Department of the Army (DA) Forms -- Complete Listing
Page 9 of 12: DA 5443
thru DA 5799
(1-2-3-4-5-6-7-8-10-11-12)
Also See our List of Commonly Used DA and DD Forms
| Form No. | Title | Version | XFDL | FF22 | FF99 | |
| DA 5447-R | OFFICER SERVICE AGREEMENT SELECTED RESERVE EDUCATIONAL ASSISTANCE PROGRAM (SHORT TITLE: MONTGOMERY GI BILL) | V1.00 | XFDL | FF22 | FF99 | |
| DA 5448-R | MOISTURE & DENSITY TESTER FIELD DATA WORKSHEET | V1.00 | XFDL | FF22 | FF99 | |
| DA 5450-R | MOISTURE & DENSITY FIELD TEST SHEET | V1.00 | XFDL | FF22 | FF99 | |
| DA 5454 | REQUEST FOR ARMY/AMERICAN COUNCIL ON EDUCATION REGISTRY TRANSCRIPT | V1.00 | XFDL | FF22 | ||
| DA 5456 | WATER POINT INSPECTION | V1.00 | XFDL | FF22 | ||
| DA 5457 | POTABLE WATER CONTAINER INSPECTION | V1.00 | XFDL | FF22 | ||
| DA 5458 | SHOWER/DECONTAMINATION POINT INSPECTION | V1.00 | XFDL | FF22 | ||
| DA 5459 | AUTHORIZATION TO RELEASE INFORMATION FROM ARMY RECORDS ON NONSUPPORT/CHILD CUSTODY/PATERNITY INQUIRIES | V1.00 | XFDL | FF22 | FF99 | |
| DA 5462 | TIP ALLOCATION WORKSHEET | V1.00 | XFDL | FF22 | FF99 | |
| DA 5462-1 | CONTINUATION OF TIP ALLOCATION WORKSHEET | V1.00 | XFDL | FF22 | FF99 | |
| DA 5463-R PDF ONLY | PETROLEUM PRODUCTS TANK FARM OUTTURN RECORD | |||||
| DA 5464-R PDF ONLY | PETROLEUM PRODUCTS PIPELINE LEAKAGE REPORT | |||||
| DA 5467-R | CIVILIAN CLEARANCE RECORD | V1.00 | XFDL | FF22 | ||
| DA 5468-R | EXIT QUESTIONNAIRE | V1.00 | FF22 | FF99 | ||
| DA 5472-R | COMPUTER'S RECORD (MPI) | V1.00 | FF22 | FF99 | ||
| DA 5473-R | PERFORMANCE REQUIREMENTS SUMMARY | V1.00 | XFDL | FF22 | FF99 | |
| DA 5475-R | COR/QAE SURVEILLANCE SCHEDULE | V1.00 | XFDL | FF22 | FF99 | |
| DA 5476-R | SURVEILLANCE ACTIVITY CHECKLIST | V1.00 | XFDL | FF22 | FF99 | |
| DA 5477-R | CUSTOMER COMPLAINT RECORD | V1.01 | XFDL | FF22 | FF99 | |
| DA 5478-R | DECISION TABLE | V1.00 | XFDL | FF22 | FF99 | |
| DA 5479-R | CONTRACT DISCREPANCY REPORT | V1.01 | XFDL | FF22 | FF99 | |
| DA 5480 | MAINTENANCE REQUEST AND ASSIGNMENT REGISTER | V1.00 | XFDL | FF22 | FF99 | |
| DA 5481-R | TALLY CHECKLIST | V1.00 | XFDL | FF22 | FF99 | |
| DA 5484 | MISSION SCHEDULE/BRIEF | V1.00 | XFDL | FF22 | ||
| DA 5500 | BODY FAT CONTENT WORKSHEET (MALE) | V1.00 | XFDL | FF22 | ||
| DA 5501 | BODY FAT CONTENT WORKSHEET (FEMALE) | V1.00 | XFDL | FF22 | ||
| DA 5511 | PERSONAL WEIGHT LOSS PROGRESS | V1.00 | XFDL | FF22 | ||
| DA 5512 | RESPITE CARE AGREEMENT | V1.00ES | XFDL | FF22 | FF99 | |
| DA 5513 | KEY CONTROL REGISTER AND INVENTORY | V1.00 | XFDL | FF22 | ||
| DA 5514-R | TAMIS TRAINING AMMUNITION FORECAST REPORT | V2.01ES | XFDL | FF22 | FF99 | |
