DA Form 5811 PDF Details

In the realm of military operations, accountability for equipment, especially ammunition, is of paramount importance. The DA Form 5811-R, known as the Certificate for Lost or Damaged Class 5 Ammunition Items, serves a critical role in maintaining this accountability. Outlined by the Department of the Army Pamphlet 710-2-1, with the Deputy Chief of Staff for Logistics (DCSLOG) as the proponent agency, this form is utilized when Class 5 ammunition items are either lost or damaged. It encompasses a comprehensive certification by the responsible individual, detailing the item's stock number, description, quantity, and the nature of the loss or damage (whether lost or damaged, and if the latter, whether due to negligence). The form further includes a section for action, which requires a review of the incident, a determination on the negligence factor, and the decision on subsequent steps, which could range from no further action to administrative adjustments, repairs, or even initiating a formal report or survey. Capturing precise details of the circumstances and decisions taken ensures a transparent documentation process, essential for operational integrity and accountability within military logistics.

QuestionAnswer
Form NameDA Form 5811
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesda form 5811, 5811 r, da 5811, da form 5811 fillable

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CERTIFICATE - LOST OR DAMAGED CLASS 5 AMMUNITION ITEMS

For use of this form, see DA PAM 710-2-1; the proponent agency is DCSLOG

PART I - CERTIFICATION

I certify that the item(s) described in blocks 1-5 below were as stated. Circumstances of the loss or damage are accurately described below.

1.

STOCK NO.

2.

DESCRIPTION

3.

QUANTITY

4. ITEM WAS (Check)

a. LOST

b. DAM-

 

AGED

 

 

5DAMAGED BY NEGLIGENCE? (Check)

a YES

b NO

 

 

6.CIRCUMSTANCES OF LOSS OR DAMAGE

7a. SIGNATURE

7b. DATE

PART II - ACTION

8. I have reviewed the evidence pertaining to the loss or damage as stated. I agree

do not agree

that the loss or damage to the class 5 item(s) was

was not

due to negligence, willful

misconduct, or deliberate unauthorized use. The following actions shall be taken.

 

CHECK ALL THAT APPLY

 

 

 

9.No further action is required.

10.An administrative adjustment shall be made in the property book for the class 5 item (s) that were not lost through negligence, willful misconduct, or deliberate unauthorized use.

11.The damaged class 5 item(s) shall be repaired as fair wear and tear as the damage was not caused by negligence, willful misconduct, or deliberate unauthorized use.

12.The circumstances surrounding the loss or damage warrant the processing of a formal Report or Survey that will be initiated immediately by the responsible property officer.

13a. SIGNATURE

13b. TITLE

13c. DATE

DA FORM 5811-R, AUG 89

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