Official Department of the Army Forms

E-Forms by Range

DA 0001 thru DA 1299 DA 3700 thru DA 4399 DA 5443 thru DA 5799 DA 1300 thru DA 2199 DA 4400 thru DA 4999 DA 5800 thru DA 7359 DA 2200 thru DA 2999 DA 5000 thru DA 5299 DA 7360 thru DA 7499 DA 3000 thru DA 3699 DA 5300 thru DA 5442 DA 7500 thru DA 9999 LABELS, GPO, HQDA, JCP, OF, OGE, OPM Standard Forms (SF)

DA 5000 thru DA 5299


Form Number Date Title Version PDF
DA 5000-R SEP 81 APPLICANT'S INTERVIEW REPORT-JUDGE ADVOCATEGENERAL'S CORPS V1.01 Fill On-line
DA 5007A FEB 03 MEDICAL RECORD - ALLERGY IMMUNOTHERAPYRECORD V1.01 Fill On-line
DA 5007B FEB 03 MEDICAL RECORD - ALLERGY IMMUNOTHERAPYRECORD V1.01 Fill On-line
DA 5008 OCT 81 TELEPHONE MEDICAL ADVICE/CONSULTATIONRECORD V1.01 Fill On-line
DA 5009 FEB 04 RELEASE AGAINST MEDICAL ADVICE V1.01ES Fill On-line
DA 5011 AUG 05 TRAINING EVALUATION SUMMARY V1.01ES Fill On-line
DA 5016-R APR 84 CHRONOLOGICAL RECORD OF MILITARYSERVICE V1.00 Fill On-line
DA 5017 NOV 01 CIVILIAN EMPLOYEE CONSENT STATEMENT V2.00ES Fill On-line
DA 5018-R NOV 81 ADAPCP CLIENT'S CONSENT STATEMENT FOR RELEASE OFTREATMENT INFORMA- TION V1.00 Fill On-line
DA 5019 NOV 01 CONDITION OF EMPLOYMENT FOR CERTAIN CIVILIANPOSITIONS IDENTIFIED CRITICAL UNDER THE DEPARTMENT OF THE ARMYDRUG-FREE FEDERAL WORKPLACE PROGRAM V3.00ES Fill On-line
DA 5026-R MAR 82 RECORD OF CERTIFICATION SMALL ARMS SHIPMENTCONTROL V1.01ES Fill On-line
DA 5027-R JUL 97 MEDCASE PROGRAM REQUIREMENT V1.03ES Fill On-line
DA 5028-R JUL 97 MEDCASE SUPPORT AND TRANSMITTAL FORM V1.00 Fill On-line
DA 5030 OCT 02 ENGINEER DIVER TRAINING APPLICATION V1.00 Fill On-line
DA 5032-R JAN 82 FIELD ARTILLERY DELIVERED MINEFIELD PLANNINGSHEET V1.00 Fill On-line
DA 5033-R PDF ONLY DEC 81 LIMITED SURFACE OBSERVATION Fill On-line
DA 5051-10-R JUL 90 MAINTENANCE TEST FLIGHT MANEUVERS GRADE SLIP(OV/RV-1) V1.00 Fill On-line
DA 5051-12-R NOV 92 MAINTENANCE TEST FLIGHT MANEUVERS GRADE SLIP(OH-58D) V1.00 Fill On-line
DA 5051-1-R APR 93 MAINTENANCE TEST FLIGHT MANEUVERS GRADE SLIP(OH-58A/C) V1.00 Fill On-line
DA 5051-2-R NOV 92 MAINTENANCE TEST FLIGHT MANEUVERS GRADE SLIP(UH-1) V1.00 Fill On-line
DA 5051-4-R NOV 92 MAINTENANCE TEST FLIGHT MANEUVERS GRADE SLIP(AH-1) V1.01 Fill On-line
DA 5051-5-R AUG 92 MAINTENANCE TEST FLIGHT MANEUVERS GRADE SLIP(CH-47) V1.00 Fill On-line
DA 5051-7-R APR 93 MAINTENANCE TEST FLIGHT MANEUVERS GRADE SLIP(OH-6) V1.00 Fill On-line
DA 5051-9-R JUL 90 MAINTENANCE TEST FLIGHT MANEUVERS GRADE SLIP(CH-54) V1.00 Fill On-line
DA 5056 FEB 02 ACTEDS INTERN WORK YEAR REQUIREMENTS V1.00 Fill On-line
DA 5070-R MAR 82 JUSTIFICATION STATEMENT FOR .0015 CONTINGENCYFUNDS V1.01 Fill On-line
DA 5071-R MAR 82 FUND CUSTODIAN RECEIPT CONTROL AND CASHACCOUNTABILITY JOURNAL V1.00 Fill On-line