| DA 5515 | TRAINING AMMUNITION CONTROL DOCUMENT | V1.01 | XFDL | FF22 | FF99 | |
| DA 5515-1 | TRAINING AMMUNITION CONTROL DOCUMENT CONTINUATION SHEET | V1.01 | XFDL | FF22 | FF99 | |
| DA 5517-R | STANDARD RANGE CARD | V1.01 | XFDL | FF22 | FF99 | |
| DA 5517-R IMAGE FILE | STANDARD RANGE CARD | V1.01 | IMG | |||
| DA 5519-R | TOOL SIGN OUT LOG/REGISTER | V1.00 | XFDL | FF22 | FF99 | |
| DA 5520 | PHYSICAL AND DENTAL COMPARISON CHART | V1.00 | XFDL | FF22 | FF99 | |
| DA 5521 | RECORD OF EMERGENCY DATA AND DESIGNATION OF BENEFICIARY FOR UNPAID COMPENSATION OF DECEASED NAF EMPLOYEE | V2.02ES | XFDL | FF22 | FF99 | |
| DA 5533 | SMART/TIPS SUGGESTION FORM | V1.00 | XFDL | FF22 | FF99 | |
| DA 5536-R | AGREEMENT HEALTH PROFESSIONALS LOAN REPAYMENT (HPLR) | V1.00 | XFDL | FF22 | FF99 | |
| DA 5548-1-R | UNIT CLIMATE PROFILE (UCP) | V1.00 | XFDL | FF22 | FF99 | |
| DA 5548-R | UNIT CLIMATE PROFILE QUESTIONNAIRE | V1.00 | XFDL | FF22 | FF99 | |
| DA 5550-R | SPIROMETER CALIBRATION LOG | V1.00 | XFDL | FF22 | FF99 | |
| DA 5551-R | SPIROMETRY FLOW SHEET | V1.00 | XFDL | FF22 | FF99 | |
| DA 5556 | PERSONNEL REQUIREMENTS DOCUMENT | V1.00 | XFDL | FF22 | FF99 | |
| DA 5557 | INDIVIDUAL RELIABILITY SCREENING AND EVALUATION RECORD | V1.00 | XFDL | FF22 | ||
| DA 5560 | NO SMOKING EXCEPT IN DESIGNATED SMOKING AREAS | V1.00 | ||||
| DA 5560-1 | DESIGNATED SMOKING AREA | V1.00 | ||||
| DA 5561-R PDF ONLY | WAITING LIST | |||||
| DA 5562-1-R PDF ONLY | NEEDS ASSESSMENT METHODOLOGY | |||||
| DA 5562-R | CHILD DEVELOPMENT SERVICES NEEDS ASSESSMENT | V2.00 | XFDL | FF22 | FF99 | |
| DA 5563-R PDF ONLY | DEMOGRAPHIC PROFILE | |||||
| DA 5568 | CHRONOLOGICAL RECORD OF WELL-BABY CARE | V1.00 | XFDL | FF22 | FF99 | |
| DA 5569 | ISONIAZID (INH) CLINIC FLOW SHEET | V2.00 | XFDL | FF22 | FF99 | |
| DA 5572-R | GIFT AGREEMENT | V1.00 | XFDL | FF22 | FF99 | |
| DA 5573-R | LOAN AGREEMENT | V1.00 | XFDL | FF22 | FF99 | |
| DA 5574-R | ASSURANCE OF COMPLIANCE | V1.00 | XFDL | FF22 | FF99 | |
| DA 5575-R | LOAN AGREEMENT (OUTGOING) | V1.00 | XFDL | FF22 | FF99 | |
| DA 5582-R | ATACMS MISSILE/MLRS PRACTICE ROCKET FIRING DATA REPORT (REPORT___OF___FOR THIS MISSION) | V1.00 | XFDL | FF22 | FF99 | |
| DA 5583 | MISSILE FIRING DATA REPORT (HELLFIRE) | V1.01 | XFDL | FF22 | ||
| DA 5584-R | VEHICLE FORECAST AND MOVEMENT SCHEDULE | V1.00 | XFDL | FF22 | FF99 | |
| DA 5585 | ADDENDUM TO CERTIFICATE OF ACKNOWLEDGEMENT OF SERVICE REQUIREMENTS (DA FORM 3540) FOR ENLISTMENT INTO THE US ARMY RESERVE TROOP PROGRAM UNIT WARRANT OFFICER FLIGHT PROGRAM | V1.00 | XFDL | FF22 | ||
