DA Form 4604 – Fill Out and Use This PDF

Updated: Nov 9, 2026

The DA Form 4604, also known as the Security Construction Statement, is a critical document used within the United States Army to certify that a construction project meets the stringent criteria set forth by AR 190-11. It requires detailed information about the facility, including room and building numbers, address, and specifics about whether it involves a new construction, an existing structure, or modification of an existing facility. To ensure your facility complies with the necessary security standards, complete and submit the form by clicking the button below.

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How to Fill Out DA Form 4604

DA Form 4604 at a glance

What it is: DA Form 4604 is the Security Construction Statement.

Who signs: 4. Enter the name of the official in item 7 below, and the grade. 7. Sign under Signature.

What to bring and attach to DA Form 4604

Prepare this form in three copies. The original will be maintained permanently in the files of the individual signing the form. The first copy will be maintained permanently in the using unit/organizational files. The second copy will be filed permanently in the arms/ammunition storage facility. All entries except item 7 will be typewritten.

A filled-in DA Form 4604 example: a new storage facility

DA Form 4604 example filled out, example: a new storage facility — An Army official completes DA Form 4604 for a new storage facility. The facility is new, so boxes a and c stay empty and item 1 lists no exceptions. The picture shows the filled form, and every value in it is made up.

How to fill out DA Form 4604, box by box

1. The construction of this facility conforms

1. The construction of this facility conforms to the criteria of AR 190-11 which is in effect on this date except as indicated hereon.

2. Room and building number, street and installation address

2. Enter the room and building number, street and installation address.

3. This applies to

3. This applies to: a. an existing structure, b. construction of new facility, c. modification of existing facility (Explain).

4. Name of official and grade, 5. Organization and 6. Address of official

4. Enter the name of the official in item 7 below, and the grade.

5. Enter the organization.

6. Enter the address of the official.

7. Signature and date signed

7. Sign under Signature.

Enter the date signed.

Sources

[1] DA Form 4604 (SEP 2006), Security Construction Statement, Department of the Army (the Official source link on this page).

DA Form 4604 PDF Details

The Security Construction Statement certifies that a facility's construction meets the physical security requirements established under AR 190-11, Physical Security of Arms, Ammunition, and Explosives. Commanders, physical security officers, and engineer officers at military installations use this form when completing new construction, renovating an existing structure, or modifying an arms room, ammunition storage area, or sensitive compartmented information facility. Three copies of the completed statement are required: the original stays with the individual who signs the form, the first copy is retained in the using unit or organizational files, and the second copy is filed with the arms or ammunition storage facility associated with the project. All entries on the form, except signatures, must be typewritten.

Who completes the Security Construction Statement

The certifying official must have direct knowledge of the construction project and authority to attest compliance with AR 190-11. This is typically the project engineer officer, the facility commander, or a designated physical security officer. The form requires the official's name, grade, organization, and address, along with a signature and date confirming that the construction conforms to all applicable specifications, except for any deviations explicitly noted on the document. Both the certifying official and the using unit commander may be required to sign depending on the installation's local security directives.

Key information required on the form

Facility room number, building number, and installation address

Street address of the construction site

Type of project: new facility construction, existing structure, or modification of an existing facility

Name, grade, organization, and address of the certifying official

Certification that construction conforms to AR 190-11, with documented notes on any approved deviations

Signature, printed name, and date of the certifying official

Related Army security and construction forms

Army personnel working on facility security compliance often need additional forms alongside the Security Construction Statement. The sworn construction statement is used for civilian construction projects requiring a certified attestation of compliance. For broader facility protection planning, the building security plan form documents ongoing physical security measures for an installation. Army personnel conducting pre-construction hazard reviews use the Army risk assessment form to evaluate potential threats and mitigations before a project begins. Army certificate documentation is also supported through the DA Form 87 Certificate of Achievement, commonly used for administrative personnel records at the same installation level.

Question	Answer
Form Name	DA Form 4604
Form Length	1 page
Fillable?	No
Fillable fields	0
Avg. time to fill out	15 sec
Governing regulation	AR 190-11
Other names	Security Construction Statement, da 4604, da 4604 fillable