DA 5072 APR 82 EMERGENCY ACTION STATEMENT V1.00 Fill On-line
DA 5073 MAY 01 MAGNETIC COMPASS DEVIATION TABLE V1.00 Fill On-line
DA 5074-1-R FEB 82 RECORD OF AWARD OF ENTRY GRADE CREDIT (HEALTHSERVICES OFFICERS) V1.00 Fill On-line
DA 5074-R FEB 82 RECORD OF AWARD OF ENTRY GRADE CREDIT (MEDICAL ANDDENTAL OFFICERS) V1.00 Fill On-line
DA 5075-R MAR 82 ARTILLERY SURVEY CONTROL POINT V1.00 Fill On-line
DA 5095-A-R JUL 87 FIRE MISSION SUMMARY (CLASSIFIED WHEN FILLEDIN) V1.00 Fill On-line
DA 5095-B-R JUL 87 FIRE PLAN SUMMARY V1.00 Fill On-line
DA 5105 PDF ONLY MAY 82 JANITORIAL STANDARDS CHECKLIST Fill On-line
DA 5106 JUL 04 MISSION SUPPORT PLAN (MSP) V1.00 Fill On-line
DA 5108-R MAY 82 DOCUMENTATION FOR PRODUCTIVITY CAPITAL INVESTMENTPROGRAMS V1.00 Fill On-line
DA 5109 SEP 02 REQUEST TO SUPERIOR TO EXERCISE ARTICLE 15, UCMJ,JURISDICTION V1.00ES Fill On-line
DA 5110 SEP 02 ARTICLE 15-RECONCILIATION LOG V1.00 Fill On-line
DA 5111 SEP 02 SUMMARY COURT-MARTIAL RIGHTS NOTIFICATION/WAIVERSTATEMENT V1.01ES Fill On-line
DA 5112 SEP 02 CHECKLIST FOR PRETRIAL CONFINEMENT V1.01ES Fill On-line
DA 5117 MAR 07 REASSIGNMENT CONTROL SHEET V1.00 Fill On-line
DA 5118 MAR 07 REASSIGNMENT STATUS AND ELECTIONSTATEMENT V1.00 Fill On-line
DA 5121 MAR 07 OVERSEAS TOUR ELECTION STATEMENT V1.00 Fill On-line
DA 5123 JUN 03 IN- AND OUT-PROCESSING RECORDSCHECKLIST V1.00 Fill On-line
DA 5123-1 JUN 03 IN-PROCESSING PERSONNEL RECORD V1.00 Fill On-line
DA 5137 MAR 09 APPLICATION FOR VOLUNTARY MOBILIZATIONPREASSIGNMENT V1.00ES Fill On-line
DA 5138 MAY 05 SEPARATION ACTION CONTROL SHEET V1.00 Fill On-line
DA 5146-R NOV 82 ASPHALT PAVEMENT INSPECTION SHEET V1.00 Fill On-line
DA 5147-R NOV 82 SECTION EVALUATION SUMMARY V1.00 Fill On-line
DA 5148-R NOV 82 PRESENT WORTH COMPUTATION V1.00 Fill On-line
DA 5149-1-R NOV 82 BRANCH IDENTIFICATION SUMMARY CONTINUATIONSHEET V1.00 Fill On-line
DA 5149-R NOV 82 BRANCH IDENTIFICATION SUMMARY V2.00 Fill On-line
DA 5150-R NOV 82 SECTION IDENTIFICATION RECORD V1.00 Fill On-line
DA 5151-R NOV 82 SECTION PAVEMENT STRUCTURE RECORD V1.00 Fill On-line
DA 5152-R NOV 82 SECTION MATERIALS PROPERTIES RECORD V1.00 Fill On-line
DA 5153-R NOV 82 SECTION TRAFFIC RECORD V1.00 Fill On-line
DA 5155-R NOV 82 BRANCH MAINTENANCE & REPAIRREQUIREMENTS V1.00 Fill On-line
DA 5156-R NOV 82 SECTION MAINTENANCE AND REPAIR RECORD V1.00 Fill On-line
DA 5159 OCT 07 INVENTORY OF ARMY PERSONNEL TESTMATERIAL V1.00 Fill On-line
DA 5160 SEP 09 TEST ADMINISTRATION STATEMENT V1.00ES Fill On-line
DA 5161-1-R OCT 01 FOOD ESTABLISHMENT SANITATION INSPECTION - REMARKSFORM V1.00 Fill On-line
DA 5161-R OCT 01 COMPREHENSIVE FOOD ESTABLISHMENTINSPECTION V1.00ES Fill On-line