| DA 5586 | ADDENDUM TO CERTIFICATE OF ACKNOWLEDGEMENT OF SERVICE REQUIREMENT FOR ENLISTMENT INTO THE UNITED STATES ARMY RESERVE OFFICER CANDIDATE SCHOOL ENLISTMENT OPTION | V1.00 | XFDL | FF22 | ||
| DA 5587 | REPORT OF DRYDOCKING, PAINTING AND CONDITION OF VESSEL BOTTOM (FROM KEEL TO TOP OF BOOT TOP LINE) | V1.00 | XFDL | FF22 | FF99 | |
| DA 5605-1-R PDF ONLY | LIFE CYCLE COST ANALYSIS | |||||
| DA 5605-2-R | LIFE CYCLE COST ANALYSIS SUMMARY | V1.00 | XFDL | FF22 | FF99 | |
| DA 5605-3-R | LIFE CYCLE COST ANALYSIS BASIC INPUT DATA SUMMARY | V1.00 | XFDL | FF22 | FF99 | |
| DA 5605-4-R | LIFE CYCLE COST ANALYSIS PRESENT WORTH: COVENTIONAL APPROACH | V1.00 | XFDL | FF22 | FF99 | |
| DA 5605-5-R | LIFE CYCLE COST ANALYSIS | V1.00 | XFDL | FF22 | FF99 | |
| DA 5614-R PDF ONLY | SUPERINTENDENT'S TELEGRAPHIC REPORT OF ACCIDENT | |||||
| DA 5615-R PDF ONLY | SET OUT REPORT | |||||
| DA 5616-R PDF ONLY | CAR INSPECTOR'S TRAIN REPORT | |||||
| DA 5617-R PDF ONLY | DAILY STATEMENT OF CARS ON HAND | |||||
| DA 5618-R PDF ONLY | CONDUCTOR'S WHEEL REPORT | |||||
| DA 5619-R PDF ONLY | DAILY EMPTY CAR SITUATION REPORT | |||||
| DA 5620-R | DAILY INSTALLATION SITUATON REPORT | V1.01 | XFDL | FF22 | FF99 | |
| DA 5621-R | LEAKAGE CURRENT MEASUREMENTS, GENERAL | V1.00 | XFDL | FF22 | FF99 | |
| DA 5622-R | LEAKAGE CURRENT MEASUREMENTS, EKG | V1.00 | XFDL | FF22 | FF99 | |
| DA 5622-R IMAGE FILE | LEAKAGE CURRENT MEASUREMENTS, EKG | V1.00 | IMG | |||
| DA 5624-R | DC DEFIBRILLATOR INSPECTION RECORD | V1.01 | XFDL | FF22 | ||
| DA 5627-R | CASH, PROPERTY AND RECONCILIATION RECORD | V1.00 | XFDL | FF22 | FF99 | |
| DA 5628-R PDF ONLY | VOUCHER FOR SPECIAL MISSION FUNDS (SMF) EXPENDITURES | |||||
| DA 5642-R | STATEMENT OF UNDERSTANDING AND SELECTED RESERVE SERVICE AGREEMENT BASIC EDUCATIONAL ASSISTANCE ENTITLEMENT FOR SERVICE IN THE SELECTED RESERVE (SHORT TITLE: (MONTGOMERY GI BILL 2X4 PROGRAM) | V1.01 | XFDL | FF22 | FF99 | |
| DA 5643-R | PHYSICAL DEMANDS ANALYSIS WORKSHEET | V2.00 | XFDL | FF22 | FF99 | |
| DA 5645-B-R | MANEUVER/PROCEDURE GRADE SLIP FOR OH-58D AEROSCOUT OBSERVERS | V1.00 | XFDL | FF22 | FF99 | |
| DA 5646-R | STATEMENT OF CONDITIONS OF SERVICE - ACTIVE GUARD RESERVE (AGR) | V1.00 | XFDL | FF22 | FF99 | |
| DA 5647-R PDF ONLY | STATEMENT OF CONDITIONS OF SERVICE - ACTIVE GUARD RESERVE (AGR) ACTIVE TRANSFER/CONVERSION ARMY RESERVE (ATCAR) | |||||
| DA 5648-R | AGR JOB AUTHORIZATION (REQUEST/CHANGE) | V1.00 | XFDL | FF22 | FF99 | |
| DA 5651 | MESSAGE CONTROL LOG | V3.00 | XFDL | FF22 | FF99 | |
| DA 5651-1 | TERMINATING MESSAGE REGISTER | V2.00 | XFDL | FF22 | FF99 | |
