Department of the Army (DA) Forms -- Complete Listing
Page 6 of 12: DA 4400
thru DA 4999
(1-2-3-4-5-7-8-9-10-11-12)
Also See our List of Commonly Used DA and DD Forms
| Form No. | Title | Version | XFDL | FF22 | FF99 | |
| DA 4430 | DEPARTMENT OF THE ARMY REPORT OF RESULT OF TRIAL | V1.00ES | XFDL | FF22 | FF99 | |
| DA 4441 | UNITED STATES ARMY TRIAL DEFENSE SERVICE | V1.00 | XFDL | FF22 | FF99 | |
| DA 4441 | UNITED STATES ARMY TRIAL DEFENSE SERVICE | IMG | ||||
| DA 4449 | CLEMENCY ACTION RECORD | V1.00 | XFDL | FF22 | FF99 | |
| DA 4450-R PDF ONLY | BALLISTIC DENSITY OF TEMPERATURE | |||||
| DA 4459 | PAROLE ACTION RECORD | V1.00 | XFDL | FF22 | FF99 | |
| DA 4460-R | ARMY LAW LIBRARY SHELF LIST | V1.00 | XFDL | FF22 | FF99 | |
| DA 4465 | PATIENT INTAKE/SCREENING RECORD (PIR) | V2.00ES | XFDL | FF22 | FF99 | |
| DA 4466 | PATIENT PROGRESS REPORT (PPR) | V1.00ES | XFDL | FF22 | FF99 | |
| DA 4469-R | WIND COMPUTATION (ELECTRONIC OR VISUAL) | V1.00 | XFDL | FF22 | FF99 | |
| DA 4474-R | REQUEST FOR ACCELERATED PAYMENT OF SRB - HARDSHIP OR COMPASSIONATE | V1.01 | XFDL | FF22 | FF99 | |
| DA 4475 | DATA REQUIRED BY THE PRIVACY ACT OF 1974 PERSONAL INFORMATION FROM THE NOK OF A DECEASED SERVICE MEMBER | V1.00 | FF22 | |||
| DA 4497 | INTERIM (ABBREVIATED) FLYING DUTY MEDICAL EXAMINATION | V1.00 | XFDL | FF22 | FF99 | |
| DA 4502-R | WORKSHEET FOR CALCULATING COST OF MANAGEMENT INFORMATION REQUIREMENTS/PRODUCTS | V1.00 | XFDL | FF22 | FF99 | |
| DA 4503-1-R | ADP PRODUCT REVIEW EVALUATION | V1.00 | XFDL | FF22 | FF99 | |
| DA 4504 | RECORD OF FIRE | V1.00 | XFDL | FF22 | FF99 | |
| DA 4505 | 155mm NUCLEAR COMPUTATION-MET CORRECTION TECHNIQUE | V1.00 | XFDL | FF22 | FF99 | |
| DA 4507-1-R | MANEUVER/PROCEDURE GRADE SLIP | V1.00 | XFDL | FF22 | FF99 | |
| DA 4507-2-R | CONTINUATION COMMENT SLIP | V2.00 | XFDL | FF22 | FF99 | |
| DA 4507-R | CREW MEMBER GRADE SLIP | V2.00 | XFDL | FF22 | FF99 | |
| DA 4511 | REQUEST FOR LOGISTICS CATALOG DATA AND/OR INFORMATION | V1.00 | XFDL | FF22 | FF99 | |
| DA 4513 | RECORD OF MISSIONS FIRED | V1.00 | XFDL | FF22 | FF99 | |
| DA 4524-R PDF ONLY | BALLISTIC DENSITY FROM SURFACE DATA | |||||
| DA 4538 | ABSTRACT OF ISSUES/SALES | V1.00 | XFDL | FF22 | FF99 | |
| DA 4550-R | MEAL CARD VERIFICATION FORM | V1.01 | XFDL | FF22 | FF99 | |
| DA 4552 | KITCHEN REQUISITION | V1.00ES | XFDL | FF22 | FF99 | |
| DA 4560-R | APPLICATION FOR APPROVAL OF ADP PRODUCT | V1.00 | XFDL | FF22 | FF99 | |
