Fill Out Your Da 4833 Form
Understanding the DA 4833 form is essential for military personnel involved in disciplinary actions. This form, titled the "Commander’s Report of Disciplinary or Administrative Action," serves as a critical tool for commanders and law enforcement officials within the U.S. Army. It allows these authorities to document and track various cases of indiscipline and the subsequent actions taken. Utilizing the DA 4833 ensures compliance with standing regulations while facilitating accurate reporting and analysis of crime trends throughout military installations. Notably, the form requires completion by the first Lieutenant Colonel in the command chain, who is responsible for including essential documentation like Article 15s and court-martial orders. This reporting is vital not only for oversight and accountability but also for identifying the resources needed to effectively address issues related to soldier conduct. Furthermore, aspects like the collection of social security numbers, although optional for disclosure, help in properly identifying individuals involved in disciplinary actions. The DA 4833 form stands as a key component in maintaining military discipline and fostering a well-regulated environment for service members.
Da 4833 Example
COMMANDER’S REPORT OF DISCIPLINARY OR ADMINISTRATIVE ACTION
For use of this form, see AR
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PRIVACY ACT STATEMENT |
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AUTHORITY: |
Title 10 USC Section 301; Title 5 USC Section 2951; E.O. 9397 dated November 22, 1943. |
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PRINCIPAL PURPOSE: |
To provide commanders and law enforcement officials with means by which information may be accurately identified. |
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ROUTINE USES: |
Your Social Security Number is used as an additional/alternate means of identification to facilitate filing and retrieval. |
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DISCLOSURE: |
Disclosure of your Social Security Number is voluntary. |
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1. |
CONTROL INFORMATION |
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Thru: |
USACRC Number: |
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MP Report Numb эг: |
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To: |
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Referred By: |
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Referral Date (YYYYMMDD) : |
Suspense Date (YYYYMMDD) : |
The first Lieutenant Colonel in the chain of command is responsible and accountable for completing DA Form 4833 with support documentation (copies of Article 15s,
Company, troop, and battery level commanders are responsible and accountable for completing DA Form 4833 with supporting documentation in all cases investigated by MPI, civilian detectives employed by the Department of the Army, and the PMO. Accurate and complete DA 4833 disposition reports are required to meet installation, command, HQDA, DOD, and federal statutory reporting requirements. The data is used to identify crime trends, establish command programs in law enforcement and other activities, and to ensure that resources are made available to support commanders who must address issues of soldier and family member indiscipline.
In
2. |
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OFFENDER INFORMATION |
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Last Name: |
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Cadency: |
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First Name: |
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Grade: |
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Middle Name: |
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SSN: |
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Date of Birth: (YYYYMMDD) : |
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3. |
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REFERRAL INFORMATION |
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Commander Decision Date: |
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No. |
Offense |
Basis |
Date |
Sexual |
Action |
Reason |
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Harassment |
Taken |
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2| Yes | | No 2IYes I I n°
2| Yes | | No ] Yes I I n°
2| Yes | | No 2IYes I I n°
J Yes | | No 2| Yes | | No
DA FORM 4833, FEB 2010 |
PREVIOUS EDITIONS ARE OBSOLETE. |
Page 1 of 6 |
APD PE V1.02ES
3. |
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REFERRAL INFORMATION (Continued) |
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No. |
Offense |
Basis |
Date |
Sexual |
Action |
Reason |
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Harassment |
Taken |
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2| Yes | | No 2| Yes | | No
2| Yes | | No 2| Yes | | No
2| Yes | | No |
Yes | | No |
J Yes | | No 2| Yes | | No
2| Yes | | No 2| Yes | | No
2| Yes | | No 2| Yes | | No
NOTE: For each offense marked NO for action taken, you must supply a reason.
