Fillable Form DA 2823 - Sworn Statement

What is DA Form 2823?

DA Form 2823 is also known as a Sworn Statement. This form is used and provided by the Department of Army. DA Form 2823 serves to legally document a statement related to criminal activities or acts within the Armed Forces. A Sworn Statement is often used the most in various court proceedings and legal proceedings that require stating facts known to a person regarding a certain case and swearing to them. It is especially helpful at the beginning of case hearings, as it allows court proceedings to continue without the physical presence of a witness.

This form is normally used by Army personnel to register a witness’s evidence or testimony in a precise and structured way, while being guided by the interviewer. This document serves as evidence in a formal investigation or as supporting documentation.

From Army Regulation 190-45:

1. General. DA Form 2823 is used to record written statements of all persons related to reported incidents.
2. Special instructions. DA Form 3881 (Rights Warning Procedure/Waiver Certificate) must be prepared before a sworn statement is taken from a subject or suspect.
3. Distribution. One copy of the statement will be attached to each copy of the related Law Enforcement Report.

DA Form 3881 (Rights Warning Procedure/Waiver Certificate)

1. General. DA Form 3881 is used to provide a standardized, legally sufficient, narrative rights warning for suspects or subjects.
2. Special instructions. This form must accompany a DA Form 2823 when the individual is a subject or suspect of a Law Enforcement Report.
3. Distribution. The DA Form 3881 must accompany each copy of the DA Form 2823. If a subject declines to be questioned, resulting in no DA Form 2823 being prepared, a copy of the DA Form 3881 will accompany each copy of the Law Enforcement Report.

In compliance with the guidelines issued by the Administrative Office of the U.S. Courts, the reverse side of the Central Violations Bureau Form provides the statement of probable cause. This is required by Rule 58(d)(3) of the Federal Rules of Criminal Procedure to support the issuance of a summons or arrest warrant. The statement of probable cause will be printed on the reverse side of the original Central Violations Bureau Form, on all copies of the Central Violations Bureau Form, or as a separate form (such as DA Form 2823). Upon receipt of the probable cause statement by the issuing officer and a finding of sufficient probable cause by the U.S. magistrate judge, bench warrants forwarded by the CVB to the U.S. magistrate judge will then be signed, dated, and issued. If the statement of probable cause has been properly completed by LE personnel, the U.S. magistrate judge can then issue the bench warrant.

How to fill out DA Form 2823?

Provide all the information required and make sure that there are no errors. 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 non-judicial punishment, other administrative disciplinary actions, security clearances, recruitment, retention, placement, and other personnel actions.

Note: Disclosure of SSN and other information is voluntary.

1. Enter the location.
2. Date
   • Year – Month — Day
3. Time
4. File number
5. Last name, First name, Middle name
6. Social Security Number
7. Grade/Status
8. Organization or address.
9. Sworn statement
   • I ( your name) want to make the following statement under oath:
   • Prepare a numbered list of each fact to which you may want to swear on.
10. Exhibit
11. Initials of person making statement

• Indication of how many pages is in the statement
  • Additional pages must contain the heading statement of (name) taken at (location) dated (date).
  • The bottom of each additional page must bear the initials of the person making the statement, and page number must be indicated.

Affidavit

• Name of Person Making Statement
• Statement of how many pages is in the statement.
• Signature of Person Making Statement
• Date of Making Statement
• Location
• Signature of Person Administering Oath
• Typed Name of Person Administering Oath
• Authority to Administer Oaths
• Witnesses
• Organization or address
• Initials of Person Making Statement
• Number of Pages

Where to file DA Form 2823?

The DA 2823 Form is provided on demand, for instance as evidence to legal proceedings or as a supporting document when submitting DA Form 638. A DA 638 form is used by the Department of the Army. This form will be used to recommend a certain soldier for some type of award.

Filing the DA 2823 requires the witness to report his personal information and the report of the proceedings will be included in the Army system of record from where the information can be retrieved by reference to the name or other personal identifiers, the witness will be furnished a Privacy Act Statement. This document will explain to the witness why the information is being collected.

Other forms that might be required are available at the Army Publishing Directorate.