Official Department of the Army Forms

E-Forms by Range


DA 4400 thru DA 4999


Form Number Date Title Version PDF
DA 4430 SEP 02 DEPARTMENT OF THE ARMY REPORT OF RESULT OFTRIAL V1.00ES Fill On-line
DA 4441 SEP 02 UNITED STATES ARMY TRIAL DEFENSESERVICE V1.00 Fill On-line
DA 4449 AUG 94 CLEMENCY ACTION RECORD V1.01ES Fill On-line
DA 4450-R PDF ONLY MAY 92 BALLISTIC DENSITY OF TEMPERATURE Fill On-line
DA 4459 AUG 94 PAROLE ACTION RECORD V1.01ES Fill On-line
DA 4460-R JUL 80 ARMY LAW LIBRARY SHELF LIST V1.00 Fill On-line
DA 4465 NOV 01 PATIENT INTAKE/SCREENING RECORD (PIR) V2.00ES Fill On-line
DA 4466 NOV 01 PATIENT PROGRESS REPORT (PPR) V1.00ES Fill On-line
DA 4469-R MAY 92 WIND COMPUTATION (ELECTRONIC OR VISUAL) V1.00 Fill On-line
DA 4474-R JUN 87 REQUEST FOR ACCELERATED PAYMENT OF SRB - HARDSHIPOR COMPASSIONATE V1.01 Fill On-line
DA 4475 MAR 06 DATA REQUIRED BY THE PRIVACY ACT OF 1974 PERSONALINFORMATION FROM THE NOK OF A DECEASED SERVICE MEMBER V1.00 Fill On-line
DA 4497 MAR 02 INTERIM (ABBREVIATED) FLYING DUTY MEDICALEXAMINATION V1.00 Fill On-line
DA 4502-R DEC 82 WORKSHEET FOR CALCULATING COST OF MANAGEMENTINFORMATION REQUIREMENTS/PRODUCTS V1.00 Fill On-line
DA 4503-1-R MAY 86 ADP PRODUCT REVIEW EVALUATION V1.00 Fill On-line
DA 4504 OCT 78 RECORD OF FIRE V1.00 Fill On-line
DA 4505 MAY 76 155mm NUCLEAR COMPUTATION-MET CORRECTIONTECHNIQUE V1.00 Fill On-line
DA 4507 OCT 09 CREW MEMBER GRADE SLIP V1.00 Fill On-line
DA 4507-1-R AUG 95 MANEUVER/PROCEDURE GRADE SLIP V1.00 Fill On-line
DA 4507-2-R AUG 95 CONTINUATION COMMENT SLIP V2.00 Fill On-line
DA 4511 JUL 00 REQUEST FOR LOGISTICS CATALOG DATA AND/ORINFORMATION V1.00 Fill On-line
DA 4513 MAY 76 RECORD OF MISSIONS FIRED V1.00 Fill On-line
DA 4524-R PDF ONLY MAY 92 BALLISTIC DENSITY FROM SURFACE DATA Fill On-line
DA 4538 JUL 02 ABSTRACT OF ISSUES/SALES V1.00 Fill On-line
DA 4550-R APR 82 MEAL CARD VERIFICATION FORM V1.01 Fill On-line
DA 4552 JUL 02 KITCHEN REQUISITION V1.01ES Fill On-line
DA 4560-R DEC 82 APPLICATION FOR APPROVAL OF ADP PRODUCT V1.00 Fill On-line
DA 4570 APR 99 REGISTER OF PRINTING/DUPLICATINGREQUISITIONS V1.01 Fill On-line
DA 4570-1 APR 99 COMMERCIAL PRINTING RECORD V1.01 Fill On-line
DA 4571-R NOV 83 DATA REQUIRED BY THE PRIVACY ACT OF 1974(ELIGIBILITY FOR AMEDD OFFICER PROCUREMENT PROGRAMS - MISCELLANEOUSDOCUMENTATION) V1.00 Fill On-line