If you selected "Yes" for any offense, continue to "Action Taken"
4. |
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ACTION TAKEN |
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□] |
Administrative |
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(see details below) |
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Court Martial or Civilian Criminal |
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Adverse Personnel Actions |
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Judicial Punishment Authority (select one): |
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Summarized |
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GCMCA Imposed |
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Summary Court Martial |
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Company Grade |
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General Officer Imposed |
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Special Court Martial |
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J Field Grade |
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Civilian Criminal/Magistrate |
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Principal Assistant |
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5. |
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No. |
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Charged Offense |
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Plea |
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Finding Offense |
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PLEA: G=Guilty, C=No Contest, N=Not Guilty,
DA FORM 4833, FEB 2010
Trial
Finding
Page 2 of 6
APD PE V1.02ES
5. |
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No. |
Charged Offense |
Plea |
Finding Offense |
Trial |
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Finding |
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PLEA: G=Guilty, C=No Contest, N=Not Guilty,
6. |
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ADMINISTRATIVE ACTIONS |
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Agency |
Date Referred |
Date Responded |
Date Imposed |
Type of Action |
Oral |
Written |
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(YYYYMMDD) |
(YYYYMMDD) |
(YYYYMMDD) |
Local |
OMPF |
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Family Advocacy |
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Counseling/Concern |
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Drug/Alcohol Abuse |
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Reprimand |
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Special Referral |
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Censure |
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Equal Opportunity |
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Admonition |
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Legal Office |
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Mental Health |
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Relief Agency |
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Adverse: |
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Date Imposed |
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Description |
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(YYYYMMDD) |
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Withholding of Privileges |
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Adverse Performance Evaluation (OER/NCOER/Academic Report) |
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Relief for Cause (OER/NCOER) |
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Mandatory Reassignment |
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Transfer (such as rehabilitative) |
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Adverse Record Entry - Flag |
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Denial of Reenlistment or Continued Service |
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Withholding of Promotion |
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Delay of Promotion |
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Promotion Revocation |
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Clearance Revocation |
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Control Roster (downgrade of clearance, PRP reclassification) |
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Resignation |
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Retirement |
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Retirement at Lower Grade |
From: |
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To: |
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Transfer to Inactive Reserve |
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Military Occupational Specialty Reclassification |
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Debarment |
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Duration: |
Days |
Months |
Years |
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DA FORM 4833, FEB 2010 |
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Page 3 of 6 |
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APD PE V1.02ES
6. |
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ADMINISTRATIVE ACTIONS (Continued) |
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Adverse: |
(Continued) |
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Date Imposed |
Description |
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(YYYYMMDD) |
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Job Termination |
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Job Suspension |
Duration: |
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Leave Without Pay |
Duration: |
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Loss of Warrant |
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Voluntary Disclosure |
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Restitution (to US Government) |
Amount: |
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Restitution (to third party |
Amount: |
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Other (return to states, etc.) |
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Contract Suspension |
Duration: |
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Contract Termination |
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Cost Adjustment |
Amount: |
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Bid Rejection |
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Recoupment |
Amount: |
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Denial of Continuation |
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Other Contract Action |
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7. |
DETAILS OF ADMINISTRATIVE SEPARATION |