| DA 5661 | DATA INTERCHANGE OF SUPPORT EQUIPMENT DATA | V1.00 | XFDL | FF22 | FF99 | |
| DA 5662 | DATA INTERCHANGE SUMMARY | V1.00 | XFDL | FF22 | FF99 | |
| DA 5666 | GAINING COMMAND FIELDING EVALUATION | V1.00 | XFDL | FF22 | FF99 | |
| DA 5667-R PDF ONLY | MANEUVER/PROCEDURE GRADE SLIP FOR CH-47 CREW MEMBERS | |||||
| DA 5669 | PREVENTIVE MEDICINE COUNSELING RECORD | V1.00 | XFDL | FF22 | ||
| DA 5671 | PARENTAL PERMISSION | V 1.00 | XFDL | FF22 | FF99 | |
| DA 5672-R | MEAL CARD CONTROL BOOK LOG | V1.00 | XFDL | FF22 | FF99 | |
| DA 5677-R PDF ONLY | POLICY STATEMENT AND MEMORANDUM OF UNDERSTANDING FOR REVIEW AND RECEIPT OF R&D DOCUMENTS | |||||
| DA 5678-R | POLICY STATEMENT AND MEMORANDUM OF UNDERSTANDING FOR PARTICIPATION IN THE U.S. ARMY POTENTIAL CONTRACTOR PROGRAM | V1.00 | XFDL | FF22 | FF99 | |
| DA 5679-R PDF ONLY | POLICY STATEMENT AND STUDY AGREEMENT FOR PARTICIPATION IN THE U.S. ARMY R&D UNFUNDED STUDY PROGRAM | |||||
| DA 5680 | MATERIEL FIELDING TEAM AFTER ACTION REPORT | V1.00 | XFDL | FF22 | FF99 | |
| DA 5681 FILE 1/2 | COORDINATION CHECKLIST AND REPORT | V1.00 | XFDL | FF22 | FF99 | |
| DA 5681 FILE 2/2 | COORDINATION CHECKLIST AND REPORT | V1.00 | FF22 | FF99 | ||
| DA 5682 | MATERIEL REQUIREMENTS LIST | V1.00 | XFDL | FF22 | FF99 | |
| DA 5684 | JOINT INVENTORY REPORT | V1.00 | XFDL | FF22 | FF99 | |
| DA 5685-R | NEW SPECIALIZED TRAINING ASSISTANCE PROGRAM (NEW STRAP) SERVICE AGREEMENT | V2.00 | XFDL | FF22 | FF99 | |
| DA 5690-R | RESERVE COMPONENTS CAREER COUNSELOR INTERVIEW RECORD | V1.00 | XFDL | FF22 | FF99 | |
| DA 5691-R | REQUEST FOR RESERVE COMPONENT ASSIGNMENT ORDERS | V1.00 | XFDL | FF22 | ||
| DA 5692-R | AMMUNITION CONSUMPTION CERTIFICATE | V1.01 | XFDL | FF22 | FF99 | |
| DA 5695 | INFORMATION MANAGEMENT REQUIREMENT/PROJECT DOCUMENT | V1.00 | XFDL | FF22 | FF99 | |
| DA 5696-1-R | INSTALLATION WORK CENTER SUMMARY | V2.00 | XFDL | FF22 | FF99 | |
| DA 5696-2-R | WORK CENTER STANDARD COMPUTATION | V1.10 | XFDL | FF22 | FF99 | |
| DA 5696-3-R | ADDITIVE/EXCLUSION/DEVIATION COMPUTATION | V1.10 | XFDL | FF22 | FF99 | |
| DA 5696-4-R | WORKLOAD FACTOR/MAN-HOUR COLLECTION | V2.00 | XFDL | FF22 | FF99 | |
| DA 5696-5-R | MANPOWER EXCEPTION | V2.00 | XFDL | FF22 | FF99 | |
| DA 5696-6-R | MANPOWER GRADE & SKILL DISTRIBUTION SUMMARY | V1.10 | XFDL | FF22 | FF99 | |
| DA 5696-R | STANDARDS APPLICATION SUMMARY | V2.00 | XFDL | FF22 | FF99 | |
| DA 5697 | VISUAL INFORMATION (VI) ACTIVITY AUTHORIZATION RECORD | V1.00 | XFDL | FF22 | FF99 | |
| DA 5698-R | WEAPON LOCATION DATA | V1.00 | XFDL | FF22 | FF99 | |
| DA 5701-228-R | OH-58A/C PERFORMANCE PLANNING CARD | V1.00 | XFDL | FF22 | ||
