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Get DA 2823 1998

DA FORM 2823 DEC 1998 DA FORM 2823 JUL 72 IS OBSOLETE USAPA V1. 00 USE THIS PAGE IF NEEDED. IF THIS PAGE IS NOT NEEDED PLEASE PROCEED TO FINAL PAGE OF THIS FORM. STATEMENT OF 9. STATEMENT Continued INITIALS OF PERSON MAKING STATEMENT PAGE 2 DA FORM 2823 DEC 1998 OF AFFIDAVIT HAVE READ OR HAVE HAD READ TO ME THIS STATEMENT WHICH BEGINS ON PAGE 1 AND ENDS ON PAGE. SWORN STATEMENT For use of this form see AR 190-45 the proponent agency is ODCSOPS AUTHORITY PRINCIPAL PURPOSE ROUTINE USES DISCLOSURE 1. LOCATION PRIVACY ACT STATEMENT Title 10 USC Section 301 Title 5 USC Section 2951 E*O. 9397 dated November 22 1943 SSN. To provide commanders and law enforcement officials with means by which information may be accurately Your social security number is used as an additional/alternate means of identification to facilitate filing and retrieval* Disclosure of your social security number is voluntary. 2. DATE YYYYMMDD 3. TIME 4. FILE NUMBER 5. LAST NAME FIRST NAME MIDDLE NAME 6. SSN 7. GRADE/STATUS 8. ORGANIZATION OR ADDRESS I 10. EXHIBIT WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH 11. INITIALS OF PERSON MAKING STATEMENT PAGE 1 OF ADDITIONAL PAGES MUST CONTAIN THE HEADING STATEMENT TAKEN AT PAGES DATED THE BOTTOM OF EACH ADDITIONAL PAGE MUST BEAR THE INITIALS OF THE PERSON MAKING THE STATEMENT AND PAGE NUMBER MUST BE BE INDICATED. 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 Typed Name of Person Administering Oath Authority To Administer Oaths. SWORN STATEMENT For use of this form see AR 190-45 the proponent agency is ODCSOPS AUTHORITY PRINCIPAL PURPOSE ROUTINE USES DISCLOSURE 1. LOCATION PRIVACY ACT STATEMENT Title 10 USC Section 301 Title 5 USC Section 2951 E*O. 9397 dated November 22 1943 SSN. LOCATION PRIVACY ACT STATEMENT Title 10 USC Section 301 Title 5 USC Section 2951 E*O. 9397 dated November 22 1943 SSN. To provide commanders and law enforcement officials with means by which information may be accurately Your social security number is used as an additional/alternate means of identification to facilitate filing and retrieval* Disclosure of your social security number is voluntary. To provide commanders and law enforcement officials with means by which information may be accurately Your social security number is used as an additional/alternate means of identification to facilitate filing and retrieval* Disclosure of your social security number is voluntary. 2. DATE YYYYMMDD 3. TIME 4. FILE NUMBER 5. LAST NAME FIRST NAME MIDDLE NAME 6. SSN 7. GRADE/STATUS 8. 2. DATE YYYYMMDD 3. TIME 4. FILE NUMBER 5. LAST NAME FIRST NAME MIDDLE NAME 6. SSN 7. GRADE/STATUS 8. ORGANIZATION OR ADDRESS I 10. EXHIBIT WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH 11. INITIALS OF PERSON MAKING STATEMENT PAGE 1 OF ADDITIONAL PAGES MUST CONTAIN THE HEADING STATEMENT TAKEN AT PAGES DATED THE BOTTOM OF EACH ADDITIONAL PAGE MUST BEAR THE INITIALS OF THE PERSON MAKING THE STATEMENT AND PAGE NUMBER MUST BE BE INDICATED. .

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