Da Form 4697 PDF Details

In navigating the complexity of managing government property, the Department of the Army relies on detailed procedures to account for its assets, particularly when items are lost, damaged, or destroyed. The DA Form 4697, titled "Report of Survey," plays a pivotal role in this process, serving as the official document used to record and evaluate incidents affecting Army property. Prepared in accordance with AR 735-5, with the Office of the Deputy Chief of Staff for Logistics (ODCSLOG) acting as the proponent agency, this form is comprehensive in its scope. It captures essential data such as the date of preparation, survey number, type of property involved, detailed item descriptions, and the circumstances under which the property was compromised. Furthermore, it delineates the responsibilities and actions of the accountable officers and establishes the need for further investigation or immediate action based on the initial findings. By requiring signatures and affidavits, it ensures accountability and provides a structured approach to handling property discrepancies, whether these involve a simple loss or require a more in-depth inquiry as stipulated by AR 15-6. Ultimately, the DA Form 4697 underscores the Army's commitment to fiscal responsibility and asset management integrity.

QuestionAnswer
Form NameDa Form 4697
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesV3, USAPPC, 40a, QTY

Form Preview Example

 

DEPARTMENT OF THE ARMY

1. DATE PREPARED

2. SURVEY NUMBER

 

REPORT OF SURVEY

 

 

 

 

 

 

 

For use of this form, see AR 735-5;

the proponent agency is ODCSLOG

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. TYPE OF PROPERTY

 

 

4. ADDRESS OF ACCOUNTABLE OFFICER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5. ORIGINATOR (Accountable officer, or primary hand receipt holder)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6.

 

7.

 

 

 

 

8.

 

9.

 

10.

NATIONAL STOCK NUMBER

 

 

 

ITEM DESCRIPTION

 

QTY

 

UNIT PRICE

 

TOTAL COST

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11. DATE AND CIRCUMSTANCES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12.

 

 

 

 

SIGNATURE AND DATE

 

13. Subscribed and sworn to

(or affirmed)

AFFIDAVIT

 

 

 

 

before me at

 

 

 

 

 

 

 

 

 

 

 

I do solemnly swear (or affirm) that (to the best of

 

 

 

 

this

 

day of

 

 

my knowledge and belief)

the articles of public

 

 

TYPED NAME, GRADE, AND SSN

 

NAME AND GRADE (type and sign)

property shown above and/or on attached sheets

 

 

 

 

 

 

 

 

 

 

 

 

 

were lost, destroyed, damaged, or worn out in the

 

 

 

 

 

 

 

 

manner stated, while in the public service.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14. DATE

15. NAME, GRADE, AND SIGNATURE OF ACCOUNTABLE OFFICER

 

 

 

16. DOCUMENT NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

17.

APPOINTING AUTHORITY

 

I have received the evidence pertaining to the lost, damaged, or destroyed property, and have determined that the following action is required.

 

a.

No further investigation is required. There is no positive evidence of negligence. I do not suspect willful misconduct, or

 

deliberate unauthorized use. I hereby forward this document to the approving authority for final action. (Proceed to block 37.)

 

b.

The circumstances surrounding the lost, damaged or destruction warrants further investigation. (Proceed to block 21.)

 

 

c.

Conduct an investigation according to AR 15-6. Attach this document, as an exhibit, to the investigation and forward

 

it to the approving authority.

 

 

 

 

 

 

18.

DATE

 

 

19. TYPED NAME, GRADE, AND TITLE OF APPOINTING AUTHORITY

20. SIGNATURE

 

 

 

 

 

 

DA FORM 4697, SEP 81

DA FORM 4696(TEST), 1 JUL 78 and DA FORM 4697(TEST),

 

1 JUL 78 ARE OBSOLETE.

USAPPC V3.00

21. APPOINTING AUTHORITY

22. STATION

23. DATE

24.

NAME, GRADE OF SURVEYING OFFICER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

25.

YOU ARE APPOINTED SURVEYING OFFICER BY ORDER OF:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Typed name, grade of Appointing Authority)

26.

FINDINGS AND RECOMMENDATION

 

 

 

 

 

 

 

 

 

I have examined all available evidence as shown in exhibits

 

 

to

 

and as indicated below have personally investigated the

 

 

 

 

 

same and it is my belief that the article(s) listed hereon and/or attached to sheets, total cost $

 

 

27.

RECOMMEND PECUNIARY CHARGE

a. ACTUAL LOSS

b. AMOUNT CHARGED

c. LOSS TO GOVERNMENT

28. DATE

29a. TYPED NAME, GRADE OF SURVEYING OFFICER

b. SIGNATURE

30.

I have examined the findings and recommendations of the Surveying Officer on this report of survey and the exhibits

to and desire to make a statement which is attached hereto; do not desire to make a statement. I am aware of my right to legal advice in preparing the statement and, if a pecuniary charge is finally approved, to make appeal and (If an en- listed man) my right to request remission of indebtedness. I am/am not the accountable officer for the lost or damaged property. The property was/was not my personal arms or equipment.

31. DATE

32a. TYPED NAME, GRADE OF INDIVIDUAL BEING CHARGED

b. SIGNATURE

33.RECOMMENDATION BY THE APPOINTING AUTHORITY

CONCUR

NONCONCUR

34. COMMENTS

35. DATE

36a. TYPED NAME, GRADE & TITLE OF APPOINTING AUTH

b. SIGNATURE

37. APPROVING AUTHORITY

 

 

 

 

 

 

a.

REJECTED. Investigation is required. Appoint a survey officer. Date

 

 

Initials

 

 

b.

REJECTED. Investigation incomplete. Additional information required. Date

 

 

Initials

 

 

c. APPROVED BY AUTHORITY OF THE SECRETARY OF THE ARMY.

 

 

 

 

 

 

38.PECUNIARY CHARGE

a. ACTUAL LOSS

b. AMOUNT CHARGED

c. LOSS TO GOVERNMENT

39. DATE

40a. TYPED NAME, GRADE & TITLE OF APPROVING AUTH

b. SIGNATURE

REVERSE, DA FORM 4697, SEP 81

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