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The DA 2823 form serves as a vital tool for documenting sworn statements related to potential criminal activities involving the U.S. Army. This form is governed by Army Regulation 190-45 and is administered by the proponent agency, the PMG. It includes a privacy act statement, outlining the legal authorities under which the information is collected, such as Title 10 and Title 5 of the United States Code. The primary purpose of the DA 2823 is to facilitate the investigation of complaints and incidents, thereby helping Army officials maintain discipline and law and order. The information collected may be shared with various entities, including federal, state, and local law enforcement agencies, as well as courts and child protective services. This sharing can assist in decisions regarding judicial or non-judicial punishment, administrative actions, security clearances, and other personnel matters. While the disclosure of personal information, including the Social Security Number, is voluntary, it is essential for the accuracy and completeness of the statement. The form requires specific details such as the location, date, time, and personal identification of the individual making the statement, ensuring a clear record of the information provided.

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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.

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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

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DA FORM 2823, NOV 2006

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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

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Form Specifications

Fact Name Details
Purpose The DA 2823 form documents potential criminal activity involving the U.S. Army.
Privacy Act Statement It is governed by Title 10, USC Section 301; Title 5, USC Section 2951; and E.O. 9397.
Disclosure of Information Disclosure of the Social Security Number (SSN) is voluntary.
Routine Uses Information may be shared with various law enforcement agencies and organizations for disciplinary actions.
Signature Requirement The person making the statement must sign and initial all corrections on the form.
Additional Pages Any additional pages must include specific headings and the initials of the person making the statement.

Da 2823: Usage Guidelines

Filling out the DA 2823 form requires careful attention to detail. This form is essential for documenting statements related to potential criminal activity within the U.S. Army. By following the steps below, you can ensure that your statement is accurately recorded and properly submitted.

  1. Locate the Form: Obtain a copy of the DA 2823 form, either online or through your unit.
  2. Fill in the Location: Enter the location where the statement is being made.
  3. Enter the Date: Write the date in the format YYYYMMDD.
  4. Specify the Time: Indicate the time when the statement is taken.
  5. Provide File Number: If applicable, include the relevant file number.
  6. Write Your Name: Fill in your last name, first name, and middle name.
  7. Include Your SSN: Enter your Social Security Number (SSN) in the designated space.
  8. State Your Grade/Status: Indicate your military grade or status.
  9. List Your Organization or Address: Provide the name of your organization or your address.
  10. Make Your Statement: Clearly write your statement under oath in the designated section.
  11. Attach Exhibits: If you have any supporting documents, label them as exhibits and reference them in your statement.
  12. Initial Your Statement: Sign your initials at the bottom of the page where your statement appears.
  13. Complete Additional Pages: If needed, use additional pages for your statement. Ensure each page has the heading "STATEMENT OF TAKEN AT" and includes your initials and page number.
  14. Sign the Affidavit: At the end of your statement, sign the affidavit confirming the truthfulness of your statement.
  15. Witness Signature: Have a witness sign and date the form, along with the person authorized to administer oaths.

Your Questions, Answered

What is the DA 2823 form used for?

The DA 2823 form, also known as the Sworn Statement, is primarily used to document potential criminal activity involving the U.S. Army. It allows Army officials to maintain discipline and law and order by investigating complaints and incidents. This form is essential for ensuring that statements made during investigations are recorded accurately and can be referred to later if necessary.

Who should use the DA 2823 form?

This form should be used by individuals who need to provide a sworn statement regarding an incident or complaint related to the U.S. Army. This could include soldiers, civilians working with the Army, or any other individuals involved in a situation that requires formal documentation of their account.

What information is required on the DA 2823 form?

The form requires various pieces of information, including the location, date, time, file number, and the full name of the person making the statement. Additionally, it asks for the individual's Social Security Number (SSN), grade or status, and organization or address. All these details help establish the context and credibility of the statement.

Is providing my Social Security Number mandatory on the DA 2823 form?

Providing your Social Security Number is voluntary. While it may assist in identifying you and your records, you are not required to disclose it if you are uncomfortable doing so. However, keep in mind that omitting this information may affect how your statement is processed.

What happens after I complete the DA 2823 form?

Once you complete the form, it must be signed and dated. The statement is then typically reviewed by a person authorized to administer oaths, who will witness your signature. This ensures that your statement is legally binding and can be used in investigations or legal proceedings.

Can I make corrections to my statement on the DA 2823 form?

Yes, you can make corrections to your statement. However, it is important to initial any corrections you make. This shows that you acknowledge and approve the changes. Each page containing your statement should also have your initials at the bottom to confirm its authenticity.

What if I need more space to write my statement?

If you need additional space, you can use extra pages. Each of these pages should include the heading "STATEMENT OF TAKEN AT" along with the date. Additionally, you must initial each page and indicate the page number. This helps keep everything organized and ensures that all parts of your statement are connected.

What is the significance of the affidavit section in the DA 2823 form?

The affidavit section is crucial as it confirms that you have read or had your statement read to you and that you fully understand its contents. By signing this section, you affirm that your statement is true and that you made it freely, without any coercion or undue influence. This adds a layer of credibility to your statement.

Who can administer oaths for the DA 2823 form?

A person authorized by law to administer oaths can witness your signature on the form. This could be a notary public, a military officer, or another designated official. Their role is to ensure that the statement is taken under oath, thereby enhancing its legal standing.

Common mistakes

  1. Incomplete Information: Many people forget to fill in all required fields. Essential details such as location, date, and time must be included to ensure the form is valid.

  2. Incorrect SSN: Providing an incorrect Social Security Number can lead to delays or complications. Always double-check the SSN for accuracy before submitting.

