DA Form 2765-1 PDF Details

For use of this form, see AR 710-4.

Proponent agency: the proponent agency is DCS, G-4.

Edition: previous editions are obsolete.

Cost detail: unit price and total price.

QuestionAnswer
Form NameDA Form 2765-1
Form Length1 page
Fillable?Yes
Fillable fields131
Avg. time to fill out22 min
EditionDEC 2023
Use of this formSee AR 710-4
Proponent agencyDCS, G-4
Matches the agency's fileYes, checked October 12, 2026
Other namesDA Form 2765-1, DA 2765-1, DA2765-1, 2765-1, Request for Issue or Turn-In
Issuing authorityDepartment of the Army
Governing regulationAR 710-4
Form purposeRequest for Issue or Turn-In
Privacy ActNot stated on the form
Official sourceDA Form 2765-1 (Rev DEC 2023),

How to Fill Out DA Form 2765-1

DA Form 2765-1 at a glance

What it is: DA Form 2765-1 is the Request for Issue or Turn-in.

Who signs: Sign in the Signature box.

A filled-in DA Form 2765-1 example: a soldier requests one funded item

DA Form 2765-1 example filled out, example: a soldier requests one funded item
Sergeant Jane Sample fills out DA Form 2765-1 to request one item. The item is funded and Exp, so Non-Funded and Non-Exp stay empty. The Signature group is left blank because the picture does not fill it, so Signature stays empty. The picture shows the entries; every value in it is made up.

How to fill out DA Form 2765-1, box by box

Item description and publication data

DA Form 2765-1 example filled out, item description and publication data

Enter the Item Description and the Publication Data.

Funded, Non-Funded, Exp and Non-Exp

DA Form 2765-1 example filled out, funded, Non-Funded, Exp and Non-Exp

The form has the boxes Funded and Non-Funded, and the boxes Exp and Non-Exp.

Signature

DA Form 2765-1 example filled out, signature

Sign in the Signature box.

More rules for DA Form 2765-1

For use of this form, see AR 710-4. The proponent agency is DCS, G-4.

Enter the Cost Detail Account Number, the Unit Price and the Total Price.

Sources

[1] DA Form 2765-1 (DEC 2023), Request for Issue or Turn-in, U.S. Army (the Official source link on this page).

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