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The DA Form 2823 is a Sworn Statement utilized primarily within the United States Army. It serves to document potential criminal activities and assist Army officials in maintaining discipline, law and order by investigating complaints and incidents. Click the button below to start filling out your DA Form 2823 today.

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Table of Contents

The DA Form 2823, known as a Sworn Statement, plays a critical role within the U.S. Army's framework for maintaining discipline, law, and order. Established under multiple authoritative statutes, including Title 10 and Title 5 of the United States Code, as well as Executive Order 9397, this document is designed to meticulously document witness statements related to potential criminal activities or pertinent incidents involving Army personnel. The form serves multiple purposes, from facilitating investigations to contributing to decisions on judicial or non-judicial punishments and other administrative actions. It also highlights the importance of privacy and voluntary disclosure, specifying that providing a Social Security Number (SSN) and other personal details is not mandatory but crucial for the documentation process. The structured format of the DA Form 2823 ensures that all necessary information, from the basics like location, date, and time of the statement, to the detailed account of events and the affirmation of the statement's truthfulness under oath, is systematically captured. Moreover, the form stipulates the need for continuation pages to include specific headings, the statement taker’s initials, and page numbers, ensuring clarity and accountability throughout the document. The integration of this form into Army procedures underscores the institution's commitment to upholding the highest standards of conduct and the rigorous pursuit of truth in all matters requiring formal examination.

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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.

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

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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

Page 3 of 3

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Form Breakdown

Fact Number Detail
1 The DA Form 2823 is known as a Sworn Statement.
2 It is governed by AR 190-45, with the proponent agency being PMG.
3 Authority for the form comes from Title 10, USC Section 301; Title 5, USC Section 2951; and Executive Order 9397 regarding Social Security Numbers (SSN).
4 The principal purpose of the form is to document potential criminal activity involving the U.S. Army and maintain discipline through investigation.
5 Information on the form can be disclosed to a range of agencies and individuals for law enforcement, personnel actions, and other official uses.
6 Disclosure of SSN and other information on the form is voluntary.
7 The form requires detailed information including location, date, time, and personal identification.
8 Witnesses and the person administering the oath must sign the form, ensuring its authenticity.
9 Additional pages must contain specific heading and initials for organization and clarity.
10 The current edition of the form at the time of providing these facts is the November 2006 version, denoted as DA FORM 2823, NOV 2006.

Guidelines on Filling in Da 2823

Filling out the DA Form 2823, or the Sworn Statement, is a crucial step in documenting potential criminal activity involving the U.S. Army. This procedure allows Army officials to maintain discipline, law, and order through the thorough investigation of complaints and incidents. The form collects specific information under a formal oath, making it a significant part of maintaining transparency and accountability within military operations. Below are the step-by-step instructions for completing this form accurately.

  1. Begin by entering the location where the statement is being made in the field marked "1. LOCATION."
  2. Fill in the date the statement is made using the format YYYYMMDD in the "2. DATE" section.
  3. Record the time the statement is taken in the "3. TIME" section.
  4. Provide a file number if available, in the "4. FILE NUMBER" section.
  5. Enter the full name of the person making the statement - last name, first name, and middle name in the "5. LAST NAME, FIRST NAME, MIDDLE NAME" section.
  6. Include the person's Social Security Number (SSN) in the "6. SSN" field. Remember, providing your SSN is voluntary but can be crucial for identification purposes.
  7. Indicate the person’s grade/status in the military in the "7. GRADE/STATUS" section.
  8. Fill in the name of the organization or address associated with the person making the statement in the "8. ORGANIZATION OR ADDRESS" field.
  9. In the large box following "9. I, ______, WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH:", write the sworn statement. If more space is needed, continue the statement on the second page, ensuring each additional page contains the heading “STATEMENT OF _____ TAKEN AT _____ DATED _____", as well as the initials of the person making the statement and page number at the bottom.
  10. For any exhibits referenced or included with the statement, list them under "10. EXHIBIT."
  11. Ensure the person making the statement initials at the bottom of each page in the space provided.
  12. On the final page, after reviewing the statement, the person making the statement must sign under the affidavit section to certify the statement's truthfulness and their willingness to provide it without coercion. Enter the date and location where the oath is administered in the designated spots.
  13. The signature of the person administering the oath and their title is required on the last page, along with the authority to administer oaths as per organizational or local regulations.

