entries in the location and time fields must adhere to specific formats. Failure to do so can lead to confusion and even invalidation of the statement.

Many people also neglect to initial all corrections made to the form. Initialing shows you acknowledge and accept those changes, which is essential for maintaining the integrity of the document. Without these initials, important corrections could be disregarded or considered unauthorized.

Incomplete personal information is another pitfall in filling out the form. Individuals should ensure that their full name, grade/status, and organization or address are clearly stated. Providing incomplete or incorrect information hampers the ability of officials to effectively process their statements.

A common oversight is the lack of required witness signatures. If you fail to include your witness, it can undermine the credibility of your statement. Ensure that a qualified individual is present and that they sign in the appropriate section.

Additionally, some people forget to number the pages of their statements. Each subsequent page should include a page number along with the initials of the person making the statement. This helps maintain organization and ensures that no pages are lost or misplaced.

Another mistake involves not re-reading the affidavit section. It’s crucial to confirm that you have understood and agree with the content of your statement. Signing without comprehension can lead to unintended consequences.

Finally, many individuals skip the final review before submission. Taking an extra moment to check the entire form for completeness and accuracy can save time and hassle later on. Each detail matters, and reviewing ensures that your statement stands as intended.

Documents used along the form

The DA 2823 form, also known as the Sworn Statement, is often used in conjunction with several other forms and documents during military investigations. Each of these serves specific purposes, ensuring that the investigation process is thorough and that proper protocols are followed.

  • DA Form 201: This is the military personnel records jacket. It contains a soldier's career information, performance evaluations, and other vital documents that support the individual's military career. Often, this form is essential during investigations to understand a person's military background and conduct.
  • DA Form 2627: This is the record of proceedings under Article 15 of the Uniform Code of Military Justice (UCMJ). It documents non-judicial punishment and is used to indicate any disciplinary actions taken against a service member. It provides context for the DA 2823 when misconduct is being reviewed.
  • DA Form 4187: This form requests a personnel action within the Army. It may be used to document changes in duty assignments, promotions, or other status updates. In investigations, it helps establish a timeline of a service member's activities and changes.
  • DA Form 3355: Known as the Army Enlisted Promotion Point Worksheet, this document provides an assessment of a soldier's qualifications for promotion. It is relevant in investigations, particularly when assessing a soldier’s overall performance record and potential for advancement.
  • Statement of Investigation: This document is a comprehensive report summarizing the findings of an investigation. It details interviews, evidence collected, and conclusions drawn by investigators. It supports the information provided in the DA 2823 and helps present a full picture to decision-makers.

These documents collectively enhance the investigation process within the military. They provide critical insights that support decision-making and maintain the integrity of military operations.

Similar forms

  • Affidavit: Like the DA 2823, an affidavit is a written statement made under oath that can serve as evidence in legal proceedings. Both documents require a declaration of truth and include information on the individual making the statement.
  • Witness Statement: This document details what a witness has observed regarding an incident. Similar to the DA 2823, it is used to gather facts and testimony relevant to an investigation.
  • Incident Report: Used by law enforcement to document an event, this report shares the purpose of formally recording facts related to an occurrence, akin to how the DA 2823 captures a sworn account of a potential crime.
  • Statement of Facts: This document serves to outline the facts of a situation. Both it and the DA 2823 provide a structured account that can be utilized in investigations.
  • Declaration: A declaration is also a written statement made under penalty of perjury. This shares the requirement of truthfulness and can be used in legal contexts, similar to the DA 2823.
  • Sworn Testimony: This involves a verbal statement given under oath in legal settings. Like the DA 2823, it commits the individual to honesty and can influence legal proceedings.
  • Charge Sheet: Typically used to formally accuse someone of a crime, it records the details surrounding the accusations, paralleling the DA 2823 in documenting serious claims for further action.

Dos and Don'ts

When filling out the DA 2823 form, there are important steps to keep in mind for a smooth process. Here’s a list of what to do and what to avoid:

  • Do read the instructions carefully before starting the form.
  • Do provide complete and accurate information in all required sections.
  • Do print neatly to ensure clarity and legibility.
  • Do initial any changes you make to the statement.
  • Don't skip any sections, even if you believe they don't apply to you.
  • Don't rush through the form; take your time to avoid mistakes.
  • Don't assume that your statement is confidential; handle it carefully.

By following these guidelines, you can help ensure your statement is processed effectively and with fewer complications.

Misconceptions

Misconceptions can complicate the understanding of the DA 2823 form. Here are seven common misunderstandings about this sworn statement.

  • It can only be used by military personnel. Many people think only active-duty members can complete this form. However, anyone involved in an incident related to the U.S. Army can use it.
  • Filling out the form means you are admitting guilt. This form is a way to provide a statement under oath. It does not imply that the person filling it out is guilty of any crime.
  • Providing a Social Security Number is mandatory. While the form requests a Social Security Number, providing it is voluntary. Individuals can choose not to disclose this information.
  • It can be filed without witness signatures. A witness may be required for the form to be valid. Having a person authorized to administer oaths present can strengthen the statement.
  • The DA 2823 form is not confidential. Some believe the information is completely private. In reality, it may be shared with various governmental agencies for legal and administrative purposes.
  • Only negative statements can be made. The form is for documenting potential criminal activity but can also be used to make affirmative statements about an incident.
  • Once submitted, the statement cannot be changed. Individuals can initial corrections. It’s essential to ensure that all details are accurate before finalizing the statement.

Understanding these misconceptions can help ensure proper use of the DA 2823 form and the statements made through it.

Key takeaways

When filling out the DA 2823 form, keep the following key points in mind:

  • Personal Information: Carefully provide your full name, Social Security Number (SSN), organization, and other identifying details accurately.
  • Statement Under Oath: Be clear and concise when articulating your statement. Include all necessary details regarding the incident or complaint.
  • Witness Requirements: Ensure that your statement is witnessed and sworn before an authorized individual. This is vital for the form to be legally binding.
  • Initials and Corrections: Initial any corrections you make on the document and be sure to initial each page of your statement. This confirms your review and agreement with the content.
  • Purpose of Disclosure: Understand that the information you provide may be shared with various law enforcement agencies and used in administrative actions. Read the privacy statement carefully.
  • Final Review: Before submitting, review the entire document to ensure accuracy, clarity, and completeness. Your signature at the end confirms your understanding and the truthfulness of your statement.

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