Homepage Fill Out Your Da 2823 Form
Article Structure

The DA Form 2823, also known as the Sworn Statement form, plays a crucial role in documenting potential criminal activity involving the U.S. Army. It is designed to aid Army officials in maintaining discipline and law and order through thorough investigations of various complaints and incidents. This form is governed by specific regulations and authority, including Title 10, USC Section 301, and the Privacy Act which outlines how personal information is handled. Notably, the form requires individuals to provide essential details such as their name, social security number, grade, and organization. Additionally, it includes a statement section where individuals can present their accounts under oath. The completed form serves not only as a personal declaration but also as a key document that may be disclosed to various law enforcement agencies, facilitating necessary legal actions related to the Army’s internal issues. Furthermore, submission of the form is voluntary, yet it helps to ensure that any accusations are taken seriously. The process encourages transparency and accountability, ensuring the integrity of incidents reported while respecting the rights of those involved.

Da 2823 Example

 

 

 

 

 

 

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.

APD AEM v1.04ES

 

 

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

Page 2 of 3

DA FORM 2823, NOV 2006

APD AEM v1.04ES

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

 

 

 

 

 

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

Page 3 of 3

APD AEM v1.04ES

Form Characteristics

Fact Name Details
Form Title DA Form 2823 is titled "Sworn Statement." It serves crucial purposes in military investigations.
Governing Regulation This form falls under the Army Regulation AR 190-45, which focuses on the investigation of non-criminal incidents.
Privacy Act Statement The form includes a Privacy Act Statement that outlines the authority under which personal data is collected, including references to various U.S. Codes.
Principal Purpose The primary aim of the form is to document potential criminal activity involving the U.S. Army and ensure order through appropriate investigations.
Routine Uses Information from this form may be shared with multiple entities, including law enforcement agencies and the Department of Veterans Affairs.
Disclosure of Information Providing a Social Security Number (SSN) and other personal details is voluntary. However, it helps in processing the statement.
Required Information The form requires details such as the individual's name, grade, organization, and the statement itself, facilitating a clear record of events.
Affidavit Section There is an affidavit at the end where the person making the statement affirms its truthfulness and consents to its use.
Form Version The most recent version of DA Form 2823 is from November 2006, and previous editions are considered obsolete.

Guidelines on Utilizing Da 2823

Completing the DA Form 2823 is a vital step in making a sworn statement related to potential criminal activity involving the U.S. Army. Care must be taken to provide accurate information, as this form will be used for investigations and may be shared with various law enforcement and personnel agencies. Follow these instructions closely to ensure all required information is filled out appropriately.

  1. Location: Write the specific location where the statement is being made.
  2. Date: Enter the date of the statement using the format YYYYMMDD.
  3. Time: Note the time the statement is being made.
  4. File Number: If applicable, provide the file number associated with the complaint or incident.
  5. Name: Fill in your last name, first name, and middle name as they appear on official documents.
  6. SSN: Enter your Social Security Number. Remember, disclosure is voluntary.
  7. Grade/Status: Indicate your rank or status within the Army.
  8. Organization or Address: Write the name of your organization or provide your address.
  9. Statement Intention: Clearly state, “I, [Your Name], want to make the following statement under oath.”
  10. Exhibit: If there are any attached documents, cite them here.
  11. Initials: Provide your initials to confirm the statement as the person making it.

If additional pages are necessary, they must include the header "STATEMENT OF TAKEN AT [Location] DATED [Date]" and contain your initials and page number at the bottom. Always remember to review your entire statement for accuracy before the final signing. This ensures clarity and authenticity in your declaration.

What You Should Know About This Form

What is the purpose of the DA 2823 form?

The DA 2823 form is 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 sworn statement serves as an important tool for accountability within the Army.

Who can fill out the DA 2823 form?

Any individual who has witnessed or been involved in an event that may relate to criminal activity within the Army can fill out this form. This includes service members, civilians, and anyone else who can provide relevant information regarding an incident.

Is it mandatory to provide my Social Security Number (SSN) on the DA 2823 form?

Providing your SSN on the DA 2823 form is voluntary. However, including your SSN may help with the identification of your statement in any subsequent investigations or actions. It's important to weigh the need for disclosure against your comfort with sharing personal information.

What should I do if I need more space to make my statement?

If additional space is required, you can use extra pages. Each new page must include the heading "STATEMENT OF TAKEN AT," the date, and your initials at the bottom. Additionally, ensure to indicate the page number to maintain clarity in your statement.

How is the information on the DA 2823 form used?

