In times of conflict or military service, the unfortunate reality is that individuals may find themselves missing or in worse cases, deceased. For such solemn instances, a crucial process is initiated, one that involves thorough documentation, part of which includes the DA Form 1155. This document serves a vital role in recording the circumstances and details surrounding servicemen and women who are classified as missing, injured, captured, detained or deceased. By meticulously capturing information ranging from personal identifiers like the individual's name, service number, and Social Security Number to more detailed data concerning the geographical location and condition of the individual at the time they were last seen, the form plays an essential part in military record-keeping. Additionally, it includes sections for the reporting person's details and a narrative of the incident, ensuring that all relevant facts and witness accounts are formally logged. This comprehensive approach aids in providing clarity and closure for the affected service members' families and maintains an accurate historical record. The DA Form 1155 is not just a formality but a critical element in the respectful handling and remembrance of those who serve.
| Question | Answer |
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| Form Name | Da Form 1155 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | da 1155 statement, 1155 witness statement pdf, da 1155, da form witness statement |
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CHECK APPLICABLE BOX |
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WITNESS STATEMENT ON INDIVIDUAL |
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MIS |
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MIA |
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CAP |
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DET |
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(AR |
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DEAD (Remains not recovered) |
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1. LAST NAME - FIRST NAME - MIDDLE INITIAL |
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2. |
SERVICE NO. |
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2A. SSN |
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3. GRADE |
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4. DATE OF DEATH OR WHEN LAST SEEN |
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5. ORGANIZATION |
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6. GEOGRAPHICAL LOCATION (Include grid coordinates |
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and nearby town) |
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7. IF ITEMS 1 AND 2 ARE UNKNOWN OR NOT POSITIVE, COMPLETE ITEMS LISTED BELOW: |
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AGE |
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WEIGHT |
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HEIGHT |
HAIR |
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EYES |
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RACE |
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HOME TOWN |
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CIVILIAN OCCUPATION |
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NICKNAME |
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WAS HE MARRIED? (If so, give wife's name if known) |
DID HE HAVE ANY CHILDREN? (If so, give names if known) |
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OTHER IDENTIFYING MARKS |
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OTHER PERSONS WHO MAY HAVE WITNESSED THIS INCIDENT |
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(such as tattoos or birthmarks) |
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OR HAVE FURTHER INFORMATION |
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DA FORM 1155, 1 JUN 66
REPLACES EDITION OF 1 JUN 61, WHICH WILL BE |
USAPA V1.00 |
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ISSUED AND USED UNTIL EXHAUSTED. |
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8.CIRCUMSTANCES SURROUNDING INCIDENT (If known, include cause of death or condition when last seen, and how identified)
9. NAME OF PERSON MAKING STATEMENT |
10. SERVICE NO./SSN |
11. UNIT |
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12. DATE |
13. SIGNATURE |
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DA FORM 1155, 1 JUN 66 |
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USAPA V1.00 |