DA 5162-R OCT 01 ROUTINE FOOD ESTABLISHMENT INSPECTIONREPORT V1.00ES Fill On-line
DA 5163-R MAY 85 NONAPPROPRIATED FUND CENTRAL PAYROLL SYSTEM TIPS,SERVICE CHARGES AND MEALS REPORT V1.01 Fill On-line
DA 5164-R SEP 85 HANDS-ON EVALUATION V2.01 Fill On-line
DA 5165-R JUL 05 FIELD EXPEDIENT SQUAD BOOK V1.00 Fill On-line
DA 5167 DEC 08 INCENTIVE AWARDS NOMINATION AND APPROVAL -NONAPPROPRIATED FUNDS V1.00ES Fill On-line
DA 5168-R JUN 99 SAFETY CLEARANCE ORDER (ELECTRICALFACILITIES) V1.00 Fill On-line
DA 5170-R MAY 86 PROPONENT MANAGEMENT INFORMATION REQUIREMENTREVIEW V1.02 Fill On-line
DA 5178-R MAY 98 PROJECT DEVELOPMENT IDENTIFIER (PDI) AND PROJECTDEVELOPMENT SKILL IDENTIFIER (PDSI) V2.01 Fill On-line
DA 5179 JUN 91 MEDICAL RECORD PREOPERATIVE/POSTOPERATIVE NURSINGDOCUMENT V1.02 Fill On-line
DA 5179-1 OCT 87 MEDICAL RECORD INTRAOPERATIVE DOCUMENT V1.01 Fill On-line
DA 5181 FEB 03 SCREENING NOTE OF ACUTE MEDICAL CARE V1.00ES Fill On-line
DA 5182-R MAR 83 SOIL SUCTION, WATER CONTENT, AND SPECIFICVOLUME V1.00 Fill On-line
DA 5184 MAY 99 CONSUMER COMPLAINT V1.00 Fill On-line
DA 5187 JUN 09 APPLICATION FOR RESPITE CAREGIVERS V1.00ES Fill On-line
DA 5188 SEP 02 MEDICAL REPORT ON APPLICANT FOR CERTIFICATION TOPROVIDE CARE FOR CHILDREN OR ADULTS WITH DISABILITIES V1.00ES Fill On-line
DA 5189 SEP 02 APPLICATION FOR RESPITE CARE FOR CHILDREN ANDADULTS WITH DISABILITIES V1.00 Fill On-line
DA 5190 SEP 02 CLINICIAN'S INFORMATION V1.00ES Fill On-line
DA 5191 SEP 02 INFORMATION ON INDIVIDUAL WITHDISABILITY V1.00ES Fill On-line
DA 5192 OCT 03 FAMILY IDENTIFICATION SHEET FOR A CHILD RECEIVINGSERVICE V1.00 Fill On-line
DA 5193 OCT 03 CHILD'S FACE AND WHEREABOUTS SHEET V1.00 Fill On-line
DA 5195 OCT 03 HEALTH DATA V1.00 Fill On-line
DA 5202-R APR 85 INTERNATIONL CONTROL IMPROVEMENT ACTIVITIESREPORT V1.00 Fill On-line
DA 5203 MAY 83 DODIC MASTER/LOT LOCATOR RECORD V1.00 Fill On-line
DA 5212-R PDF ONLY MAY 83 GUNNER'S REFERENCE CARD (LRA) Fill On-line
DA 5219 JUN 09 CHILD DEVELOPMENT SERVICES (CDS) FAMILY CHILD CARE(FCC) PROVIDER APPLICATION V1.00ES Fill On-line
DA 5220-R JUL 89 CHILD DEVELOPMENT SERVICES (CDS) FAMILY CHILD CARE(FCC) PROVIDER BACKGROUND CLEARANCE REQUEST V2.01 Fill On-line
DA 5221-R JUL 89 CHILD DEVELOPMENT SERVICES (CDS) FAMILY CHILD CARE(FCC) CERTIFICATION DENIAL/ REVOCATION V2.00 Fill On-line
DA 5222-R JUL 89 CHILD DEVELOPMENT SERVICES (CDS) SPONSORCONSENT V2.01 Fill On-line
DA 5223-R JUL 89 CHILD DEVELOPMENT SERVICES (CDS) CHILD HEALTHASSESSMENT V2.00 Fill On-line
DA 5224-R JUL 89 CHILD DEVELOPMENT SERVICES (CDS) CHILD AND FAMILYPROFILE V2.00 Fill On-line
DA 5225-R JUL 89 CHILD DEVELOPMENT SERVICES (CDS) MEDICALDISPENSATION RECORD V2.00 Fill On-line