DA 4572 OCT 09 STATEMENT OF UNDERSTANDING FOR APPOINTMENT AS ACOMMISSIONED OFFICER V1.00ES Fill On-line
DA 4573 MAR 82 DOCUMENT CONTROL AND DESTRUCTIONCERTIFICATE V1.01 Fill On-line
DA 4574-R NOV 76 RADIOPHARMACEUTICAL STOCK RECORD V1.00 Fill On-line
DA 4591-R MAY 98 RETENTION DATA WORKSHEET V1.00 Fill On-line
DA 4598-R DEC 82 INSTALLATION CASH TRANSFER REQUEST V1.00 Fill On-line
DA 4601-R MAR 77 REPORT OF MANPOWER AND FISCAL RESOURCES IN SUPPORTOF THE CIVILIAN EQUAL EMPLOYMENT OPPORTUNITY PROGRAM V1.00 Fill On-line
DA 4604 SEP 06 SECURITY CONSTRUCTION STATEMENT V1.00 Fill On-line
DA 4605-R PDF ONLY AUG 90 DEPARTMENT OF THE ARMY MUNITIONS CONTROL CASEPROCESSING WORKSHEET Fill On-line
DA 4610-R SEP 96 EQUIPMENT CHANGES IN MTOE/TDA V2.00 Fill On-line
DA 4612-R OCT 93 NUMBER AND TYPES OF DECORATIONSAPPROVED V1.00 Fill On-line
DA 4620-R JUN 77 SPECIAL C-E AUTHORIZATION REQUEST V1.01 Fill On-line
DA 4644-R DEC 82 ARMY RESERVE REENLISTMENT DATA V1.00 Fill On-line
DA 4651 AUG 05 REQUEST FOR RESERVE COMPONENT ASSIGNMENT ORATTACHMENT V1.00 Fill On-line
DA 4655-R JAN 83 TARGET LIST WORKSHEET V1.00 Fill On-line
DA 4656-R JAN 83 SCHEDULING WORK SHEET V1.00 Fill On-line
DA 4657 MAY 05 STATEMENT OF RETIREMENT - ELIGIBLE SOLDIER -REMAINING SERVICE OBLIGATION V1.00 Fill On-line
DA 4658 MAY 05 STATEMENT OF RETIREMENT - ELIGIBLE SOLDIER - NOTELIGIBLE TO REENLIST V1.00 Fill On-line
DA 4664-1-R JUN 83 TEMPEST INSPECTION REPORT SUPPLEMENT - FACILITYPROFILE V1.00 Fill On-line
DA 4664-R JUN 83 TEMPEST INSPECTION REPORT V1.00 Fill On-line
DA 4665 MAR 00 PATIENT'S TRUST FUND--DAILY SUMMARYRECORD V1.01 Fill On-line
DA 4669-R AUG 90 COMSEC MATERIAL VOUCHER CONTROLREGISTER V1.00 Fill On-line
DA 4677 OCT 78 THERAPEUTIC DOCUMENTATION CARE PLAN(NON-MEDICATION) V1.00 Fill On-line
DA 4678 FEB 79 THERAPEUTIC DOCUMENTATION CARE PLAN(MEDICATIONS) V1.01 Fill On-line
DA 4691 FEB 04 INITIAL APPLICATION FOR CLINICAL PRIVILEGES ANDSTAFF APPOINTMENT V1.00 Fill On-line
DA 4691-1 FEB 04 APPLICATION FOR RENEWAL OF CLINICAL PRIVILEGES ANDSTAFF APPOINTMENT V1.01 Fill On-line
DA 4700 FEB 03 MEDICAL RECORD-SUPPLEMENTAL MEDICALDATA V1.00 Fill On-line
DA 4701-R APR 85 REQUEST FOR AVFUELS IDENTAPLATES V1.00 Fill On-line
DA 4702-R APR 85 MONTHLY BULK PETROLEUM ACCOUNTINGSUMMARY V2.01 Fill On-line
DA 4707 JUL 78 ENTRANCE PHYSICAL STANDARDS BOARD (EPSBD)PROCEEDINGS V1.01 Fill On-line