| DA 4570 | REGISTER OF PRINTING/DUPLICATING REQUISITIONS | V1.01 | XFDL | FF22 | FF99 | |
| DA 4570-1 | COMMERCIAL PRINTING RECORD | V1.01 | XFDL | FF22 | FF99 | |
| DA 4571-R | DATA REQUIRED BY THE PRIVACY ACT OF 1974 (ELIGIBILITY FOR AMEDD OFFICER PROCUREMENT PROGRAMS - MISCELLANEOUS DOCUMENTATION) | V1.00 | XFDL | FF22 | FF99 | |
| DA 4572-R | STATEMENT OF UNDERSTANDING FOR APPOINTMENT AS A COMMISSIONED OFFICER | V1.00 | XFDL | FF22 | FF99 | |
| DA 4573 | DOCUMENT CONTROL AND DESTRUCTION CERTIFICATE | V1.01 | XFDL | FF22 | FF99 | |
| DA 4574-R | RADIOPHARMACEUTICAL STOCK RECORD | V1.00 | XFDL | FF22 | FF99 | |
| DA 4591-R | RETENTION DATA WORKSHEET | V1.00 | XFDL | FF22 | FF99 | |
| DA 4598-R | INSTALLATION CASH TRANSFER REQUEST | V1.00 | XFDL | FF22 | FF99 | |
| DA 4601-R FILE 1/2 | REPORT OF MANPOWER AND FISCAL RESOURCES IN SUPPORT OF THE CIVILIAN EQUAL EMPLOYMENT OPPORTUNITY PROGRAM | V1.00 | XFDL | FF22 | FF99 | |
| DA 4601-R FILE 2/2 | REPORT OF MANPOWER AND FISCAL RESOURCES IN SUPPORT OF THE CIVILIAN EQUAL EMPLOYMENT OPPORTUNITY PROGRAM | V1.00 | FF22 | FF99 | ||
| DA 4604 | SECURITY CONSTRUCTION STATEMENT | V1.00 | XFDL | FF22 | ||
| DA 4605-R PDF ONLY | DEPARTMENT OF THE ARMY MUNITIONS CONTROL CASE PROCESSING WORKSHEET | |||||
| DA 4610-R | EQUIPMENT CHANGES IN MTOE/TDA | V2.00 | XFDL | FF22 | FF99 | |
| DA 4612-R | NUMBER AND TYPES OF DECORATIONS APPROVED | V1.00 | XFDL | FF22 | FF99 | |
| DA 4620-R | SPECIAL C-E AUTHORIZATION REQUEST | V1.00 | XFDL | FF22 | FF99 | |
| DA 4644-R | ARMY RESERVE REENLISTMENT DATA | V1.00 | XFDL | FF22 | FF99 | |
| DA 4651 | REQUEST FOR RESERVE COMPONENT ASSIGNMENT OR ATTACHMENT | V1.00 | XFDL | FF22 | ||
| DA 4655-R | TARGET LIST WORKSHEET | V1.00 | XFDL | FF22 | FF99 | |
| DA 4656-R | SCHEDULING WORK SHEET | V1.00 | XFDL | FF22 | FF99 | |
| DA 4657 | STATEMENT OF RETIREMENT - ELIGIBLE SOLDIER - REMAINING SERVICE OBLIGATION | V1.00 | XFDL | FF22 | ||
| DA 4658 | STATEMENT OF RETIREMENT - ELIGIBLE SOLDIER - NOT ELIGIBLE TO REENLIST | V1.00 | XFDL | FF22 | ||
| DA 4664-1-R | TEMPEST INSPECTION REPORT SUPPLEMENT - FACILITY PROFILE | V1.00 | XFDL | FF22 | FF99 | |
| DA 4664-R | TEMPEST INSPECTION REPORT | V1.00 | XFDL | FF22 | FF99 | |
| DA 4665 | PATIENT'S TRUST FUND--DAILY SUMMARY RECORD | V1.00 | XFDL | FF22 | FF99 | |
| DA 4669-R | COMSEC MATERIAL VOUCHER CONTROL REGISTER | V1.00 | XFDL | FF22 | ||
| DA 4677 | THERAPEUTIC DOCUMENTATION CARE PLAN (NON-MEDICATION) | V1.00 | XFDL | FF22 | FF99 | |