DA 5226-R JUL 89 CHILD DEVELOPMENT SERVICE (CDS) SPONSOR/ PROGRAMAGREEMENT V3.00 Fill On-line
DA 5227 FEB 02 DA EMPLOYMENT AND MOBILITY AGREEMENT FOR DA ACTEDSINTERNS V1.00ES Fill On-line
DA 5228 FEB 02 DEPARTMENT OF THE ARMY PRESIDENTIAL MANAGEMENTINTERN MOBILITY AGREEMENT V1.00ES Fill On-line
DA 5234-R JUL 83 OER CONTROL LOG V1.00 Fill On-line
DA 5235-R JUL 83 VOLUNTER STATEMENT FOR THE ENLISTED CLUB MANAGEMENTCAREER PROGRAM (MOS OOJ) V1.00 Fill On-line
DA 5237-R JUL 83 PSNCO EER SUSPENSE ROSTER V1.00 Fill On-line
DA 5239-R SEP 08 100-, 200-, AND 300-METER DOWNRANGE FEEDBACKSCORECARD V1.00 Fill On-line
DA 5241-R SEP 08 SINGLE AND MULTIPLE TARGETS FIELD FIRE IISCORECARD V1.00 Fill On-line
DA 5246-R JUL 89 ARMY CHILD DEVELOPMENT SERVICES (CDS)REPORT V1.01 Fill On-line
DA 5247-R SEP 83 REQUEST FOR SECURITY DETERMINATION V2.00 Fill On-line
DA 5248-R SEP 83 REPORT OF UNFAVORABLE INFORMATION FOR SECURITYDETERMINATION V1.20 Fill On-line
DA 5250 AUG 83 ROTC SCHOLARSHIP - RESERVE FORCES DUTY V1.00 Fill On-line
DA 5251-R PDF ONLY MAR 86 CONAUTH KEY MANAGEMENT WORKSHEET Fill On-line
DA 5252-R PDF ONLY NOV 83 STATEMENT - EVIDENCE OF CITIZENSHIPSTATUS Fill On-line
DA 5257-R DEC 83 STINGER GUNNER PERFORMANCE EVALUATIONSHEET V1.00 Fill On-line
DA 5258-R DEC 83 REDEYE GUNNER PERFORMANCE EVALUATIONSHEET V1.00 Fill On-line
DA 5261-1-R NOV 84 SELECTED RESERVE INCENTIVE PROGRAM - EDUCATIONALASSISTANCE ADDENDUM V2.00 Fill On-line
DA 5261-2-R FEB 96 SELECTED RESERVE INCENTIVE PROGRAM -REENLISTMENT/EXTENSION BONUS ADDENDUM V2.00 Fill On-line
DA 5261-3-R FEB 96 SELECTED RESERVE INCENTIVE PROGRAM - AFFILIATIONBONUS ADDENDUM V3.01 Fill On-line
DA 5261-4-R FEB 96 STUDENT LOAN REPAYMENT PROGRAM ADDENDUM V3.00 Fill On-line
DA 5261-5-R FEB 96 SELECTED RESERVE INCENTIVE PROGRAM - USAR PRIORSERVICE ENLISTMENT BONUS ADDENDUM V1.00 Fill On-line
DA 5261-R FEB 96 SELECTED RESERVE INCENTIVE PROGRAM - ENLISTMENTBONUS ADDENDUM V2.01 Fill On-line
DA 5286 JAN 84 INDIVIDUAL BASIC TRAINING (BT), ADVANCED INDIVIDUALTRAINING (AIT), ONE STATION UNIT TRAINING (OSUT) V1.01 Fill On-line
DA 5286-1 JAN 84 INDIVIDUAL TRAINING RECORD (CONTINUATIONSHEET),BASIC TRAINING (BT), ADVANCED INDIVIDUAL TRAINING (AIT), ONESTATION UNIT TRAINING (OSUT) V1.01 Fill On-line
DA 5289-R MAR 84 TRAVELING PURCHASE REQUEST V1.00 Fill On-line
DA 5297 JUL 02 ABSTRACT OF VENDOR DELIVERIES V1.00 Fill On-line
DA 5298 JUL 02 OPERTIONAL RATIONS ACCOUNTABILITY V1.00 Fill On-line

DA 0001 thru DA 1299 DA 3700 thru DA 4399 DA 5443 thru DA 5799 DA 1300 thru DA 2199 DA 4400 thru DA 4999 DA 5800 thru DA 7359 DA 2200 thru DA 2999 DA 5000 thru DA 5299 DA 7360 thru DA 7499 DA 3000 thru DA 3699 DA 5300 thru DA 5442 DA 7500 thru DA 9999 LABELS, GPO, HQDA, JCP, OF, OGE, OPM Standard Forms (SF)