DA 4708 SEP 78 QUANTITY CHANGE FOR SUBSTITUTE IN PROPERTYBOOK V1.01 Fill On-line
DA 4711 MAR 07 STATEMENT OF LAW VIOLATIONS V1.00 Fill On-line
DA 4713 JUL 03 VOLUNTEER DAILY TIME RECORD V1.01 Fill On-line
DA 4719 JUN 09 CHILD DEVELOPMENT SERVICES (CDS) REGISTRATIONCARD V1.00ES Fill On-line
DA 4727 PDF ONLY SEP 78 FIELD RECORD AND COMPUTATIONS -TELLUROMENTER Fill On-line
DA 4730 JUN 05 CERTIFICATE FOR PERFORMANCE OF HAZARDOUSDUTY V1.01 Fill On-line
DA 4734-R OCT 78 DEPARTMENT OF THE ARMY UNITED STATES OF AMERICAINVENTION DISCLOSURE V1.00 Fill On-line
DA 4753 OCT 78 NOTICE OF UNSAFE OR UNHEALTHFUL WORKINGCONDITION V2.00 Fill On-line
DA 4754 OCT 78 VIOLATION INVENTORY LOG V2.00 Fill On-line
DA 4755 OCT 78 EMPLOYEE REPORT OF ALLEGED UNSAFE OR UNHEALTHFULWORKING CONDITIONS V2.01 Fill On-line
DA 4756 OCT 78 INSTALLATION HAZARD ABATEMENT PLAN V2.00 Fill On-line
DA 4757 SEP 84 REGISTRATION/SPECIAL CORRECTION WORKSHEET V2.00 Fill On-line
DA 4762 JUN 04 ATHLETE'S APPLICATION V1.01 Fill On-line
DA 4787 MAR 07 REASSIGNMENT PROCESSING V1.01 Fill On-line
DA 4789 JUN 79 STATEMENT OF ENTITLEMENT TO SELECTIVE REENLISTMENTBONUS V1.00 Fill On-line
DA 4790 NOV 06 CERTIFICATION FOR DISTRIBUTION OF PUBLICATION(S) INSUPPORT OF GOVERNMENT CONTRACT V1.00 Fill On-line
DA 4797 FILE 1/2 JAN 04 INTERNATIONAL STANDARDIZATION AGREEMENTRATIFICATION-IMPLEMENTATION DATA SHEET V1.02 Fill On-line
DA 4797 FILE 2/2 JAN 04 INTERNATIONAL STANDARDIZATION AGREEMENTRATIFICATION-IMPLEMENTATION DATA SHEET V1.01 Fill On-line
DA 4797-1 JAN 04 INTERNATIONAL STANDARDIZATION AGREEMENT REVIEW DATASHEET V1.01 Fill On-line
DA 4799-R PDF ONLY AUG 79 PROBATIONARY AGENT MONTHLY EVALUATIONREPORT Fill On-line
DA 4809-R APR 82 MEAL CARD CONTROL REGISTER V1.00 Fill On-line
DA 4815 APR 99 FORMS CONTROL REGISTER V1.00 Fill On-line
DA 4817-R PDF ONLY DEC 85 CONSENT/NONCONSENT TO DISCLOSE PERSONALINFORMATION Fill On-line
DA 4824 APR 05 ADDENDUM TO CERTIFICATE AND ACKNOWLEDGEMENT OFSERVICE REQUIREMENTS (DA FORM 3540) FOR ALL PERSONNEL APPLYING FORPARTICPATION IN THE RESERVE OFFICER TRAINING CORPS(ROTC)/SIMULTANEOUS MEMBERSHIP PROGRAM (SMP) V2.00 Fill On-line
DA 4826 APR 05 ADDENDUM TO CERTIFICATE AND ACKNOWLEDGEMENT OFSERVICE REQUIREMENTS (DA FORM 3540) FOR ENLISTMENT UNDER THEALTERNATE TRAINING PROGRAM V1.00 Fill On-line
DA 4831-R FILE 1/2 NOV 79 CALIBRATION AND REPAIR PROGRAM REPORT V1.01 Fill On-line
