Da Form 4833 - Commander'S Report Of Disciplinary Or Administrative Action

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(YYYYMMDD)
SUSPENSE DATE
COMMANDER'S REPORT OF DISCIPLINARY OR ADMINISTRATIVE ACTION
For use of this form, see AR 190-45; the proponent agency is Office of the Provost Marshal General
PRIVACY ACT STATEMENT
AUTHORITY:
Title 10 USC Section 301; Title 5 USC Section 2951; E.O. 9397 dated November 22, 1943
(SSN).
PRINCIPAL PURPOSE:
To provide commanders and law enforcement officials with means by which information may be accurately identified.
ROUTINE USES:
Your social security number is used as an additional/alternate means of identification to facilitate filing and retrieval.
DISCLOSURE:
Disclosure of your social security number is voluntary.
1. THRU
2. TO
3. FROM
4. USACRC CONTROL NUMBER
5. MP REPORT NUMBER
6. SUB-INSTALLATION IDENTIFIER
The first Lieutenant Colonel in the chain of command is responsible and accountable for completing DA Form 4833 with support documentation (copies of Article
15s, court-martial orders, reprimands, etc) for all USACIDC investigations. The unit and brigade commander or their equivalent will also receive a copy of the DA
Form 4833 for all USACIDC investigations.
Company, troop, and battery level commanders are responsible and accountable for completing DA Form 4833 with supporting documentation in all cases
investigated by MPI, civilian detectives employed by the Department of the Army, and the PMO. Accurate and complete DA 4833 disposition reports are
required to meet installation, command, HQDA, DOD, and federal statutory reporting requirements. The data is used to identify crime trends, establish command
programs in law enforcement and other activities, and to ensure that resources are made available to support commanders who must address issues of soldier
and family member indiscipline.
In court-martial cases, a conviction of an offense at court-martial may be for a different, or lesser included offense. List the offense for which the individual was
convicted at court-martial in the remarks section.
Block 5. Provost Marshals must enter the Military Police Report number for all cases referred to commanders.
Block 6. This block is used to enter report number from a civilian law enforcement agency police report. Other information on the civilian law enforcement
agency (e.g. civilian law enforcement agency address) may be entered in the remarks section.
(Last, First, MI)
8. GRADE
9. SSN
(YYYYMMDD)
7. NAME OF SUBJECT
10. DATE OF BIRTH
11b. DATE OF OFFENSE(s)
11a. OFFENSE(s)
11c. ACTION TAKEN
11d. IF NO ACTION TAKEN, EXPLAIN:
(YYYYMMDD)
YES
NO
YES
NO
YES
NO
(check all that apply)
12. ACTION TAKEN
* Subject was advised that although no action was taken, the report would be retained in Army records and that requests for amendment,
correction, or expungement may be submitted IAW AR 190-45 (MP Reports) or AR 195-2 (CID Reports).
a. NON-ADVERSE PERSONNEL ACTION REFERRAL:
(Check appropriate blocks)
(YYYYMMDD)
(YYYYMMDD)
REFERRED TO
DATE REFERRED
DATE RESPONDED
F = FAMILY ADVOCACY
D = DRUG/ALCOHOL ABUSE
S = SPECIAL REFERRAL
E = EQUAL OPPORTUNITY
L = LEGAL OFFICE
M = MENTAL HEALTH
R = RELIEF AGENCY
b. ADVERSE PERSONNEL ACTION:
REPRIMAND
ORAL
WRITTEN
FILED:
LOCALLY
OMPF
LETTER OF CONCERN/COUNSELING
ADVERSE OER/NCOER COMMENT
RELIEF FOR CAUSE OER/NCOER
SUSPENDED SECURITY CLEARANCE OR OTHER ADVERSE ACTION REGARDING SECURITY CLEARANCE
DISCHARGE PURSUANT TO AR 635-200 (ENLISTED)/AR 600-8-24 (OFFICER)
Regulation
Chapter
Characterization
Discharge Date
(Article 15, UCMJ) (ATTACH COPY OF ARTICLE 15)
c. NONJUDICIAL PUNISHMENT
GCMCA IMPOSED
SUMMARIZED
FIELD GRADE
COMPANY GRADE
GENERAL OFFICER IMPOSED
(If subject was tried by court-martial attach a copy of the court-martial order giving findings and sentences.)
d. JUDICIAL
SUMMARY COURT MARTIAL
GENERAL COURT-MARTIAL
SPECIAL COURT-MARTIAL
CIVILIAN OR MAGISTRATE CRIMINAL COURT
Page 1 of 2
DA FORM 4833, JUN 2004
DA FORM 4833, Dec 1998, IS OBSOLETE
APD 9V1.000

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