| DA 4678 | THERAPEUTIC DOCUMENTATION CARE PLAN (MEDICATIONS) | V1.01 | XFDL | FF22 | FF99 | |
| DA 4691 | INITIAL APPLICATION FOR CLINICAL PRIVILEGES AND STAFF APPOINTMENT | V1.00 | XFDL | FF22 | FF99 | |
| DA 4691-1 | APPLICATION FOR RENEWAL OF CLINICAL PRIVILEGES AND STAFF APPOINTMENT | V1.00 | XFDL | FF22 | FF99 | |
| DA 4700 | MEDICAL RECORD-SUPPLEMENTAL MEDICAL DATA | V1.00 | XFDL | FF22 | FF99 | |
| DA 4701-R | REQUEST FOR AVFUELS IDENTAPLATES | V1.00 | XFDL | FF22 | FF99 | |
| DA 4702-R | MONTHLY BULK PETROLEUM ACCOUNTING SUMMARY | V2.01 | XFDL | FF22 | FF99 | |
| DA 4707 | ENTRANCE PHYSICAL STANDARDS BOARD (EPSBD) PROCEEDINGS | V1.01 | XFDL | FF22 | FF99 | |
| DA 4708 | QUANTITY CHANGE FOR SUBSTITUTE IN PROPERTY BOOK | V1.01 | XFDL | FF22 | FF99 | |
| DA 4711 | STATEMENT OF LAW VIOLATIONS | V1.00 | XFDL | FF22 | ||
| DA 4713 | VOLUNTEER DAILY TIME RECORD | V1.01 | XFDL | FF22 | FF99 | |
| DA 4719-R | CHILD DEVELOPMENT SERVICES REGISTRATION CARD(CDS) | V2.00 | XFDL | FF22 | FF99 | |
| DA 4727 PDF ONLY | FIELD RECORD AND COMPUTATIONS - TELLUROMENTER | |||||
| DA 4730 | CERTIFICATE FOR PERFORMANCE OF HAZARDOUS DUTY | V1.00 | XFDL | FF22 | ||
| DA 4734-R | DEPARTMENT OF THE ARMY UNITED STATES OF AMERICA INVENTION DISCLOSURE | V1.00 | XFDL | FF22 | FF99 | |
| DA 4734-R IMAGE FILE | DEPARTMENT OF THE ARMY UNITED STATES OF AMERICA INVENTION DISCLOSURE | V1.00 | IMG | |||
| DA 4753 | NOTICE OF UNSAFE OR UNHEALTHFUL WORKING CONDITION | V2.00 | XFDL | FF22 | ||
| DA 4754 | VIOLATION INVENTORY LOG | V2.00 | XFDL | FF22 | ||
| DA 4755 | EMPLOYEE REPORT OF ALLEGED UNSAFE OR UNHEALTHFUL WORKING CONDITIONS | V2.00 | XFDL | FF22 | ||
| DA 4756 | INSTALLATION HAZARD ABATEMENT PLAN | V2.00 | XFDL | FF22 | ||
| DA 4757 | REGISTRATION/SPECIAL CORRECTION WORK SHEET | V2.00 | XFDL | FF22 | FF99 | |
| DA 4762 | ATHLETE'S APPLICATION | V1.01 | XFDL | FF22 | FF99 | |
| DA 4787 | REASSIGNMENT PROCESSING | V1.00 | XFDL | FF22 | ||
| DA 4789 | STATEMENT OF ENTITLEMENT TO SELECTIVE REENLISTMENT BONUS | V1.00 | XFDL | FF22 | FF99 | |
| DA 4790 | CERTIFICATION FOR DISTRIBUTION OF PUBLICATION(S) IN SUPPORT OF GOVERNMENT CONTRACT | V1.00 | XFDL | FF22 | ||
| DA 4797 FILE 1/2 | INTERNATIONAL STANDARDIZATION AGREEMENT RATIFICATION-IMPLEMENTATION DATA SHEET | V1.01 | XFDL | FF22 | ||
| DA 4797 FILE 2/2 | INTERNATIONAL STANDARDIZATION AGREEMENT RATIFICATION-IMPLEMENTATION DATA SHEET | V1.01 | FF22 | |||
