On advance, the disbursing officer states: I have entrusted funds and/or other items as indicated in this statement to the above named as my agent officer.
Agent officer, on advance: I have funds and/or other items as indicated above. I have assumed pecuniary responsibility therefore.
Loss or shortage: the agent officer will notify the disbursing officer immediately upon discovery of any loss or shortage.
On return, disbursing officer: I have received funds and/or other items as indicated on this statement from the above named agent officer.
On return, agent officer: the above statement of account is correct.
| Question | Answer |
|---|---|
| Form Name | DD Form 1081 |
| Form Length | 1 page |
| Fillable? | Yes |
| Fillable fields | 74 |
| Avg. time to fill out | 13 min |
| Edition | MAR 2017 |
| Who signs | The disbursing officer and the agent officer |
| Other names | DD 1081, DD1081, DD-1081, DD Form 1081, Form 1081, Statement of Agent Officer's Account |
| Issuing Agency | U.S. Department of Defense |
| Form Purpose | Statement of Agent Officer's Account |
| Used By | Finance Officers and Agent Officers |
| Official source | DD Form 1081 (Rev MAR 2017), Department of Defense |
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