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Date Imposed |
(YYYYMMDD) : Regulation: |
Chapter: |
Characterization:
NOTE: Proceed to Commander's Remarks
8. |
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Date Adjudged |
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Sanction |
(YYYYMMDD) |
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Fine |
Amount: |
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Forfeiture |
Amount: |
Duration: |
Extra Duty |
Days: |
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Restriction |
Days: |
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Correctional Custody |
Days: |
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Confinement |
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Duration: |
Bad Conduct Discharge |
Effective Date: |
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Dishonorable Discharge |
Effective Date: |
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Reduction in Grade |
From: |
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To: |
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Probation |
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Duration: |
Special Assignment |
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Duration: |
Total Forfeiture (all pay/allowance) |
Duration: |
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Death |
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Civil Recovery |
Amount: |
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Civil Award |
Amount: |
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DA FORM 4833, FEB 2010
Days
Days
Days
] Days
c] Days
Days
Days
Days
c
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□
Months Years
Months Years
Months c Years
Effective Date (YYYYMMDD):
Months
Months Years [] Life
Months Years
Months Years
Months Years || Life
Page 4 of 6
APD PE V1.02ES
9. |
SUSPENDED SANCTIONS |
Were Any Sanctions Suspended? | | Yes | | No
NOTE: If no sanctions were suspended, proceed to "Commander's Remarks"
Suspended |
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Suspended Sanction Information |
Sanction |
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Date Suspended: |
Suspension Duration: |
Fine |
Suspended Portion US$: |
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Suspension Conditions: |
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Forfeiture
Extra Duty
Restriction
Correctional
Custody
Confinement
Reduction in
Grade
Probation
Special
Assignment
Total
Forfeiture
Civil Recovery
Civil Award
Date Suspended: |
Suspension Duration: |
Suspended Portion US$: |
Suspended Portion Time: |
Suspension Conditions: |
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Date Suspended: |
Suspension Duration: |
Suspended Portion Time: |
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Suspension Conditions: |
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Date Suspended: |
Suspension Duration: |
Suspended Portion Time: |
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Suspension Conditions: |
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Date Suspended: |
Suspension Duration: |
Suspended Portion Time: |
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Suspension Conditions: |
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Date Suspended: |
Suspension Duration: |
Suspended Portion Time: |
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Suspension Conditions: |
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Date Suspended: |
Suspension Duration: |
Suspension Conditions: |
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Date Suspended: |
Suspension Duration: |
Suspended Portion Time: |
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Suspension Conditions: |
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Date Suspended: |
Suspension Duration: |
Suspended Portion Time: |
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Suspension Conditions: |
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Date Suspended: |
Suspension Duration: |
Suspended Portion Time: |
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Suspension Conditions: |
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Date Suspended: |
Suspension Duration: |
Suspended Portion Time: |
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Suspension Conditions: |
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Date Suspended: |
Suspension Duration: |
Suspended Portion Time: |
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Suspension Conditions: |
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DA FORM 4833, FEB 2010 |
Page 5 of 6 |
APD PE V1.02ES
10. |
Commander's Remarks |
USASCRC Number: |
Sanction: |
11. |
COMMANDING OFFICER |
Was a DNA sample collected from the offender? | | Yes |
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Name: |
Grade: |
AKO |
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Signature: |
Signature Date (YYYYMMDD) : |
DA FORM 4833, FEB 2010 |
Page 6 of 6 |
APD PE V1.02ES
Form Characteristics
| Fact Name | Description |
|---|---|
| Form Purpose | The DA Form 4833 is used to report disciplinary or administrative actions taken against a military member. |
| Governing Law | The form is governed by AR 190-45 and various sections of Title 10 and Title 5 of the U.S. Code. |
| Privacy Act | It collects personal information under the authority of Title 10 USC Section 301 and Title 5 USC Section 2951. |
| Voluntary Disclosure | Providing your Social Security Number is voluntary; it is mainly used for identification purposes. |
| Responsible Parties | The first Lieutenant Colonel in the chain of command is responsible for completing the form with supporting documents. |
| Reporting Requirements | The completed form must meet installation, command, and federal reporting requirements regarding crime trends. |
| Conviction Reporting | In court-martial cases, the form requires reporting the offense for which the individual was convicted. |
| Referral Process | Provost Marshals must provide the "MP Report Number" for cases referred to commanders. |
| Offender Information | The form includes sections for capturing detailed offender information, including name and date of birth. |
| Action Taken | Different actions can result from the form, including administrative actions, non-judicial punishment, or court-martial outcomes. |
Guidelines on Utilizing Da 4833
Completing the DA Form 4833 is essential for documenting disciplinary or administrative actions effectively. This form provides a structured format to capture relevant details that assist commanders and law enforcement officials in managing disciplinary actions. Below are the steps to fill out the form accurately.
- Start by entering Control Information in Block 1, including the USACRC Number and dates.
