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Sworn Statement (DA2823). Prepare a DA Form 2823 (Sworn Statement). ACTION:. Given a requirement to conduct an interview, and blank Department of the Army (DA) Forms 2823 (Sworn Statement). CONDITIONS :. DA Form 2823 must be complete, concise, and with corrected errors. STANDARDS:.

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Sworn Statement (DA2823)

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Sworn statement da2823

Sworn Statement (DA2823)


Sworn statement da2823

Prepare a DA Form 2823 (Sworn Statement)

ACTION:

Given a requirement to conduct an interview, and blank Department of the Army (DA) Forms 2823 (Sworn Statement).

CONDITIONS:

DA Form 2823 must be complete, concise, and with corrected errors.

STANDARDS:


Sworn statement da2823

ADMINISTRATIVE INFORMATION

SAFETY REQUIREMENTS: No Major Considerations

RISK ASSESSMENT LEVEL: Low

ENVIRONMENTAL CONSIDERATIONS: No Major

Considerations


Sworn statement da2823

CAN I USE A PENCIL TO WRITE A SWORN

STATEMENT?

I WITNESSED A MURDER

NO!

Only black ink is authorized.


Sworn statement da2823

ONLY

STATEMENTS WILL

BE ACCEPTED

IN THE FOLLOWING FORMATS:

TYPED, WRITTEN

OR

PRINTED

  • The DA Form 2823 is the permanent record of testimony.


Sworn statement da2823

SWORN STATEMENT

For use of this form, see AR 190-45; the proponent agency is ODCSOPS

LOCATION

DATE

TIME

FILE NUMBER

LAST NAME, FIRST NAME, MIDDLE NAME

SOCIAL SECURITY NUMBER

GRADE/STATUS

ORGANIZATION OR ADDRESS

Personal Data


Sworn statement da2823

Personal Data

PRIVACY ACT STATEMENT

AUTHORITY: Title 10 USC Section 301; Title 5 USC Section 2951; E.O. 9397 dated November 22,1943 (SSN).

PRINCIPAL PURPOSE: To provide commanders and law enforcement officials with means by which information is accurately recorded.

ROUTINE USES: Your social security number is used as an additional/alternate means of identification to facilitate filing and retrieval.

DISCLOSURE: Disclosure of your social security number is voluntary.

THESE TWO BLOCKS WILL BE COMPLETED

WHEN THE AFFIDAVIT IS SWORN TO

DATE

TIME

FILE NUMBER

LOCATION

Ft Leonard Wood, MO

LEAVE BLANK

SOCIAL SECURITY NUMBER

GRADE/STATUS

LAST NAME, FIRST NAME, MIDDLE NAME

123-45-6789

E-2/RA

SNUFFY, Joe Momma

ORGANIZATION OR ADDRESS

Company A, 43d AG BN, Ft Leonard Wood, MO 65473


Sworn statement da2823

I, ______________________ , WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH:

Body of Statement

continued...


Sworn statement da2823

I, ______________________ , WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH:

Body of Statement

First Name, Middle Initial and Last Name

Joe M. Snuffy

On the Legal Statements the questions are provided, just make sure the soldier fully answers all questions or puts unknown.

Any other statement must include the 5 “W” in the narrative. Also ask pertinent questions after narrative.


Sworn statement da2823

STATEMENTS MUST ANSWER THE FOLLOWING:

THE FIVE W’s OF THE CRIME

WHO?

WHY?

WHAT?

WHEN?

WHERE?

AND H

HOW?


Sworn statement da2823

I, ______________________ , WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH:

Always ask this question when closing the statement out.

Joe M. Snuffy

Q.

Do you have anything else you may want to add concerning this matter under investigation?

A. No.///END OF STATEMENT///--------------------------------------

CLOSE STATEMENT

ALWAYS

THREE SLASHES (///) BEFORE THE WORD “END” OF STATEMENT

AND THREE SLASHES(///) AFTER THE WORD “STATEMENT”

continued...


Sworn statement da2823

I, ______________________ , WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH:

WHAT'S WRONG WITH THIS STATEMENT?

Joe M. Snuffy

Q.

What is your room number and building number where the larceny occurred?

SPACE IN BETWEEN

SENTENCES

Room number 15 of building 2401.

A.

OPEN SPACE BETWEEN QUESTIONS

AND ANSWERS

STATEMENT NOT CLOSED OUT

BORDER TO BORDER


Sworn statement da2823

Body of Statement (continued)

  • Either you or the individual completes.

  • Written, printed, or typed from border to border.

  • Narrative, question/answer format, or combination.

  • Contains who, what, where, when, why, and how.

  • Contains all elements of proof.

  • “Do you have anything you wish to add concerning the matter under investigation?”

  • //End of Statement//


Sworn statement da2823

PAGE 1 OF ___ PAGES

INITIALS OF PERSON MAKING

STATEMENT

EXHIBIT

ADDITIONAL PAGES MUST CONTAIN THE HEADING “STATEMENT OF ________ TAKEN AT _____ DATED_____ CONTINUED.”

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, DEC 1998

Exhibit

LEAVE BLANK FOR NOW

LEAVE BLANK

FOR COURT

PURPOSES

DISREGARD THIS STATEMENT!