Following these steps ensures that the DA Form 2823 is accurately and completely filled out, allowing for an official record of statements regarding incidents or complaints within the U.S. Army. Remember, the accuracy of this document is paramount, as it can be used in investigations, judicial or non-judicial punishments, and other administrative actions.

Learn More on Da 2823

What is a DA Form 2823?

The DA Form 2823 is a document used by the U.S. Army to record sworn statements. It's employed primarily to document potential criminal activities and support investigations, ensuring discipline, law, and order are maintained within the service.

Who can administer an oath for a DA Form 2823?

Only individuals authorized by law to administer oaths can supervise the signing of a DA Form 2823. This includes military officers, military police, and legal officers. The person administering the oath must ensure that the statement is willingly given and accurately recorded.

Is providing my Social Security Number (SSN) required on the DA Form 2823?

Disclosure of your SSN on the DA Form 2823 is voluntary. However, it's often used to help identify individuals accurately and facilitate the investigation process. The decision to provide your SSN should be considered carefully, taking into account privacy concerns.

What happens if additional pages are needed for my statement?

If your statement exceeds the space provided on the first page, additional pages can be used. These pages must have the heading "STATEMENT OF (name) TAKEN AT (location) DATED (date)." Each additional page must be numbered and bear the initials of the person making the statement at the bottom.

How is the authenticity of the statement on the DA Form 2823 ensured?

The authenticity of the statement on the DA Form 2823 is ensured in several ways:

  1. The individual making the statement must initial all corrections and initial at the bottom of each page containing the statement.
  2. The statement concludes with an affidavit, where the individual acknowledges having read or been read the statement, understanding its contents, and asserting its truthfulness.
  3. The affidavit must be signed in the presence of an authorized individual who also signs the form, affirming that the oath was properly administered.

Can the information on a DA Form 2823 be disclosed to other agencies?

Yes, the information provided on a DA Form 2823 can be disclosed to various entities for official purposes. This includes 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. Such disclosures are made to support judicial or administrative actions, security clearances, and other personnel matters.

What should I do if I need to make a sworn statement but I'm not on a military installation?

If you need to make a sworn statement and you're not on a military installation, it's best to contact the nearest U.S. Army legal office, military police unit, or your chain of command for guidance. They can advise on how to proceed and may be able to facilitate the process by connecting you with an authorized individual who can administer the oath and witness the statement remotely or through alternative means.

Common mistakes

When filling out the DA Form 2823, Sworn Statement, individuals often make errors that can impact the processing and outcome of the document. Recognizing and avoiding these mistakes is crucial for ensuring the statement's authenticity and reliability. Below are five common mistakes:

  1. Not providing accurate details in the heading: The form requires specific information such as location, date, and time. Failing to provide accurate details can result in confusion or a lack of credibility in the sworn statement.

  2. Omitting the Social Security Number (SSN): Although disclosing your SSN is voluntary, it is essential for identification purposes. Excluding it might delay or complicate the verification and processing of the statement.

  3. Improper completion of the statement section: Individuals sometimes fail to clearly and comprehensively describe the events in question. It's crucial to provide a detailed account in the statement section to ensure a thorough understanding of the incident.

  4. Neglecting to initial corrections and pages: Every correction made on the form and each page containing part of the statement must be initialed by the person making the statement. This oversight could call into question the authenticity of the information provided.

  5. Forgetting to sign or having the form properly witnessed: The form is incomplete without the signature of the person making the statement and the official administering the oath. The absence of these signatures invalidates the document.

By paying close attention to these areas, individuals can avoid common mistakes and ensure their statements are properly documented and considered valid.

Documents used along the form

The DA Form 2823, or Sworn Statement, serves a critical function in documenting potential criminal activity and maintaining discipline within the U.S. Army. It's a pivotal element in the investigative process, but it rarely stands alone. Various other forms and documents are commonly utilized alongside the DA Form 2823 to ensure a comprehensive and effective inquiry. Here's a look at some of these documents and their purposes.