- Fill out the Offender Information in Block 2. Provide the last name, first name, middle name, grade, date of birth, and Social Security Number.
- In Block 3, indicate the Commander Decision Date.
- Proceed to Block 4. For each offense, mark “Yes” or “No” in the Referral Information. If “No” is selected for all offenses, skip to Block 10.
- If “Yes” is selected for any offense, provide the details of the action taken in Block 4, selecting the appropriate options for administrative and judicial actions.
- Complete Block 5 with the outcomes of NJP, court-martial, or civilian criminal court proceedings. Include charging offense, plea, and findings.
- In Block 6, if applicable, fill out the details of any non-adverse or adverse actions taken.
- Continue to Block 7 to provide details of any administrative separation actions imposed.
- Fill out Block 8 regarding any judicial or non-judicial sanctions, including fine amounts and durations.
- For suspended sanctions, complete Block 9, if relevant, indicating any details about suspended portions and conditions.
- In Block 10, include any Commander's Remarks, ensuring to document any sanctions or decisions clearly.
- Conclude by signing and dating the form in Block 11. Ensure that the signature belongs to the commanding officer.
What You Should Know About This Form
What is the purpose of the DA 4833 form?
The DA 4833 form, also known as the Commander’s Report of Disciplinary or Administrative Action, serves to document actions taken in response to investigations conducted by military police or civilian law enforcement. It helps commanders and law enforcement officials accurately identify and report incidents of indiscipline. The form's data is essential for understanding crime trends within military installations and for establishing command programs that support law enforcement efforts.
Who is responsible for completing the DA 4833 form?
The completion of the DA 4833 form lies primarily with the first Lieutenant Colonel in the chain of command. This officer must gather and include relevant supporting documentation, such as copies of Article 15s or court-martial orders. Additionally, company, troop, and battery level commanders are also tasked with filling out the form in cases investigated. It is crucial that these reports are accurate and complete to comply with various regulatory and reporting obligations.
How is the DA 4833 form used in legal proceedings?
In contexts involving court-martial or civilian criminal actions, the DA 4833 form outlines the specifics of each case, such as the offenses charged and the outcomes of the legal proceedings. Commanders must note the offense for which a service member was convicted, even if it differs from the original charge. This form aids in building a comprehensive record that may be used in subsequent legal evaluations and decisions regarding future actions against the individual.
What information is collected on the DA 4833 form?
The form collects a variety of information, including personal details of the offender, specifics of the offenses, action taken, and outcomes of disciplinary measures. Essential elements include the names, grades, and Social Security Numbers of those involved, any referrals made, and a detailed account of action taken, whether administrative or judicial. This comprehensive data ensures that all necessary parties are informed and helps facilitate effective management of disciplinary issues.
Is disclosure of Social Security Numbers mandatory on the DA 4833 form?
Providing your Social Security Number on the DA 4833 form is voluntary. However, it is used as an additional means of identification to assist with filing and retrieval of records. While commanders are encouraged to include this information for improved accuracy, individuals can opt to withhold it without facing penalties, as disclosure remains a personal choice.
Common mistakes
When filling out the DA 4833 form, individuals often overlook key details that can lead to complications later. One common mistake is not providing complete control information. Fields such as the USACRC number, MP Report Number, and Sub-Installation require accuracy to avoid delays in processing.
Another frequent error involves the omission of supporting documentation. The form specifically requests copies of Article 15s, court-martial orders, and other relevant documents. Failing to include these can result in a rejection of the submission or additional questions from higher authorities.
People sometimes misinterpret the referral information section. It is crucial to clearly indicate whether actions were taken for each offense reported. Leaving this section incomplete or unclear can create misunderstandings and may hinder the command's review process.
Inaccurate personal information is a significant issue too. For example, incorrect social security numbers, names, or dates of birth can lead to identification problems. Always double-check the spelling of names and verify that all identification details match official records.
