1. REGULATION NUMBER
INTERNAL CONTROL EVALUATION CERTIFICATION
2. DATE OF REGULATION
For use of this form, see AR 11-2; the proponent agency is ASA(FM&C).
3. ASSESSABLE UNIT
4. FUNCTION
5. METHOD OF EVALUATION (Check all that apply)
a. CHECKLIST
b. ALTERNATIVE METHOD (Indicate method)
APPENDIX (Enter appropriate letter)
6. EVALUATION CONDUCTED BY
a. NAME
(Last, First, MI)
b. DATE OF EVALUATION
7. REMARKS
(See Attached)
Use this block to describe the method used to test key controls, the internal control weakness(es) detected by the evaluation (if any) and the
corrective action(s) taken. (THIS IS MANDATORY)
a. METHOD OF TESTING KEY CONTROLS
(Check all that apply)
Direct Observation
Review of Files or
Analysis
Sampling
Simulation
Interviews
Other Documentation
Other
(Explain)
b. EVALUATION RESULTS
(Include specific items tested):
c. INTERNAL CONTROL DEFICIENCIES DETECTED, IF ANY. (Include potential material weaknesses):
d. DESCRIBE CORRECTIVE ACTIONS TAKEN, IF APPLICABLE.
8.
CERTIFICATION
I certify that the key internal controls in this function have been evaluated in accordance with provisions of AR 11-2, Army Managers'
Internal Control Program. I also certify that corrective action has been initiated to resolve any deficiencies detected. These deficiencies and
corrective actions (if any) are described above or on attached documentation. This certification statement and any supporting documentation
will be retained on file subject to audit/inspection until superseded by a subsequent internal control evaluation.
a. ASSESSABLE UNIT MANAGER
(1) Typed Name and Title
(2) Signature
b. DATE CERTIFIED
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PREVIOUS EDITIONS ARE OBSOLETE.
DA FORM 11-2, SEP 2012
APD LF v1.01ES