Da Form 5123 PDF Details

Transitioning within the military involves a complex and detailed process to ensure that Soldiers are properly moved from their current units to their new assignments, maintaining readiness and accountability at every step. Key to this process is the DA Form 5123, the In- and Out-Processing Records Checklist, a critical document mandated by AR 600-8-101 and developed by DCS, G-1, under the authority of Section 301, Title 5, USC. This form serves multiple purposes: it is designed to smooth the transition of Soldiers by making sure that they possess all necessary documents for in- and out-processing, it helps in identifying any legal conditions that might prevent deployment, and it ensures the continuity of information needed for a successful relocation. The DA Form 5123 requires Soldiers and their units to confirm the presence or absence of a broad array of documents ranging from personnel record documents such as Enlisted Record Briefs (ERB) or Officer Record Briefs (ORB), medical and dental records, to personal possession items and critical Soldier information, thus underscoring its extensive use in managing various facets of a Soldier's military life. Failure to accurately complete and disclose the requested information on this form can result in improper in- and out-processing, highlighting its significance in the operational readiness and the personal affairs of those serving. Given its comprehensive scope and the privacy considerations it entails under the Privacy Act of 1974, the DA Form 5123 embodies a vital tool in the administrative framework supporting Soldiers as they transition between assignments, a reflection of the structured approach the military takes to maintain its operational effectiveness and support its personnel.

QuestionAnswer
Form NameDa Form 5123
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namessoldiers dd ensure pdf, out da form fill, da form 5123 1, da mandatory dd

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IN- AND OUT-PROCESSING RECORDS CHECKLIST

For use of this form, see AR 600-8-101; the proponent agency is DCS, G-1.

DATA REQUIRED BY THE PRIVACY ACT OF 1974

AUTHORITY: PRINCIPAL PURPOSE:

ROUTINE USES:

Section 301, Title 5, USC.

To ensure the proper in-processing of Soldiers into their gaining units and the proper out-processing of Soldiers from their losing units.

To ensure that Soldiers have all of the documents for both in- and out-processing and to ensure the identification of certain legal conditions that could preclude Soldiers from deployment, if present, during in- and out-processing. Forms will not be disclosed outside Department of Defense (DoD) and DoD sponsored agencies.

DISCLOSURE: Disclosure of this information is voluntary; however, failure to disclose the requested information could result in improper in- and out-processing.

INSTRUCTIONS

This form will be initiated at the losing unit during out-processing and provided to the Soldier along with the documents listed below. The gaining unit will complete this form by checking for the presence of each document. Confirm whether or not each document is present by checking "Yes" if the document is present and "No" if the document is absent. Prepare this form in two copies: One copy remains at the losing unit, and the Soldier two copies: One copy remains at the losing unit, and the Soldier hand carries the other copy to the gaining unit.

1.NAME (Last, First, Middle)

2. RANK

3. MOS/AOC

 

OUT-PROC

 

IN-PROC

4. REQUIRED RECORDS, DOCUMENTS, OR OTHER ITEMS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YES NO

 

YES NO

A. PERSONNEL RECORD DOCUMENTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Enlisted Record Brief (ERB) or Office Record Brief (ORB).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Promotion board proceedings.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DA Form 268 (Report to Suspend Favorable Action (FLAG)).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DA Form 78-R (Recommendation for Promotion to 1LT/CW2).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DA Form 31 (Request and Authority for Leave), original copy.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Service member deployment history out-processing verification sheet.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DD Form 93 (Record of Emergency Data).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VA Form SGLV 8286A (Family coverage election and certificate).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Go Army Ed (Army Continuing Education System (ACES) Record).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DA Form 3068-1 (Marine Service Record).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DA Label 164

(Nuclear/Chemical Personnel Record Label) . Mandatory for all Soldiers being reassigned to

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

duty positions in the PRP/CPRP.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DA Form 3645 (Organizational Clothing and Individual Equipment Record).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DA Form 3180

(Personnel Screening and Evaluation) . Mandatory for Soldiers assigned to projected for assignment

 

 

 

 

 

 

 

 

 

 

to PRP or CPRP positions, Soldiers holding a nuclear or chemical related MOS or AOC and Soldiers who have been

 

 

 

 

 

 

 

 

 

 

disqualified from PRP or CPRP assignment. Note: Ensure that a copy is filed in the Medical Record (DA Form 3444

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

series).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DA Form 3955 (Change of Address and Directory Card).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DDForm 1172-2 (Application for Identification Card-DEERS Enrollment) . Ensure the currency and accuracy of

application (s) for eligible Family member (s). Changes in Family member status should be reported to the MPD/S1 for appropriate Defense Enrollment Eligibility Reporting System (DEERS) maintenance processing and/or ID card issue, if applicable, as prescribed by AR 600-8-14.