Failure to document a reason for selecting "No" in the action taken section, particularly regarding offenses, adds another layer of complexity. This should be accompanied by clear explanations for each instance where no action was taken, as required by the form.
Another mistake is neglecting to utilize the remarks section effectively. This area serves as a space for important clarifications. If details about a case or specific actions taken need to be addressed, this is the appropriate place to provide that context.
Sometimes, individuals forget to finalize the form properly. This includes securing the commander’s signature and ensuring that the form is dated appropriately. A form that is unsigned or undated can lead to potentially serious delays in processing.
Individuals often underestimate the importance of accurate dates. Failing to provide the correct referral, response, and action imposed dates can confuse the timeline of disciplinary action and cause further complications.
Finally, some may neglect the privacy aspect of the form. Although disclosure of a Social Security Number is voluntary, it is vital to understand that this can be essential for precise identification. Ignoring this can affect the processing of the report.
By being mindful of these common mistakes, individuals can ensure that their DA 4833 forms are completed correctly, leading to a smoother administrative process.
Documents used along the form
The DA Form 4833 is an important document utilized in military settings to report disciplinary or administrative actions taken against service members. To ensure a complete assessment and handling of such cases, other forms and documents may also be needed. The following list outlines several commonly used forms related to the DA 4833, each serving a specific purpose in the documentation and tracking of military disciplinary actions.
- DA Form 4856: This form is known as the Developmental Counseling Form. It is utilized by leaders to document counseling sessions, offering feedback and guidance to soldiers to support their professional growth and address performance issues.
- DA Form 2627: This form is used for Non-Judicial Punishment (NJP) under Article 15 of the Uniform Code of Military Justice. It records disciplinary actions taken and outlines the rights of the service member, along with the details of the offense and the imposed punishment.
- DD Form 458: This form is the Charge Sheet used to initiate court-martial proceedings. If a serious infraction occurs, the DD Form 458 outlines the charges against the service member and sets the stage for a formal military trial.
- DA Form 350-38: This form, known as the Request for Disciplinary Action, is used to submit a request for disciplinary actions along with supporting evidence. This form ensures proper protocol is followed when making recommendations for disciplinary measures.
- DA Form 25-50: This certificate is a Commander's Officer Evaluation Report. It is vital for performance assessments and can influence promotion and assignment opportunities, especially after disciplinary actions.
- AR 15-6 Investigation Report: This report documents investigations into incidents involving soldier misconduct. Findings from AR 15-6 investigations may influence decisions related to the DA Form 4833 and determine further actions required.
- MP Report: This document includes military police reports related to investigations and incidents. The information contained in these reports may provide crucial context when reviewing a DA Form 4833 submission.
- DA Form 200: This form is known as the Financial Liability Investigation of Property Loss. While not directly related to disciplinary actions, it may arise in cases where a service member's actions lead to property damage or loss, necessitating an investigation.
- Form 5110: This form is used for documenting and processing administrative separation proceedings. If disciplinary actions lead to separation from service, this form will be part of the official record.
Each form plays a critical role in the military justice system, ensuring due process, documentation, and accountability. Properly managing these documents assists in maintaining order and discipline within military environments, supporting commanders in their decision-making processes.
Similar forms
The DA Form 4833, known as the Commander’s Report of Disciplinary or Administrative Action, serves as a vital document for reporting various actions taken against military personnel. There are several other forms that operate similarly to the DA Form 4833, each designed to document proceedings and actions within military, legal, or administrative frameworks. Here’s a look at ten forms that share similar functions:
- DA Form 2823: Also known as the Sworn Statement form, it is used to collect formal witness statements or evidence in administrative or legal matters involving military personnel, similar to recording disciplinary actions.
- DA Form 518: This is the Report of Result of Trial form, which summarizes court-martial outcomes. Like the DA Form 4833, it provides a record of administrative actions based on judicial proceedings.
- DD Form 149: The Application for Correction of Military Record form allows individuals to request changes to their service records. This process can relate to disciplinary actions recorded on the DA Form 4833.
