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DA Form 3492 is a Department of the Army form in the DA series. Title of record: US ARMY MEDICAL DEPARTMENT CERTIFICATE FOR RESIDENTS, INTERNS AND FELLOWS (S&I, HQDA (DASG-PSZ-MG), 5109 LEESBURG PIKE, STE 691, FALLS CHURCH, VA 22041-3528). Function: us army medical department certificate for residents, interns and fellows (s&i, hqda (dasg-psz-mg), 5109 leesburg pike, ste 691, falls church, va 22041-3528). The edition presently published bears the date 09/01/2005, with a status of ACTIVE. Physical extent is unknown page(s) and about unknown fillable fields.
Proponency for the form rests with TSG. The governing authority is AR 351-3, which establishes the circumstances of use and the required routing. Preparation falls to the individual named in the entries or to the unit administrator acting on that individual's behalf; review and signature follow the chain set out in the governing authority.
Available formats: none published here. Each is a rendering of the same official layout; the content is identical across them and only the means of completion differs. The pdf is the reference copy. Fillable pdf carries interactive form fields; a printable pdf is the same page image without them, intended for pen entry after printing.
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Entry proceeds block by block in the order printed on the page. Identifying particulars occupy the head of the form: name, identification number, unit or organisation, and date of preparation. These fields govern how the record is later retrieved from the file, so they are completed before any substantive block.
Fillable fields accept typing directly. Tab advances from one field to the next in the order the form was built, which is normally the reading order of the page. Check boxes and option buttons are clicked; where a set of options is exclusive, selecting one clears the rest. Fields sized for a single line will not wrap, and text exceeding the width is truncated in print even where it remains visible on screen. Long entries belong in the remarks area or on a continuation, not compressed into a narrow field.
Signature comes at the end, applied in ink or by an accepted electronic method. Until it is applied the document is a draft. Additional signatures — reviewer, approver, witness — are taken in printed block order, each dated when signed rather than when the form was drafted. The commonest error is a mandatory field left blank; where nothing applies, the entry is marked accordingly instead of being skipped. Transposed identification digits, day and month reversed in dates, and carried-over data from a reused working copy account for most of the remainder.
Where personal information is gathered, the form carries a Privacy Act statement giving the collection authority, the purpose, the routine uses, and the mandatory or voluntary character of the disclosure. It is read before entries are made rather than afterwards. A completed copy holds personal data and is stored and transmitted under the corresponding safeguards.
Once completed, the form goes where the governing authority directs: to the designated office, along the unit administrative channel, or into the personal file. The preparer retains a copy. The length of retention and the manner of filing are set by the records schedule for the series, not by local arrangement.
Associated documents are located through the series and number scheme. Forms in the DA series with the same proponent or the same prescribing directive tend to be used as a set, and any form named on the face of another normally accompanies it. Continuations, cover sheets, and transmittals fall into this category and are gathered before the package is sent.
Revision by the proponent supersedes an edition. Version is read from the edition date printed on the form itself, and a stored copy is compared against the current edition before it is used again. Documents already executed under an earlier edition are not redone because of the change.
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Questions and answers
- What is DA Form 3492?
- US ARMY MEDICAL DEPARTMENT CERTIFICATE FOR RESIDENTS, INTERNS AND FELLOWS (S&I, HQDA (DASG-PSZ-MG), 5109 LEESBURG PIKE, STE 691, FALLS CHURCH, VA 22041-3528)
- Which edition is current?
- 09/01/2005
- Who is responsible for this form?
- TSG
- In which formats can it be downloaded?
- No file published here