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Content Overview

The DA 2823 form, commonly referred to as the Sworn Statement form, plays a crucial role in documenting potential criminal activities related to the U.S. Army. This form is utilized under the guidelines of Army Regulation 190-45, with the primary purpose of aiding Army officials in maintaining discipline and law enforcement through thorough investigations of complaints and incidents. It collects essential information such as the individual's name, Social Security Number (SSN), grade, and organization, which are vital for the investigation process. The form also includes a privacy act statement, ensuring that individuals are aware of how their information may be used and disclosed to various government entities, including law enforcement agencies and courts. Notably, the completion of this form is voluntary, particularly regarding the disclosure of the SSN. Each statement made under oath must be carefully documented, with provisions for additional pages if necessary. The individual making the statement must affirm its truthfulness and understanding before a legally authorized person, who will then administer the oath. This structured approach not only facilitates the collection of accurate information but also upholds the integrity of the investigative process within the Army.

Key takeaways

Here are some key takeaways about filling out and using the DA 2823 form:

  • Purpose: The DA 2823 form is used to document potential criminal activity involving the U.S. Army.
  • Privacy Act Statement: The form collects personal information, including Social Security Numbers, under specific legal authorities.
  • Voluntary Disclosure: Providing your SSN and other information is voluntary, but it is important for the investigation process.
  • Accurate Information: Ensure all details, such as location, date, and time, are filled out accurately.
  • Signature Requirement: The person making the statement must sign the form, confirming the truth of the statement.
  • Initials on Pages: Each additional page must have the initials of the person making the statement and indicate the page number.
  • Witnesses: The statement must be subscribed and sworn to before an authorized person who can administer oaths.
  • Corrections: Any corrections made on the statement must be initialed by the person making the statement.
  • Statement Continuation: If the statement continues onto additional pages, include the heading "STATEMENT OF TAKEN AT DATED" at the top of each page.
  • Final Review: Read the entire statement before signing to ensure understanding and agreement with its content.

Guide to Writing Da 2823

Filling out the DA 2823 form requires careful attention to detail. This form is essential for documenting statements made under oath regarding potential criminal activity involving the U.S. Army. To ensure that your statement is accurate and complete, follow the steps outlined below.

  1. Location: Write the location where the statement is being made.
  2. Date: Enter the date in the format YYYYMMDD.
  3. Time: Indicate the time when the statement is made.
  4. File Number: Provide the relevant file number associated with the incident.
  5. Last Name, First Name, Middle Name: Fill in your full name as it appears on official documents.
  6. Social Security Number (SSN): Enter your SSN. Remember, disclosure is voluntary.
  7. Grade/Status: Specify your military grade or status.
  8. Organization or Address: List your organization or current address.
  9. Statement Under Oath: Write "I, [Your Name], WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH:" followed by your statement.
  10. Exhibit: If applicable, reference any exhibits that support your statement.
  11. Initials: Sign your initials at the bottom of the page where you made your statement.

If additional pages are needed, ensure that each page contains the heading "STATEMENT OF TAKEN AT" along with the date. Each additional page must also bear your initials and indicate the page number.

Finally, review your statement carefully. At the end, you will need to affirm that you understand the contents and that your statement is true. Sign the document, and have it witnessed by someone authorized to administer oaths.

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Form Preview 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

Documents used along the form

The DA Form 2823, known as the Sworn Statement, is an essential document used within the U.S. Army to record sworn statements related to potential criminal activities. However, several other forms and documents often accompany it to ensure thorough documentation and processing of incidents. Below is a list of these commonly used forms, each serving a specific purpose in the investigative process.

  • DA Form 4833: This form is used to report the results of an investigation into an incident involving a soldier. It summarizes the findings and any recommended actions, helping to keep a clear record of the outcome of investigations.
  • DA Form 15-6: A detailed investigation report, this form is utilized to document the findings of an informal investigation. It outlines the circumstances surrounding the incident and provides recommendations for further action, ensuring that all relevant information is captured.
  • Florida Motor Vehicle Bill of Sale form: A vital document for vehicle transactions in Florida, it acts as a receipt detailing the sale and ensuring legal recognition. For further information, visit toptemplates.info/bill-of-sale/motor-vehicle-bill-of-sale/florida-motor-vehicle-bill-of-sale.
  • DA Form 3975: The Military Police Report, often referred to as the MP Report, is used by military police to document incidents and offenses. This form serves as an official record of law enforcement activities and is crucial for any follow-up investigations or legal proceedings.
  • DA Form 2824: This is a sworn statement form that allows individuals to provide additional information or context regarding an incident. It is often used to supplement the DA Form 2823, ensuring that all perspectives are captured in the investigation.
  • DA Form 200: This form is used to report and document the loss or damage of government property. It is essential for maintaining accountability and ensuring that all incidents related to property are properly recorded and investigated.

These forms collectively contribute to a comprehensive understanding of incidents involving the Army, ensuring that all necessary information is documented and available for review. Each form plays a vital role in maintaining order and discipline within the military, facilitating investigations, and supporting the legal process when necessary.