Da Form 7434 PDF Details

Embarking on the journey to obtain or renew a U.S. Army Marine certification is a significant step that involves meticulous attention to detail and adherence to stringent criteria outlined in the DA Form 7434. This form serves as a pivotal component in the process, enabling applicants to apply for original certification, renewal, upgrades, and endorsements within the realm of Army marine operations. Governed by the regulations specified in AR 56-9, with the oversight of DCS, G-4 as the proponent agency, the form is not just a mere application but a comprehensive declaration of an individual’s qualifications, physical fitness, and vision capabilities. Applicants are required to disclose personal information, including their military grade, primary Military Occupational Specialty (MOS), and unit assignment. Additionally, a crucial aspect of the application is the physical statement, which necessitates a specific medical fitness level and visual acuity, underscored by the necessity to pass the Pseudoisochromatic Plate (PIP) test for color perception. The legal warning against falsification underscores the seriousness of the application process, reminding all that integrity and honesty are paramount, with severe penalties awaiting those who disregard this admonition. Furthermore, the form’s validity is bound to a one-year timeframe post-approval, suggesting a cycle of regular evaluation and certification for those in marine roles. With commanders holding the authority to approve or disapprove applications, the DA Form 7434 is not just a formality but a critical step in validating one’s ability and readiness to undertake responsibilities associated with the U.S. Army’s marine operations.

QuestionAnswer
Form NameDa Form 7434
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesUNCORRECTED, Watercraft, 2009, JUL

Form Preview Example

APPLICATION FOR US ARMY MARINE CERTIFICATION

For use of this form see AR 56-9; the proponent agency is DCS, G-4.

READ BEFORE SIGNING

"Whoever, in any matter within the jurisdiction of any department or agency of the United States knowingly and willfully falsifies, conceals, or covers up by trick, scheme, or device, a material fact, or makes or uses any false writing on a document knowing the same to contain any false, fictitious or fraudulent statement or entry, shall be fined not more than $10,000 or imprisonment of not more than 5 years or both." (18 USC 1001)

1. TYPE OF CERTIFICATION (Check one)

ORIGINAL

RENEWAL

UPGRADE

ENDORSEMENT

2.NAME (Last, First, MI)

3. GRADE

4. DOR

5. PRIMARY MOS

6. UNIT OF ASSIGNMENT

7. APPLICANTS SIGNATURE

8.DATE (YYYYMMDD)

PHYSICAL STATEMENT

In accordance with AR 56-9, Watercraft, Physical Standards:

1.Profile serial MUST be 2 or better for P, U, L, H, E, and be 1 for S.

2.MUST pass color perception using the Pseudoisochromatic Plate (PIP) test and have visual acuity required by Chapter 5-2.

9. PROFILE

P

U

L

H

E

S

10. DATE OF LAST PHYSICAL (YYYYMMDD)

11. MEDICAL CORPS/MEDICAL SERVICE CORPS SIGNATURE (Required)

12. GRADE

13. MOS/BRANCH

14. TITLE

15. VERIFICATION DATE (YYYYMMDD)

16. COLOR PERCEPTION

16a. TEST TYPE

16b. SCORE

/

PASS

FAIL

17. VISUAL ACUITY

17a. UNCORRECTED

 

 

 

 

 

17b. CORRECTED

 

 

 

 

 

R

 

/

 

L

 

/

 

R

 

/

 

L

 

/

18. OPTOMETRIST SIGNATURE (Required)

19. GRADE

20. MOS/BRANCH

21. TITLE

22. VERIFICATION DATE (YYYYMMDD)

APPLICATION IS VALID FOR ONE YEAR FROM ABOVE DATE

23.

COMMANDER'S AUTHENTICATION

 

APPROVED

 

 

DISAPPROVED

 

 

 

 

 

 

 

 

 

 

 

 

24.

COMMANDER'S SIGNATURE

 

 

25. DATE (YYYYMMDD)

 

 

 

 

 

 

 

DA FORM 7434, JUL 2009

APD LC v1.00ES

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The best ways to fill out 16a step 1

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VERIFICATION DATE YYYYMMDD, OPTOMETRIST SIGNATURE Required, and MEDICAL CORPSMEDICAL SERVICE inside 16a

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