The information provided on the DA 2823 form may be disclosed to various entities, including law enforcement agencies, courts, and other governmental bodies. It can be used for disciplinary actions, security clearances, and personnel evaluations, among other purposes. Your statement may have implications beyond the immediate situation.

What happens after I submit the DA 2823 form?

Once submitted, the form will be reviewed by the appropriate officials within the Army. If necessary, further inquiries may be conducted based on the information you provided. Keep in mind that your statement could influence investigations or administrative actions.

Can I refuse to provide a statement using the DA 2823 form?

Yes, you can choose not to provide a statement or to refrain from completing the DA 2823 form. However, it is important to understand that declining to provide a statement may impact the investigation process. It is advisable to consider your options and consult with a trusted representative or legal advisor if needed.

Common mistakes

When filling out the DA 2823 form, individuals may encounter several common pitfalls that can lead to complications or delays in processing. Understanding these mistakes can help ensure that your statement is clear, complete, and accepted without issue.

One frequent error is failing to provide complete identification information. The form requests specific details such as last name, first name, and middle name, but sometimes individuals only fill in part of their name. Omitting these details can create confusion about who is making the statement and may hinder the investigation.

Another mistake occurs when applicants neglect to provide their Social Security Number (SSN). While the form states that providing the SSN is voluntary, including it can aid in the accuracy of records. Omitting it may lead to difficulties in tracking or verifying the statement in the future.

Some individuals misunderstand the importance of the statement's date and time. Not small details, these elements are crucial for establishing a timeline. If left blank or inaccurately filled out, it can lead to challenges in assessing the context and relevance of the statement.

Additionally, ensuring that each page of a multi-page statement contains the correct heading and initials is vital. If additional pages are included, a common oversight is not following the instruction to write "STATEMENT OF TAKEN AT" and the date at the bottom of each page. This omission can cause important information to be overlooked.

Errors often occur in the section where individuals declare their intention to make a statement. Some might forget to include their name in the blank space before "WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH." This essential part is necessary for clarifying who is making the statement.

Another common issue arises when people rush through the affirmation section. The statement must be read or read aloud to the individual making it. Some skip this critical step, failing to initial all corrections, which can lead to doubts regarding the authenticity of the statement.

Finally, signatories must remember that their signature and the date need to be filled in accurately at the end of the form. Close attention to detail here matters, as any discrepancies can result in questions about the effectiveness of the sworn statement, potentially rendering it invalid in legal contexts.

By avoiding these mistakes when completing the DA 2823 form, individuals can contribute to a smoother process for documenting their statements. Taking the time to carefully fill out the form and following the instructions meticulously can make a significant difference.

Documents used along the form

The DA 2823 form, known as the Sworn Statement, plays a crucial role in documenting potential criminal activities related to the U.S. Army. This form is often accompanied by several other forms and documents that help ensure a thorough investigation process. Below is a brief overview of these commonly used documents.

  • DA Form 15-6: This is the Investigation Report form used to document findings from investigations, especially those involving misconduct or criminal activities within the Army.
  • DA Form 2824: This form is for collecting witness statements. It supplements the sworn statement by helping to gather diverse perspectives regarding an incident.
  • AF Form 1168: Used by the Air Force, this form records a statement from any individual involved in a situation. It serves a similar purpose to the DA 2823 for Air Force matters.
  • SF 95: This is a claim for damage, personal injury, or death that a person may submit. It is often used if the circumstances of the incident involve potential liability or compensation issues.
  • DA Form 67-9: This is the Noncommissioned Officer Evaluation Report. Although not directly related to statements, it may provide performance context for individuals involved in investigations.
  • DD Form 149: This form is for requesting correction of military records. It may come into play if the outcome of an investigation affects a service member's record or personal status.
  • DA Form 7454: Known as the Military Affairs Statement of Support, this form can be used to show support for military personnel during investigations or administrative reviews.
  • Witness Affidavit: This document can be submitted as a formal, sworn statement from witnesses. It adds credibility to the investigation by providing detailed accounts from individuals not directly involved.

These forms and documents enhance the effectiveness of investigations and the overall integrity of military operations. Each plays a distinct role in ensuring all relevant information is captured and considered.