| DA 5701-47-R | CH-47 PERFORMANCE PLANNING CARD | V1.00 | FF22 | |||
| DA 5701-58-R | OH 58-D PERFORMANCE PLANNING CARD | V1.00 | XFDL | FF22 | ||
| DA 5701-60-R | H-60 PERFORMANCE PLANNING CARD | V1.00 | FF22 | |||
| DA 5701-64-R | AH-64 PERFORMANCE PLANNING CARD | V1.00 | XFDL | FF22 | FF99 | |
| DA 5704-R | ALTERNATE PISTOL QUALIFICATION COURSE SCORECARD | V1.00 | XFDL | FF22 | ||
| DA 5706-R | TRACK BULLETIN | V1.00 | XFDL | FF22 | FF99 | |
| DA 5748-R | SHIPMENT UNIT PACKING LIST AND LOAD DIAGRAM | V1.00 | XFDL | FF22 | FF99 | |
| DA 5750 | INADVERTENT DISCLOSURE OATH | V1.00 | XFDL | FF22 | FF99 | |
| DA 5752-R | ROPE LOG (USAGE AND HISTORY) | V1.01 | XFDL | FF22 | FF99 | |
| DA 5754 | MALPRACTICE HISTORY AND CLINICAL PRIVILEGES QUESTIONNAIRE | V1.00 | XFDL | FF22 | FF99 | |
| DA 5755 | CONSIGNMENT AGREEMENT (NONAPPROPRIATED FUNDS) | V1.00 | XFDL | FF22 | FF99 | |
| DA 5755-1 | CONSIGNMENT CONTROL SHEET | V1.00 | XFDL | FF22 | FF99 | |
| DA 5756 | CONCESSIONAIRE CONTRACT - SHORT TERM (NONAPPROPRIATED FUNDS) | V1.00 | XFDL | FF22 | FF99 | |
| DA 5760-R | CHILD DEVELOPMENT SERVICES (CDS) MANAGEMENT PERSONNEL, CUMULATIVE INDIVIDUAL EDUCATION PLAN (IEP) TRAINING RECORD | V1.10 | XFDL | FF22 | FF99 | |
| DA 5761-1-R | FAMILY CHILD CARE (FCC) RISK ASSESSMENT TOOL OBSERVATION SUMMARY | V2.00 | XFDL | FF22 | FF99 | |
| DA 5761-2-R | FAMILY CHILD CARE (FCC) RISK ASSESSMENT TOOL INTERVIEW SUMMARY | V2.00 | XFDL | FF22 | FF99 | |
| DA 5761-3-R | FAMILY CHILD CARE (FCC) RISK ASSESSMENT TOOL REPORT | V2.00 | XFDL | FF22 | FF99 | |
| DA 5761-R | FAMILY CHILD CARE (FCC) RISK ASSESSMENT TOOL OBSERVATION | V1.10 | XFDL | FF22 | FF99 | |
| DA 5762-R PDF ONLY | FAMILY CHILD CARE (FCC) PROVISIONAL CERTIFICATION RECORD OPERATIONAL REQUIREMENTS | |||||
| DA 5763-R | CHILD DEVELOPMENT SERVICES (CDS) INDIVIDUAL EDUCATION PLAN (IEP), FAMILY CHILD CARE (FCC) PROVISIONAL CERTIFICATION TRAINING RECORD | V2.00 | XFDL | FF22 | FF99 | |
| DA 5766 | CHAPLAINS' FUND VOUCHER | V1.00 | XFDL | FF22 | FF99 | |
| DA 5785-R PDF ONLY | SNIPER'S OBSERVATION LOG | |||||
| DA 5786-R PDF ONLY | SNIPER'S RANGE CARD | |||||
| DA 5787-R PDF ONLY | MILITARY SKETCH | |||||
| DA 5788-R PDF ONLY | SNIPER'S DATA CARD | |||||
| DA 5789-R | RECORD FIRING SCORECARD * KNOWN DISTANCE COURSE | V1.00 | XFDL | FF22 | FF99 | |
| DA 5790-R | RECORD FIRING SCORECARD *SCALED TARGET ALTERNATE COURSE | V1.00 | XFDL | FF22 |
Page 9 of 12: DA 5443
thru DA 5799
(1-2-3-4-5-6-7-8-10-11-12)
Also See our List of Commonly Used DA and DD Forms
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