DA Form 5811 R – Fill Out and Use This PDF

The DA Form 5811-R is officially designated as the Certificate for Lost or Damaged Class 5 Ammunition Items. Its primary use, as outlined in DA PAM 710-2-1, involves the documentation and certification of incidents concerning the loss or damage of classified ammunition, under the auspices of the DCSLOG. Detailed within this form are provisions for certifying the circumstances of the loss or damage, determining accountability, and outlining the subsequent actions required, whether it be no further action, administrative adjustments, repairs, or formal reporting.

For individuals responsible for the custody and management of Class 5 Ammunition Items, accurately completing the DA 5811-R form is crucial for maintaining operational integrity and accountability within military logistics operations. Ensure accuracy and compliance by clicking the button below to fill out the form.

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DA Form 5811 PDF Details

The DA Form 5811-R is mandated under DA PAM 710-2-1 to record accountability incidents involving Class 5 ammunition. Section 1 of the form captures the item's National Stock Number (NSN), nomenclature, unit of issue, quantity, and whether the item was lost or damaged. Section 2 requires a narrative description of the circumstances surrounding the incident, including the date, location, and the individual responsible for custody. Section 3 is completed by a reviewing authority who documents the determination of negligence, selects the appropriate action (no further action, administrative adjustment, repair, or formal report of survey), and signs the form. Properly completing all three sections is essential for maintaining supply accountability under Army Regulation 710-2.

This form is required when Class 5 ammunition items are reported lost during training exercises, field operations, or storage, or when physical damage renders them unserviceable. The proponent agency, DCSLOG, reviews completed forms to ensure compliance with Army logistics policies. Failure to file DA Form 5811-R when required can result in adverse administrative action against the responsible individual. All entries must be legible, accurate, and supported by witness statements where applicable.

Question	Answer
Form Name	DA Form 5811
Form Length	1 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	15 sec
Other names	da form 5811, 5811 r, da 5811, da form 5811 fillable

How to Edit DA Form 5811 Online for Free

How to Fill Out DA Form 5811-R: Step-by-Step

Follow these steps to complete the form accurately:

Section 1 – Item Identification. Enter the National Stock Number (NSN), item nomenclature, unit of issue, and quantity of the lost or damaged Class 5 ammunition. Check the appropriate box to indicate whether the item was lost or damaged.
Section 2 – Circumstances. Write a clear, factual narrative explaining how and where the loss or damage occurred, the date, and the full name of the individual responsible for custody. Be specific: include the location, the unit, and any relevant operational context.
Section 3 – Action by Reviewing Authority. The commanding officer or designated reviewing authority reviews the facts, determines whether negligence was involved, selects the required action, and signs the form. This section must be completed before submission.
Submit and File. Deliver the original to your unit's supply officer. Retain a copy for unit records. If a formal report of survey is required, attach the DA Form 5811-R to the survey package as supporting documentation.

Frequently Asked Questions

What is DA Form 5811-R used for?
It certifies the loss or damage of Class 5 (ammunition) items and establishes accountability under DA PAM 710-2-1. It is filed whenever ammunition in a soldier's custody is lost or damaged, regardless of cause.

Who completes each section?
The individual responsible for the ammunition completes Sections 1 and 2. The reviewing authority (typically the commanding officer) completes Section 3 and signs off on the determination and action.

Can I fill out this form online?
Yes. Use FormsPal's free OCR PDF editor to complete the DA Form 5811 R in your browser. You can download, print, or save the finished form directly.

What are Class 5 items?
In U.S. Army supply classification, Class 5 refers to all types of ammunition, including missiles, bombs, propellants, and related components.

What happens if negligence is found?
If the reviewing authority determines negligence, a formal report of survey may be initiated, which can lead to financial liability for the responsible individual under Army Regulation 735-5.

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