Similar forms

The DA Form 2823 is a sworn statement used primarily within the military to document potential criminal activity and maintain order. Various other documents serve similar purposes. Here’s a look at nine of them:

  • Affidavit: Like the DA 2823, an affidavit is a written statement confirmed by oath. It is often used in legal proceedings to provide evidence.
  • Witness Statement: This document captures a person's account of an incident. It shares similarities with the DA 2823 in that it serves as evidence and is often used in investigations.
  • Police Report: A police report is created by law enforcement after an incident occurs. It includes witness statements and factual information much like what is recorded in a DA 2823.
  • Incident Report: Used by organizations, this report details events surrounding a specific incident. It documents facts and witness accounts alike the DA Form 2823.
  • Character Statement: This document provides personal insights and assessments of an individual. It can be sworn and thus embodies an individual's formal declaration, similar to the DA 2823.
  • Sworn Declaration: A sworn declaration holds the same weight as an affidavit. It is a written statement that is signed under penalty of perjury, aligning closely with the intent of the DA Form 2823.
  • Testimonial Statement: This is a statement provided by someone with firsthand knowledge of an event. It can be presented in court, paralleling the use of the DA 2823 for formal documentation.
  • Statement of Facts: This is an organized presentation of details surrounding an event. Similarities include the methodical approach to documenting occurrences and responsible parties.
  • Complaint Form: Often utilized in various institutions, this form allows individuals to report grievances formally. Like the DA 2823, it serves as a means for documentation and investigation of issues.

Dos and Don'ts

When filling out the DA 2823 form, it's vital to approach the process thoughtfully. Here are seven important recommendations, including what to do and what to avoid.

  • Do ensure that all personal information is accurate.
  • Don’t skip any required fields; missing information can lead to complications.
  • Do write clearly and legibly to avoid misunderstandings.
  • Don’t include irrelevant details that do not pertain to the statement being made.
  • Do initial any corrections to verify they are intentional.
  • Don’t rush through the form; take your time to review it thoroughly.
  • Do ensure that your statement reflects your knowledge of events accurately.

Filling out the form carefully can promote clarity and ensure that your statement is valid. By following these guidelines, you not only protect your own interests but also contribute to an accurate record.

Misconceptions

Understanding the DA Form 2823, which is a sworn statement used by the U.S. Army, can sometimes be challenging. Several misconceptions may hinder individuals from comprehending its purpose and use. Below are some of the common misconceptions related to this form, along with clarifications.

  • It is only used for criminal accusations. While this form does document potential criminal activity, it can also address various incidents that require attention from Army officials. The emphasis is on maintaining discipline and order.
  • My information will be kept confidential and never shared. Although there's a commitment to protect privacy, the information collected may be disclosed to various law enforcement agencies and other relevant authorities for investigative purposes.
  • Submitting this form guarantees action from the Army. Completing the DA Form 2823 does not ensure that the Army will take action. It serves as a documentation tool, which may or may not lead to further investigation or response.
  • Only Army personnel can complete this form. In truth, anyone with relevant information can provide a statement. This includes witnesses or civilians who may have observed an incident requiring Army attention.
  • The form requires legal assistance to be filled out correctly. While legal help can be beneficial, individuals can complete the form on their own. Clear instructions are provided within the document to assist in its completion.
  • My Social Security Number (SSN) is mandatory for submission. Providing the SSN is voluntary. Individuals can choose whether or not to disclose this information, although omitting it might impact the processing of their statement.
  • Filing this form will result in punishment for the person involved. The form is simply a means to document a statement and does not inherently lead to punitive measures. The outcome depends on the findings of any subsequent investigations.

By addressing these misconceptions, individuals can better navigate the challenges associated with the DA Form 2823 and understand its role within the Army's framework for maintaining order and discipline.

Key takeaways

When filling out the DA 2823 form, here are some key points to keep in mind:

  • Understand the Purpose: The DA 2823 is designed to document sworn statements regarding potential criminal activity within the U.S. Army.
  • Privacy Matters: Be aware that your information, including your Social Security Number (SSN), is voluntary but may be shared with various law enforcement agencies.
  • Location and Time: Clearly specify the location, date, and time at which the statement is taken. Accuracy is crucial for proper record-keeping.
  • Detailed Personal Information: Provide a complete name, including first, middle, and last names, along with your rank or status and organizational details.
  • Signature Required: Your statement needs to be signed, confirming that you understand its content and that it is truthful.
  • Initial Corrections: If there are any corrections to the statement, make sure to initial them to indicate that they are approved.
  • Statements on Additional Pages: If more space is required, additional pages must maintain the proper headings and include your initials on each page.
  • Witnessing the Statement: The statement must be subscribed and sworn to before an authorized individual, which adds an extra level of credibility.
  • Administration of Oaths: Ensure that the person administering the oath is authorized to do so. Their information must also be documented.