- DA Form 2627: The Record of Proceedings Under Article 15 is used to document non-judicial punishment. The structure and purpose for documenting outcomes align closely with the DA Form 4833.
- DD Form 214: This form provides a summary of a service member’s military career upon separation. It may include information on disciplinary actions that could have been reported on the DA Form 4833.
- DA Form 1059: This form records academic evaluations of soldiers who have completed training programs. Similar to the DA Form 4833, it captures an official record of a soldier's performance, including any disciplinary actions.
- SF 86: This is the Questionnaire for National Security Positions, which requires disclosure of criminal history and related issues. This information can be similar to what might be documented in a DA Form 4833.
- DD Form 2648: The Initial Counseling form is used when transitioning service members require orientation and guidance, addressing any disciplinary issues noted on the DA Form 4833.
- DA Form 1058: This form, which documents a statement of charges, is closely related to the DA Form 4833 in terms of laying out the basis for disciplinary actions taken.
- DA Form 7456: The Army Record Retention Schedule outlines how different records are maintained and for how long. It ties into the importance of keeping forms like the DA Form 4833 for accountability.
These forms play important roles in maintaining accountability, documenting actions, and providing transparency within military processes, much like the DA Form 4833 does.
Dos and Don'ts
When filling out the DA Form 4833, there are important guidelines to follow:
- Provide accurate personal information for the offender.
- Include the correct MP Report Number in Block-1.
- Ensure that all supporting documentation is attached.
- Double-check all dates for accuracy and proper formatting (YYYYMMDD).
- Accurately detail any offenses and actions taken in the appropriate sections.
Conversely, avoid the following common mistakes:
- Do not leave any required fields blank.
- Avoid using incorrect formats for the Social Security Number.
- Do not provide incomplete or misleading information about offenses.
- Do not overlook the importance of commander’s remarks; they must be thorough.
- Avoid submitting the form without proper authorization signatures.
Misconceptions
The DA Form 4833 often comes with several misconceptions that can lead to confusion for those who need to interact with it. Below are four common misconceptions and clarifications for each:
- Misconception 1: The DA Form 4833 is only for serious criminal offenses.
- Misconception 2: Only high-ranking officers need to fill out the DA Form 4833.
- Misconception 3: Providing a Social Security Number is mandatory on the DA Form 4833.
- Misconception 4: The DA Form 4833 does not affect future military career prospects.
While the form is indeed used in the context of serious offenses, it is also utilized for a broad range of disciplinary and administrative actions. This includes minor infractions that may not lead to significant legal consequences but still require documentation.
This form can be filled out by various ranks, including company, troop, and battery level commanders. It is crucial for all levels of command to ensure accurate reporting of disciplinary actions.
The disclosure of one's Social Security Number is, in fact, voluntary. It serves as an additional method of identification but is not strictly required for the form's completion.
Records documented on the DA Form 4833 can have long-term implications for a service member's career. Actions taken and noted on this form may influence things like promotions, assignments, and overall evaluations.
Key takeaways
Filling out the DA Form 4833 correctly is essential for documenting disciplinary or administrative actions. Commanders in the chain of command must ensure that they gather all necessary supporting documents, such as Article 15s and court-martial orders, to accompany the form.
Accurate information is crucial. The completed DA Form 4833 plays a significant role in meeting reporting requirements for various entities, including installation command and federal agencies. Proper data allows for the identification of crime trends, aiding resource allocation for law enforcement and command programs.
- The form must detail any offenses resulting in court-martial convictions and include relevant outcomes.
- Commanders are responsible for entering the “MP Report Number” for cases referred to them, ensuring that cross-references with civilian law enforcement reports are clear.
- When marking "No" for action taken on any offense, a valid reason must be provided to maintain thorough documentation.
Timelines are important. Commanders should be mindful of all dates included in the process, such as referral and suspense dates, to ensure that all actions are tracked appropriately.
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