  • DA Form 4856: Counseling Form - This form is used to record counseling sessions between a supervisor and a soldier, which can be related to the matters discussed in the DA 2823.
  • DA Form 5988-E: Equipment Maintenance and Inspection Form - Frequently referenced in investigations that involve Army equipment, to check maintenance and service history.
  • DA Form 638: Recommendation for Award - Used for recommending soldiers for awards, which can be relevant to an investigation if conduct being awarded is under review.
  • DD Form 214: Certificate of Release or Discharge from Active Duty - May be used in conjunction with DA 2823 when the investigated incident affects the discharge status of an individual.
  • DA Form 31: Request and Authority for Leave - This form can be reviewed to establish the whereabouts of personnel during the time of the incident detailed in the DA 2823.
  • DA Form 4187: Personnel Action - Used to document administrative actions taken against a soldier, which could be the result of findings from the DA 2823.
  • DA Form 67-9: Officer Evaluation Report - Officer conduct reviews may be relevant to an investigation, especially if leadership decisions are under scrutiny.
  • DA Form 2166-8: Noncommissioned Officer Evaluation Report - Similar to the DA Form 67-9, but for noncommissioned officers, it can provide background information on the conduct and performance of those involved.
  • DA Form 2828: Consent for Release of Information - Obtained to permit the sharing of personal information that might be necessary for the course of an investigation.
  • DA Form 5500/5501: Body Fat Content Worksheet - Although less commonly associated, these forms could be pertinent in investigations involving physical readiness or health issues.

Each of these documents plays a specific role in the broader investigative process, providing crucial data that supports the findings of a Sworn Statement. By piecing together information from these various sources, authorities can gain a comprehensive understanding of the circumstances surrounding an incident, ultimately leading to informed decisions regarding discipline, rewards, and other personnel actions. Together, they embody the multifaceted approach required to uphold justice and accountability within the ranks.

Similar forms

  • The DD Form 2656, Data for Payment of Retired Personnel, is similar as it collects personal and sensitive information critical for processing retirement benefits for military personnel, akin to how the DA 2823 form gathers details for investigating incidents within the Army.

  • SF 86, Questionnaire for National Security Positions, shares similarities because it requires detailed personal information, and its content is utilized to assess trustworthiness and reliability, just as the DA 2823 form is used to document and investigate potential criminal activity and misconduct.

  • The SF 312, Classified Information Nondisclosure Agreement, parallels the DA 2823 form in the aspect of containing a sworn statement aspect, where individuals acknowledge their responsibilities and potential consequences related to handling classified information.

  • NA Form 13022, Discharge Papers and Separation Documents, while primarily used for documenting the separation of military personnel, shares the burden of accurately capturing individual’s service details and conditions of discharge, which may also be referenced during investigations of prior service conduct similar to contexts where DA 2823 may be utilized.

  • The PD Form 251, Arrest Report, like the DA 2823, is an official document used by law enforcement to record details concerning arrests, including personal information and statements related to the incident, underlining the importance of precision and accountability in the process.

  • VA Form 21-4138, Statement in Support of Claim, bears resemblance as it allows veterans to provide a personal statement regarding their claims for benefits, often requiring detailed accounts of incidents or conditions similar to the testimonial nature of DA 2823 form in documenting statements under oath.

Dos and Don'ts

When filling out the DA Form 2823, it's important to approach the process with the utmost care and attention to detail. This document plays a crucial role in documenting potential criminal activities and maintaining discipline within the U.S. Army. To assist you in this process, here is a list of things you should and shouldn't do:

Things You Should Do:

  1. Ensure all information is accurate and truthful. This form is a legal document, and any falsification of information can have serious consequences.
  2. Complete the form in a legible manner. If the form is filled out by hand, make sure your handwriting is readable to avoid any misunderstandings or errors in documenting your statement.
  3. Initial any corrections made on the form. It’s important to acknowledge any changes to ensure the accuracy and integrity of the statement.
  4. Review the entire statement before signing it. Confirm that the information provided reflects your intended statement and that you understand the content fully.