DA 4831-R FILE 2/2 NOV 79 CALIBRATION AND REPAIR PROGRAM REPORT V1.00 Fill On-line
DA 4833 JUN 04 COMMANDER'S REPORT OF DISCIPLINARY ORADMINISTRATIVE ACTION V1.00 Fill On-line
DA 4836 SEP 04 OATH OF EXTENSION OF ENLISTMENT ORREENLISTMENT V1.01 Fill On-line
DA 4838-R JAN 80 MAINTENANCE PROCESS ANALYSIS WORKSHEET V1.00 Fill On-line
DA 4839 JAN 80 CAREER INTERN PROGRAM CERTIFICATE OFACHIEVEMENT Fill On-line
DA 4840-R SEP 96 REQUEST FOR TYPE CLASSIFICATION EXEMPTION/LIN FORCOMMERCIAL EQUIPMENT V1.01 Fill On-line
DA 4841-R JUL 89 CHILD DEVELOPMENT SERVICES (CDS) PROGRAM/FACILITYREPORT V1.00 Fill On-line
DA 4843 APR 04 GUEST/ATTENDANCE SHEET V1.00 Fill On-line
DA 4850-1-R PDF ONLY DEC 94 NONAPPROPRIATED FUNDS TIME AND ATTENDANCESUPPLEMENT REPORT Fill On-line
DA 4856 MAR 06 DEVELOPMENTAL COUNSELING FORM V2.00 Fill On-line
DA 4876 JUN 05 REQUEST AND RELEASE OF MEDICAL INFORMATION TOCOMMUNICATIONS MEDIA V1.02ES Fill On-line
DA 4878 JUN 04 ARMY CHESS TOURNAMENT APPLICATION V1.00 Fill On-line
DA 4880-R MAY 80 SUPPLEMENTAL CONTRACTOR COST REPORT V1.00 Fill On-line
DA 4881 JUL 04 AGREEMENT FOR THE LOAN OF US ARMYMATERIEL V1.00 Fill On-line
DA 4881-1 JUL 04 AGREEMENT FOR THE LOAN OF US ARMY MATERIELCERTIFICATE FOR SIGNATURE BY AN ALTERNATE V1.00 Fill On-line
DA 4881-2 JUL 04 MILITARY PROPERTY OF THE UNITED STATES - EXHIBIT1 V1.00 Fill On-line
DA 4881-3 JUL 04 SURETY BOND FOR SAFEKEEPING OF PUBLIC PROPERTY ANDGUARANTEEING REIMBURSEMENT TO THE GOVERNMENT FOR EXPENSES INCIDENTTO THE LOAN OF ARMY MATERIEL - EXHIBIT II V1.00 Fill On-line
DA 4881-4 JUL 04 POWER OF ATTORNEY V1.00 Fill On-line
DA 4881-5 JUL 04 AGREEMENT FOR THE LEASE OF US ARMYMATERIEL V1.00 Fill On-line
DA 4881-6 JUL 04 REQUEST AND APPROVAL FOR LOAN OR LEASE OF EQUIPMENTAND LOAN OR LEASE AGREEMENT V1.00 Fill On-line
DA 4884-R PDF ONLY MAY 92 WEATHER DATA FOR SOUND RANGING Fill On-line
DA 4886 MAY 93 ISSUE-IN-KIND-PERSONAL CLOTHING RECORD V1.10 Fill On-line
DA 4888-R OCT 04 C-12 TAKEOFF AND LANDING DATA (TOLD) V1.000 Fill On-line
DA 4909 SEP 06 ARMY FLYING ACTIVITY ANNUAL STATUSREPORT V1.01 Fill On-line
DA 4916 JUN 09 CERTIFICATE OF SERVICE/ATTEMPTEDSERVICE V1.00ES Fill On-line
DA 4917 JUN 09 ADVICE AS TO APPELLATE RIGHTS V1.00ES Fill On-line
DA 4918 JUN 09 PETITION FOR GRANT OF REVIEW IN THE UNITED STATESCOURT OF APPEALS FOR THE ARMED FORCES V1.00ES Fill On-line
