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U.S. DOD Form dod-da-5138-r M TAB TAB TAB SEPARATION ACTION CONTROL SHEET For use of this form, see AR 635-200; the proponent agency is PERSON NAME (Last, First, Middle Initial) SSN UNIT DATE PREPARED
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How to fill out DA Form 5138:

01
Ensure that you have the necessary information and documentation required to complete the form. This may include personal information, dates, and specific details related to the purpose of the form.
02
Review the form carefully to understand each section and its requirements. Read any accompanying instructions or guidelines provided with the form.
03
Begin by entering your personal information accurately in the designated section. This may include your name, rank, unit, and contact information.
04
Follow the instructions provided in each subsequent section to complete the necessary fields, such as dates, descriptions, and signatures. Be sure to provide accurate and concise information.
05
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Once the form is completed, sign and date it as required. If any additional signatures are necessary, ensure that the appropriate individuals sign the form in the designated areas.

Who needs DA Form 5138:

01
Military personnel who are required to report certain incidents, accidents, or other events as mandated by regulations and policies.
02
Individuals who need to document specific information related to their duties, such as safety officers, investigative personnel, or administrative personnel.
03
Anyone involved in an incident or accident who needs to provide an official report for documentation purposes and possibly for further review or investigation.
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Da form 5138 is a form used by the United States Army to report safety hazards, unsafe conditions, or near-miss incidents.
Any Army personnel who identifies a safety hazard, unsafe condition, or near-miss incident is required to file da form 5138.
To fill out da form 5138, you need to provide information about the safety hazard, unsafe condition, or near-miss incident, including location, description, and any corrective actions taken.
The purpose of da form 5138 is to ensure that the United States Army is aware of and able to address safety hazards, unsafe conditions, and near-miss incidents to prevent accidents and injuries.
The information to be reported on da form 5138 includes the date and time of the hazard or incident, location, description, any injuries or damages, corrective actions, and the name and contact information of the person filing the form.
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