Things You Shouldn't Do:

  1. Do not leave any sections blank that apply to your statement. If a section is not applicable, it's better to mark it as "N/A" (Not Applicable) rather than leaving it empty.
  2. Avoid using technical jargon or acronyms that may not be easily understood. The statement should be clear and accessible to anyone who reads it.
  3. Do not sign the form without thoroughly reviewing it. Remember, by signing, you're affirming that the statement is true and that you've understood all its contents.
  4. Do not feel pressured to complete the form without adequate time to consider your statement. Take the time you need to ensure the document accurately reflects your account of events.

Misconceptions

Understanding the DA Form 2823, also known as a Sworn Statement, is crucial for members of the U.S. Army and other individuals involved in official investigations. There are several misconceptions about this form that can lead to confusion. Clarifying these misconceptions ensures that the form is used correctly and efficiently.

  • The form is only used for criminal activities: While the DA Form 2823 is often associated with documenting potential criminal activity involving the U.S. Army, it is also used for non-criminal matters such as administrative inquiries and other non-criminal investigations.

  • Anyone can administer the oath: The form requires that the statement be sworn before an individual authorized by law to administer oaths. This typically means a commissioned officer, not just any member of the military or public.

  • Disclosing Social Security Number (SSN) is mandatory: The Privacy Act Statement on the form notes that disclosing your SSN and other information is voluntary, not mandatory. However, providing it can help in the identification process.

  • The form is only for use within the Army: While primarily designed for Army use, the information on a DA Form 2823 can be disclosed to federal, state, local, and foreign government law enforcement agencies, among others, as described under its routine uses.

  • Filling out the form grants consent for any use of the information: The routine uses section clearly outlines how the information can be used, which includes specific legal, administrative, and operational purposes, not for any use without limitation.

  • The form cannot be corrected: Corrections can be made on the form. The individual making the statement is required to initial all corrections to ensure that any changes are acknowledged and authenticated.

  • Electronic signatures are not allowed: The current regulations and practices around electronic signatures evolve, and depending on the specific requirements and allowances of the authority requesting the DA Form 2823, electronic signatures may or may not be accepted. Always check the latest guidelines.

  • Witnesses are mandatory for the form to be considered valid: While witnesses can add to the credibility of the statement made, the form's validity rests on it being properly filled out and the oath administered by an authorized person. Witness signatures provide additional validation but are not necessarily required for the form's authenticity.

Understanding these aspects of the DA Form 2823 ensures that individuals can fill out, submit, and process these forms accurately and in compliance with relevant regulations and procedures.

Key takeaways

The DA Form 2823, Sworn Statement, is a critical document within the U.S. Army used to record potential criminal activity and maintain discipline, law, and order through thorough investigation. Understanding its proper use and implications is essential for both the individuals completing the form and those overseeing the process.

  • Accuracy is paramount: Every detail in the DA Form 2823 must be precise. From personal information to the statement itself, inaccuracies can compromise the investigation's integrity.
  • Voluntary Disclosure: Providing your Social Security Number (SSN) and other data is voluntary but crucial for record-keeping and verification.
  • Widespread Use: The information collected might be shared with an array of entities, including federal, state, local, and foreign law enforcement agencies, highlighting the importance of the document's accuracy and the potential implications of the information provided.
  • Multiple Purposes: Beyond documenting incidents, the DA Form 2823's information may influence judicial or administrative disciplinary actions, security clearances, and other significant personnel decisions.
  • Ensuring Continuity: For statements that extend beyond one page, continuity must be maintained. Each additional page should carry the heading "STATEMENT OF TAKEN AT DATED," the initials of the person making the statement, and the page number, ensuring the statement's flow and integrity.
  • Final Affirmation: The individual making the statement must affirm the truthfulness and completeness of the information provided. This includes initialing all corrections and confirming the statement was made freely, without coercion or inducement.
  • Legal Oath Administration: The form concludes with the statement being sworn before a person authorized to administer oaths, underscoring the legal seriousness and the obligation of the truth.

Given its significant legal and administrative implications, filling out the DA Form 2823 with thoroughness, truthfulness, and detail cannot be overstated. It serves as a vital component in upholding justice and order within the Army's ranks.

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