DA 4919 JUN 09 REQUEST FOR FINAL ACTION V1.00ES Fill On-line
DA 4922 SEP 99 CHAPLAINS' FUND GENERAL LEDGER V1.00 Fill On-line
DA 4922-1 SEP 99 CHAPLAINS' FUND GENERAL LEDGER(CONTINUATION) V1.00 Fill On-line
DA 4923 SEP 99 CHAPLAINS' FUND CHARGE PURCHASE REQUEST MEMORANDUMRECORD V1.00 Fill On-line
DA 4924 SEP 99 CHAPLAINS' FUND PROPERTY RECORD V1.00 Fill On-line
DA 4925 SEP 99 CHAPLAINS' FUND STATEMENT OF ASSETS V1.00 Fill On-line
DA 4926 SEP 99 CHAPLAINS' FUND ANNUAL SUMMARY FINANCIAL DATAREPORT V1.00 Fill On-line
DA 4927-R JUN 88 PHYSICIANS COMPARABILITY ALLOWANCE SERVICEAGREEMENT V2.00 Fill On-line
DA 4930 SEP 06 ALARM/INTRUSION DETECTION RECORD V1.00 Fill On-line
DA 4935 AUG 05 REQUEST FOR UNIT VACANCY FILL (AR140-10) V1.01 Fill On-line
DA 4939 MAR 09 GENERAL/FLAG OFFICER'S QUARTERS QUARTERLYOBLIGATIONS REPORT V1.00ES Fill On-line
DA 4941 MAY 05 STATEMENT OF OPTIONS, QUALITATIVE MANAGEMENTPROGRAM (QMP) V1.00 Fill On-line
DA 4944-R JUL 92 REPORT ON LEGAL ASSISTANCE SERVICES V1.00 Fill On-line
DA 4945 JUL 02 DINING FACILITY MODERNIZATION PLANDEVELOPMENT V1.00 Fill On-line
DA 4948-R NOV 89 FREEDOM OF INFORMATION ACT (FOIA)/OPERATIONSSECURITY (OPSEC) DESK TOP GUIDE V1.01 Fill On-line
DA 4949 JAN 82 ADMINISTRATIVE ADJUSTMENT REPORT (AAR) V1.10 Fill On-line
DA 4951 APR 99 LEASE/PURCHASE ANALYSIS FOR COPYING/DUPLICATINGMACHINES V1.01 Fill On-line
DA 4965 JUN 99 COMMAND LOGISTICS REVIEW PROGRAM OBSERVATIONWORKSHEET V1.00 Fill On-line
DA 4975 JUN 04 ARMY ART CONTEST V1.01 Fill On-line
DA 4977-R JAN 87 INDIVIDUAL READY RESERVE BONUS PROGRAM -AGREEMENT V1.00 Fill On-line
DA 4982-1-R NOV 88 M90 VELOCIMETER WORK SHEET V1.00 Fill On-line
DA 4982-R NOV 88 MUZZLE VELOCITY RECORD V1.00 Fill On-line
DA 4985 JAN 02 NAF REFERRAL AND SELECTION LIST (NonappropriatedFund Employment) V2.00ES Fill On-line
DA 4989-R MAR 86 WARRANT OFFICER FLIGHT TRAININGAPPLICATION V1.00 Fill On-line
DA 4991-R MAY 98 DECLINATION OF CONTINUED SERVICESTATEMENT V1.00 Fill On-line
DA 4995-1-R OCT 81 ANNUAL STATUS REPORT OF EXEMPTED LASERS V1.01 Fill On-line
DA 4995-R OCT 81 LASER EXEMPTION FROM FEDERAL STANDARDS V1.00 Fill On-line
DA 4996-R APR 94 QUALITY CONTROL CARD V1.00 Fill On-line
DA 4997-R AUG 81 LOCATOR CARD V1.00 Fill On-line
DA 4998-R APR 94 QUALITY CONTROL AND SURVEILLANCE RECORD FOR TOEMEDICAL ASSEMBLAGES V1.00 Fill On-line
DA 4999 JAN 82 DUE IN RECORD V1.00 Fill On-line