DA FORM 5123, FEB 2015

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OUT-PROC

 

IN-PROC

4. REQUIRED RECORDS, DOCUMENTS, OR OTHER ITEMS

 

YES NO

 

YES NO

a. PERSONNEL RECORD DOCUMENTS (Continued)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DA Form 1306 (Statement of Jump and Loading Manifest) . Mandatory for all Soldiers holding MOS 92R or an SQI

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

or ASI indicating jump qualification.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DA Form 1307

(Individual Jump Record) . Mandatory for all Soldiers holding MOS 92R or an SQI or ASI

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

indicating jump qualification.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DA Form 1315

(Reenlistment Data) . Mandatory for Soldiers in the ranks of SSG and below.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DA Form 3078 (Personal Clothing Request).

DA Form 330 (Language Proficiency Questionnaire).

A copy of the following must be present as evidence that an investigation or final clearance has been requested

(listed in precedence).

SF Form 86 (Questionnaire for National Security Positions).

DA Form 5305 (Family Care Plan).

DA Form 3513 (Individual Flight Records Folder, United States Army). Mandatory for Soldiers holding PMOS,

AOC, SSI, SQI, or ASI requiring flight.

DA Form 3479-1 (Trainee Controller Evaluation). Mandatory for all Soldiers who perform duties described in TC 3-04.81.

DD Form 2366 (Montgomery GI Bill Act of 1984 (MGIB)).

DA Form 348 (Equipment Operator's Qualification Record (Except Aircraft)) . Mandatory for all Soldiers who are qualified to operate an Army vehicle other than full track combat vehicles or hold an MOS/AOC requiring the operation of an Army motor vehicle other than full track combat vehicles.

DD Form 2648 (Preseparation Counseling Checklist).

b.HEALTH AND DENTAL RECORDS

DD Form 2795 (Pre-Deployment Health Assessment Questionnaire) . Required for all Soldiers being

reassigned or deployed overseas.

DD Form 2766 (Adult Preventive and Chronic Care Flowsheet).

DA Form 3444 series (Dental Record).

Medical Protection System (MEDPROS) individual medical readiness (IMR) report.

DA Label 162 (Emergency Medical Identification Symbol). Mandatory for all Soldiers issued a medical warning tag.

SF Form 601 (Health Record - Immunization Record). Cross check against MEDPROS.

Anthrax Vaccine Immunization Program (AVIP) status. MEDPROS.

DA Form 4515 (Personnel Reliability Program Record Identifier). Mandatory for all Soldiers assigned or projected for assignment to PRP positions.

DA Form 3349 (e-profile). Cross check against DD Form 2795 for evidence of a physical profile.

NOTE: Electronically generate hand written not authorized.

MOS Administrative Retention Review(MAR2 processing). Mandatory for all Soldiers who have a permanent physical profile category of 3 or 4. NOTE: Must be electronically generate.

HIV screening. Check DD Form 2795 or medical records.

DA FORM 5123, FEB 2015

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OUT-PROC

 

 

IN-PROC

 

4. REQUIRED RECORDS, DOCUMENTS, OR OTHER ITEMS

 

 

 

 

 

 

 

 

 

 

YES

 

 

NO

 

 

YES

NO

 

b. HEALTH AND DENTAL RECORDS (Continued)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Body Composition Program documents.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Army Substance Abuse Program (ASAP).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DNA collection records.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

c. SOLDIER'S PERSONAL POSSESSION ITEMS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DD Form 2S (Res) (Armed Forces of the United States Geneva Conventions Identification Card). Ensure that the

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

information on the ID card is current and accurate.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Common Access Card (CAC). Ensure that the information on the CAC is current and accurate.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DA Form 31 (Request and Authority for Leave). Individual copy.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Travel/itinerary. Mandatory only for all Soldiers traveling over water.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PHS Form 731 (International Certificate of Vaccination). Cross check against the SF Form 601.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Eyeglasses (2 pairs each). Cross check against the MEDPROS.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Protective mask inserts. Cross check against the MEDPROS.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Identification tags (2 each).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hearing aids with extra batteries. Cross check against the MEDPROS.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medical warning tag. Mandatory for Soldiers with DA Label 162 affixed to the health and dental records.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Passport and/or visa, if required.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NATO travel orders. Mandatory for all Soldiers assigned to or traveling through a country identified as having this

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

requirement in the Foreign Service Guide.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reassignment order.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

d. CRITICAL SOLDIER INFORMATION ITEMS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is the Soldier a sole surviving son or daughter?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is the Soldier a citizen of the Federal Republic of Germany?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is the Soldier a citizen of Turkey or a dual U.S./Turkish national?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is the Soldier a former prisoner of war or hostage? If yes, list the country or countries where the Soldier was held

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

captive.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is the Soldier a former Peace Corps member? If Yes, list the country or countries where Peace Corps service

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

was performed.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Does the Soldier have a pending or approved request for noncombatant status as a conscientious objector per

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AR 600-43?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is the Soldier pregnant?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Has the Soldier given birth within the last 6 months?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Has the Soldier been awarded adoption placement within the last 6 months?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If enlisted, has the Soldier completed initial entry training?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If a warrant officer, has the Soldier completed the Warrant Officer Basic Course, and is the Soldier MOS qualified?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If a commissioned officer, has the Soldier completed an Army Officer Basic Course?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DA FORM 5123, FEB 2015

 

Page 3 of 3

APD LC v1.01

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