DA Form 2823, JUL 72, IS OBSOLETE


Sworn statement da2823

Continuation Page

THIS PAGE IS ONLY USED IF THE INTERVIEWEE COMPLETES THE FIRST PAGE AND NEEDS ADDITIONAL PAGES (MORE THAN 2 PAGES.)


Sworn statement da2823

Last Page

(2nd Page of Statement)


Sworn statement da2823

Heading of Last Page

LEAVE BLANK FOR NOW

Joe M. Snuffy

CONTINUATION OF STATEMENT (IF NEEDED)

LEAVE BLANK OTHERWISE


Sworn statement da2823

BEFORE THE INTERVIEWEE SIGNS THE SWORN

STATEMENT HAVE THAT INDIVIDUAL READ HIS

OR HER STATEMENT AND CORRECT ANY ERRORS

BY LINING (SINGLE LINE) THROUGH THE

ERROR. THE CORRECTION WILL BE MADE

ABOVE THE ERROR AND THAT PERSON WILL

INITIAL THE CORRECTION.

NOT YOU

FREEMAN

JMS

PVT FREMAN


Sworn statement da2823

I, ______________________ , WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH:

REQUIRED INITIALS

Joe M. Snuffy

Q.

What is your room number and building number where

the larceny occurred?

2601

JMS

A.

Room number 15 of building 2401.

Q.

Do you have anything else you may want to add

concerning this matter under investigation?

A.

No.///END OF STATEMENT///

JMS


Sworn statement da2823

INITIALS OF PERSON MAKING STATEMENT

PAGE __ OF __ PAGES

DA FORM 2823, DEC 1998

PAGE NUMBER ALL PAGES

1

2

THIS IS THE FIRST

PAGE OF THE

STATEMENT

NEVER

WILL YOU HAVE

PAGE 1 OF 1 PAGES


Sworn statement da2823

INITIALS OF PERSON MAKING STATEMENT

PAGE __ OF __ PAGES

DA FORM 2823, DEC 1998

INITIAL ALL PAGES

1

2

JMS

THIS IS THE FIRST

PAGE OF THE

STATEMENT


Sworn statement da2823

Joe M. Snuffy

2

HAVE THE PERSON READ THE AFFIDAVIT

OR

READ THE AFFIDAVIT OUTLOUD

TO THE INDIVIDUAL

  • JMS

2

2


Sworn statement da2823

ADMINISTER THE OATH

"Do you swear or affirm that the information

given by you in this statement is true and

correct to the best of your knowledge,

so help you God."

(So help you God may be omitted)


Sworn statement da2823

Joe M. Snuffy

2

DATE-COMPLETE MONTH SPELLED OUT

23rd

February

2002

POST AND STATE

Fort Leonard Wood, Missouri

John Q. Somebody, SGT

ARTICLE AUTHORIZING YOU TO

ADMINISTER THE OATH TO MILITARY

PERSONNEL SUBJECT TO THE UCMJ

ART 136 (b) (4) UCMJ

AMP

2

2


Sworn statement da2823

Joe M. Snuffy

2

Joe Momma Snuffy

Soldier’s Full Payroll Signature

23rd

2002

JANUARY

Fort Leonard Wood, Missouri

YOUR SIGNATURE

John Q. Somebody, SGT

ART 136 (b) (4) UCMJ

JMS

2

2


Sworn statement da2823

NOTE!

IMMEDIATELY AFTER THE PERSON MAKING

THE STATEMENT, SIGNS THE STATEMENT,

GO TO THE FIRST PAGE TO COMPLETE

THE DATE AND TIME BLOCK.

THE DATE BLOCK WILL ALWAYS BE A FOUR

DIGIT YEAR (YYYY), TWO DIGIT MONTH (MM),

AND TWO DIGIT DAY (DD). (EXAMPLE: 2002/06/13)

THE TIME BLOCK WILL ALWAYS BE MILITARY

TIME (EXAMPLE: 1605, 0550, 2345)


Sworn statement da2823

FIRST PAGE OF

DA FORM 2823

OBTAIN DATE/TIME AND INITIALS

PRIVACY ACT STATEMENT

AUTHORITY: Title 10 USC Section 301; Title 5 USC Section 2951; E.O. 9397 dated November 22,1943 (SSN).

PRINCIPAL PURPOSE: To provide commanders and law enforcement officials with means by which information is accurately recorded.

ROUTINE USES: Your social security number is used as an additional/alternate means of identification to facilitate filing and retrieval.

DISCLOSURE: Disclosure of your social security number is voluntary.

DATE

TIME

FILE NUMBER

LOCATION

JMS

JMS

Ft Leonard Wood, MO

2105

2002/02/23

GRADE/STATUS

SOCIAL SECURITY NUMBER

LAST NAME, FIRST NAME, MIDDLE NAME

E-2/RA

123-45-6789

SNUFFY, Joe Momma

ORGANIZATION OR ADDRESS

Co A, 43d AG BN, Ft Leonard Wood, MO 65473


Sworn statement da2823

SECOND PAGE (TOP) OF

DA FORM 2823

OBTAIN DATE/TIME AND INITIALS

2105

2002/02/23

Joe M. Snuffy

JMS

JMS

THIS WILL ALWAYS CONTAIN

THE SAME TIME/DATE AS PAGE 1


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