| DA 4797-1 | INTERNATIONAL STANDARDIZATION AGREEMENT REVIEW DATA SHEET | V1.00 | XFDL | FF22 | FF99 | |
| DA 4799-R PDF ONLY | PROBATIONARY AGENT MONTHLY EVALUATION REPORT | |||||
| DA 4809-R | MEAL CARD CONTROL REGISTER | V1.00 | XFDL | FF22 | FF99 | |
| DA 4815 | FORMS CONTROL REGISTER | V1.00 | XFDL | FF22 | ||
| DA 4817-R PDF ONLY | CONSENT/NONCONSENT TO DISCLOSE PERSONAL INFORMATION | |||||
| DA 4824 | ADDENDUM TO CERTIFICATE AND ACKNOWLEDGEMENT OF SERVICE REQUIREMENTS (DA FORM 3540) FOR ALL PERSONNEL APPLYING FOR PARTICPATION IN THE RESERVE OFFICER TRAINING CORPS (ROTC)/SIMULTANEOUS MEMBERSHIP PROGRAM (SMP) | V2.00 | XFDL | FF22 | ||
| DA 4826 | ADDENDUM TO CERTIFICATE AND ACKNOWLEDGEMENT OF SERVICE REQUIREMENTS (DA FORM 3540) FOR ENLISTMENT UNDER THE ALTERNATE TRAINING PROGRAM | V1.00 | XFDL | FF22 | ||
| DA 4831-R FILE 1/2 | CALIBRATION AND REPAIR PROGRAM REPORT | V1.00 | XFDL | FF22 | FF99 | |
| DA 4831-R FILE 2/2 | CALIBRATION AND REPAIR PROGRAM REPORT | V1.00 | FF22 | FF99 | ||
| DA 4833 | COMMANDER'S REPORT OF DISCIPLINARY OR ADMINISTRATIVE ACTION | V1.00 | XFDL | FF22 | FF99 | |
| DA 4836 | OATH OF EXTENSION OF ENLISTMENT OR REENLISTMENT | V1.01 | XFDL | FF22 | FF99 | |
| DA 4838-R | MAINTENANCE PROCESS ANALYSIS WORKSHEET | V1.00 | XFDL | FF22 | FF99 | |
| DA 4839 | CAREER INTERN PROGRAM CERTIFICATE OF ACHIEVEMENT | XFDL | ||||
| DA 4840-R | REQUEST FOR TYPE CLASSIFICATION EXEMPTION/LIN FOR COMMERCIAL EQUIPMENT | V1.01 | XFDL | FF22 | FF99 | |
| DA 4841-R FILE 1/6 | CHILD DEVELOPMENT SERVICES (CDS) PROGRAM/FACILITY REPORT | V1.00 | XFDL | FF22 | FF99 | |
| DA 4841-R FILE 2/6 | CHILD DEVELOPMENT SERVICES (CDS) PROGRAM/FACILITY REPORT | V1.00 | FF22 | FF99 | ||
| DA 4841-R FILE 3/6 | CHILD DEVELOPMENT SERVICES (CDS) PROGRAM/FACILITY REPORT | V1.00 | FF22 | FF99 | ||
| DA 4841-R FILE 4/6 | CHILD DEVELOPMENT SERVICES (CDS) PROGRAM/FACILITY REPORT | V1.00 | FF22 | FF99 | ||
| DA 4841-R FILE 5/6 | CHILD DEVELOPMENT SERVICES (CDS) PROGRAM/FACILITY REPORT | V1.00 | FF22 | FF99 | ||
| DA 4841-R FILE 6/6 | CHILD DEVELOPMENT SERVICES (CDS) PROGRAM/FACILITY REPORT | V1.00 | FF22 | FF99 | ||
| DA 4843 | GUEST/ATTENDANCE SHEET | V1.00 | XFDL | FF22 | FF99 | |
| DA 4850-1-R PDF ONLY | NONAPPROPRIATED FUNDS TIME AND ATTENDANCE SUPPLEMENT REPORT | |||||
| DA 4856 | DEVELOPMENTAL COUNSELING FORM | V2.00 | XFDL | FF22 | ||
| DA 4876 | REQUEST AND RELEASE OF MEDICAL INFORMATION TO COMMUNICATIONS MEDIA | V1.01 | XFDL | FF22 | ||
