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U.S. Office of Personnel ManagementOffice of Merit Systems Oversight and Effectiveness Classification Appeals and FLEA Programs Philadelphia Oversight Division 600 Arch Street, Room 3400 Philadelphia,
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How to fill out DA Form 5172 R:

01
Start by downloading a copy of DA Form 5172 R from the official U.S. Army website or obtain a physical copy from your unit's supply office.
02
Begin by filling out the personal information section at the top of the form. Provide your full name, rank, unit, date, and any other requested details accurately.
03
Next, provide the description of the incident or event in detail. Include relevant information such as the date, time, location, and a clear description of what transpired.
04
In the witness section, provide the names, ranks, and contact information of any individuals who witnessed the incident. Include their full names and unit affiliation if applicable.
05
Fill in the remarks section with any additional details or information that may be necessary to support your report. Be concise yet thorough in your explanations.
06
If required, attach any supporting documents such as photographs, drawings, or additional reports that may be relevant to the incident. Make sure to reference these attachments in the remarks section.
07
Review the completed form for accuracy and ensure all necessary sections have been filled out correctly. Double-check for spelling errors or missing information.
08
Once satisfied with the form, sign and date it at the bottom. If you have a supervisor or higher-ranking individual who should review the form, obtain their signature as well.
09
Submit the completed DA Form 5172 R to the appropriate authority as per your unit's standard operating procedures.

Who needs DA Form 5172 R?

01
Soldiers or military personnel who have witnessed or been involved in an incident or event that requires documentation.
02
Unit commanders or superiors who require an official record of incidents for administrative or investigative purposes.
03
Any individual responsible for conducting an investigation or reviewing incidents within the military chain of command.
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DA Form 5172-R is a Personnel Security Questionnaire used by the Department of the Army to gather information from individuals who require a security clearance.
Individuals who need a security clearance from the Department of the Army are required to file DA Form 5172-R.
DA Form 5172-R should be filled out completely and accurately, providing all requested information about the individual's background, employment history, and personal information.
The purpose of DA Form 5172-R is to gather information needed to determine if an individual is eligible for a security clearance within the Department of the Army.
Information such as biographical data, employment history, foreign travel, criminal record, and references must be reported on DA Form 5172-R.
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