  3. Missing Initials: Failing to initial each page or correction can invalidate the statement. Each additional page must have the required initials and page number noted.

  4. Not Understanding the Statement: Some individuals sign without fully understanding the content. It’s crucial to read the entire statement carefully and ensure comprehension before signing.

Documents used along the form

The DA Form 2823, also known as the Sworn Statement, is an important document used within the U.S. Army to record potential criminal activity and facilitate investigations. In conjunction with this form, several other documents may be required to support the investigation process. Below is a list of commonly used forms and documents that accompany the DA Form 2823.

  • DA Form 3975: This is the Military Police Report. It documents incidents involving military personnel or property and serves as a formal record of the investigation. The report includes details about the incident, parties involved, and any actions taken by law enforcement.
  • DA Form 4833: This form is used for reporting and documenting the results of an investigation, particularly when it leads to disciplinary action. It captures the findings and recommendations of the investigating officer.
  • DA Form 2824: This is the Commander's Report of Disciplinary Action. It outlines the actions taken against personnel following an investigation, including any disciplinary measures or recommendations for further action.
  • DA Form 2-1: This is the Personnel Qualification Record. It provides a summary of a service member's qualifications, duty assignments, and training history. This document can be useful in assessing the background of individuals involved in an incident.
  • DA Form 268: This is the Report to Suspend Favorable Personnel Actions. It is used to temporarily halt any favorable actions regarding a service member, such as promotions or reassignments, while an investigation is ongoing.
  • DA Form 31: This is the Request and Authority for Leave form. It may be relevant in cases where a service member's leave status impacts the investigation or the availability of witnesses.

Each of these forms plays a vital role in the investigative process within the Army. They help ensure that all relevant information is documented and that appropriate actions are taken based on the findings. Understanding the purpose of these documents can aid in navigating the complexities of military investigations more effectively.

Similar forms

The DA Form 2823, also known as the Sworn Statement, serves a critical role in documenting potential criminal activity within the U.S. Army. It is similar to several other documents used in legal and administrative contexts. Here are seven documents that share similarities with the DA Form 2823:

  • Affidavit: Like the DA Form 2823, an affidavit is a written statement confirmed by oath or affirmation. Both documents require the individual to declare the truth of the contents under penalty of perjury.
  • Witness Statement: A witness statement records the observations or knowledge of an individual regarding an event. Similar to the DA Form 2823, it is often used in investigations and legal proceedings to establish facts.
  • Incident Report: This document details an event or occurrence, usually involving a crime or accident. Both the incident report and the DA Form 2823 aim to provide a factual account that can be used for further investigation or legal action.
  • Police Report: A police report is filed by law enforcement to document an incident. Like the DA Form 2823, it captures statements from involved parties and witnesses, serving as an official record for potential legal proceedings.
  • Deposition: A deposition is a witness's sworn out-of-court testimony, which can be used in legal proceedings. Both depositions and the DA Form 2823 require the individual to provide truthful statements under oath.
  • Statement of Facts: This document outlines specific facts related to a case or situation. Similar to the DA Form 2823, it is often used to clarify details and provide context in legal matters.
  • Testimony: Testimony refers to a formal written or spoken statement given in a court of law. Much like the DA Form 2823, it is a sworn statement that holds legal significance and can impact the outcome of a case.

Understanding these documents can help individuals navigate the complexities of legal and administrative processes. Each serves a unique purpose, yet they all share the common goal of documenting information accurately and truthfully.

Dos and Don'ts

When filling out the DA 2823 form, it's important to follow certain guidelines to ensure accuracy and completeness. Below are five things you should and shouldn't do.

  • Do provide accurate information, including your full name and Social Security Number.
  • Do write clearly and legibly to avoid any confusion.
  • Do initial any corrections you make on the form.
  • Do ensure each additional page includes your initials and the page number.
  • Do read the entire statement carefully before signing.
  • Don't leave any required fields blank; all sections must be completed.
  • Don't use abbreviations or shorthand that may not be understood.
  • Don't sign the form without fully understanding its contents.
  • Don't submit the form without ensuring it is the most current version.
  • Don't provide false information, as this can lead to serious consequences.

Misconceptions

Here are four common misconceptions about the DA 2823 form:

  • It's only for serious crimes. Many people believe that the DA 2823 form is only necessary for major criminal activities. In reality, it can be used for any potential misconduct involving the U.S. Army, regardless of severity.
  • Submitting the form is mandatory. Some individuals think they must fill out the DA 2823 form if approached by authorities. However, while it's important for documentation, disclosing information is voluntary.
  • The form is only for military personnel. A common belief is that only service members can use this form. In fact, anyone who witnesses or is involved in an incident related to the Army can submit a statement using the DA 2823.
  • Information on the form is kept private. Many assume that all details shared will remain confidential. However, the information may be disclosed to various law enforcement agencies and other entities as part of routine use.

Key takeaways

Filling out the DA 2823 form is an important step in documenting potential criminal activity within the U.S. Army. Here are some key takeaways to keep in mind:

  • Understand the Purpose: The DA 2823 form is designed to document statements related to incidents or complaints, allowing Army officials to maintain discipline and investigate matters effectively.
  • Privacy Considerations: While providing your Social Security Number (SSN) and other personal information is voluntary, it may be necessary for the investigation process.
  • Accurate Information: Ensure that all fields, including your name, organization, and statement details, are filled out accurately to avoid any confusion during the review process.
  • Initial Corrections: If you make any corrections on the form, initial each change to confirm that you acknowledge the modifications.
  • Witness Requirement: The form must be signed in front of a person authorized to administer oaths, ensuring the validity of your statement.

By following these guidelines, individuals can effectively complete the DA 2823 form and contribute to the integrity of the investigative process within the Army.