| DA 4878 | ARMY CHESS TOURNAMENT APPLICATION | V1.00 | XFDL | FF22 | FF99 | |
| DA 4880-R | SUPPLEMENTAL CONTRACTOR COST REPORT | V1.00 | XFDL | FF22 | FF99 | |
| DA 4881 | AGREEMENT FOR THE LOAN OF US ARMY MATERIEL | V1.00 | XFDL | FF22 | FF99 | |
| DA 4881-1 | AGREEMENT FOR THE LOAN OF US ARMY MATERIEL CERTIFICATE FOR SIGNATURE BY AN ALTERNATE | V1.00 | XFDL | FF22 | FF99 | |
| DA 4881-2 | MILITARY PROPERTY OF THE UNITED STATES - EXHIBIT 1 | V1.00 | XFDL | FF22 | FF99 | |
| DA 4881-3 | SURETY BOND FOR SAFEKEEPING OF PUBLIC PROPERTY AND GUARANTEEING REIMBURSEMENT TO THE GOVERNMENT FOR EXPENSES INCIDENT TO THE LOAN OF ARMY MATERIEL - EXHIBIT II | V1.00 | XFDL | FF22 | FF99 | |
| DA 4881-4 | POWER OF ATTORNEY | V1.00 | XFDL | FF22 | FF99 | |
| DA 4881-5 | AGREEMENT FOR THE LEASE OF US ARMY MATERIEL | V1.00 | XFDL | FF22 | FF99 | |
| DA 4881-6 | REQUEST AND APPROVAL FOR LOAN OR LEASE OF EQUIPMENT AND LOAN OR LEASE AGREEMENT | V1.00 | XFDL | FF22 | FF99 | |
| DA 4884-R PDF ONLY | WEATHER DATA FOR SOUND RANGING | |||||
| DA 4886 | ISSUE-IN-KIND-PERSONAL CLOTHING RECORD | V1.10 | XFDL | FF22 | FF99 | |
| DA 4888-R | C-12 TAKEOFF AND LANDING DATA (TOLD) | V1.000 | XFDL | FF22 | FF99 | |
| DA 4908 | ARMY EMERGENCY RELIEF FUND CAMPAIGN | V1.00 | XFDL | FF22 | ||
| DA 4908 IMAGE FILE | ARMY EMERGENCY RELIEF ANNUAL FUND CAMPAIGN | V1.00 | IMG | |||
| DA 4909 | ARMY FLYING ACTIVITY ANNUAL STATUS REPORT | V1.01 | XFDL | FF22 | ||
| DA 4916 | CERTIFICATE OF SERVICE/ATTEMPTED SERVICE | V1.00ES | XFDL | FF22 | FF99 | |
| DA 4917 | ADVICE AS TO APPELLATE RIGHTS | V1.00ES | XFDL | FF22 | FF99 | |
| DA 4918 | PETITION FOR GRANT OF REVIEW IN THE UNITED STATES COURT OF APPEALS FOR THE ARMED FORCES | V1.00ES | XFDL | FF22 | FF99 | |
| DA 4919 | REQUEST FOR FINAL ACTION | V1.00ES | XFDL | FF22 | FF99 | |
| DA 4922 | CHAPLAINS' FUND GENERAL LEDGER | V1.00 | XFDL | FF22 | FF99 | |
| DA 4922-1 | CHAPLAINS' FUND GENERAL LEDGER (CONTINUATION) | V1.00 | XFDL | FF22 | FF99 | |
| DA 4923 | CHAPLAINS' FUND CHARGE PURCHASE REQUEST MEMORANDUM RECORD | V1.00 | XFDL | FF22 | FF99 | |
| DA 4924 | CHAPLAINS' FUND PROPERTY RECORD | V1.00 | XFDL | FF22 | FF99 | |
| DA 4925 | CHAPLAINS' FUND STATEMENT OF ASSETS | V1.00 | XFDL | FF22 | FF99 | |
| DA 4926 | CHAPLAINS' FUND ANNUAL SUMMARY FINANCIAL DATA REPORT | V1.00 | XFDL | FF22 | FF99 | |
| DA 4927-R | PHYSICIANS COMPARABILITY ALLOWANCE SERVICE AGREEMENT | V2.00 |