DD Form 220 at a glance
What it is: The Active Duty Report is used to report items of information to individuals reporting for active duty.
Who signs: Sign on the Signed line.
A filled-in DD Form 220 example: a USAR member reports for active duty
How to fill out DD Form 220, box by box
Tap a group of boxes to open it, and a picture to see it full size.
Reserve component
Check one Reserve Component: ARNGUS, ANGUS, USAR or AFRES.
Date, TO and FROM
Write the DATE (YYMMDD), the TO (Appropriate Military Department) and the FROM (Initial Active Duty Station).
Name, DoD ID number, grade or rank, branch and retirement
Write the NAME (Last, First,MI), DoD ID NUMBER, GRADE OR RANK, BRANCH OF ARMED SVC and RETIREMENT YR ENDING.
Effective date, reporting date and date departed
Enter the EFFECTIVE DATE OF ENTRY ON ACTIVE DUTY by YEAR, MONTH and DAY; it is determined by personnel officer at first duty station IAW criteria outlined in AR 37-104-4.
Enter the REPORTING DATE: the date specified in orders or the actual reporting date if later than date specified.
Enter the DATE DEPARTED FROM DUTY STATION TO HOME.
Authority for active duty, length of tour and orders
Enter the AUTHORITY FOR ACTIVE DUTY.
Enter the LENGTH OF TOUR (Less than 90 days if ARNGUS or USAR), the ORDERS NO., PARAGRAPH NO., date DATED (YYMMDD) and the HQ (Designation and location of HQ issuing orders).
Statement of physical condition and signing
Write the STATEMENT OF PHYSICAL CONDITION (In lieu of medical examination): after I have been treated by, write the (Name of Physician) (Last, First,MI), which was accomplished at, the (YYMMDD) and the (Name and location of hospital or medical treatment facility).
Check I have been treated by or have not been treated by clinics, physicians, healers or other practitioners, and since that time, during the period from, write the (Name of physician) (Last, First, MI), the (YYMMDD) to (YYMMDD) and the (Description of injury or illness).
If you were hospitalized, write where: I was hospitalized in (Name and location of hospital or medical treatment facility), The attending physician was (Last, First, MI) and Diagnosis was (Description of injury or disease).
Check I do or do not believe that I am now medically qualified to perform satisfactory military service, and write the Date (YYMMDD).
Sign on the Signed line.
Entered on active duty
16. (ARMY USE ONLY) Upon mobilization this item will be filled in for members of units of reserve components of the Army and copies of orders will be attached to this form: Entered on active duty as a member of (Unit and unit home station); Ordered to active duty from (Home of record or home address) (Include ZIP code).
Yes, forwarded to
Check YES, FORWARDED TO and write the (Address of Reserve or NG unit) (Include ZIP Code) and the DATE (YYMMDD), or NO, REPORT WILL BE FORWARDED ON OR ABOUT (YYMMDD), or NOT APPLICABLE, or RESET ITEM 17.
Date of rank
18. (ARMY USE ONLY) DATE OF RANK (YYMMDD) (For officers and warrant officers ordered to active duty for 12 or more months, enter computation below).
Typed name of adjutant, enclosures and remarks
19a. The adjutant or other officer representing commander signs, and write the TYPED NAME OF ADJUTANT OR OTHER OFFICER REPRESENTING COMMANDER (Last, First,MI) and b. GRADE OR RANK.
List enclosures, if any, under 20. ENCLOSURES.
Explain reason for delay, if any, in complying with orders, under 21. REMARKS.
Common questions about DD Form 220
What is a DD form 220?
The Active Duty Report is used to report items of information to individuals reporting for active duty.
Sources
[1] DD Form 220, Active Duty Report (the Official source link on this page).