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DA Form 4107 is a DA series document issued for use across the Department of the Army. Official title: OPERATION REQUEST AND WORKSHEET. Purpose: operation request and worksheet. The current edition carries the date 03/01/1982 and is listed with a publication status of ACTIVE. The form runs to 1 page(s) and contains approximately 200 entry fields.
Responsibility for content and revision lies with TSG. The prescribing directive is AR 40-66, which sets both the trigger for use and the disposition of the completed document. Entry is made by the named party or by the records clerk holding the file, with review and signature applied in the prescribed order.
Distributed formats: PDF. The layout is common to all of them; what varies is the method of entry. The pdf is the reference version. In the fillable pdf the entry areas are live objects that accept typing; in the printable version the same areas are inert and are filled by hand after printing.
Any modern browser or reader will display a pdf. Interactive fields behave more predictably in a standalone reader than in an in-browser viewer, which sometimes shows fields it cannot store.
Download of every format is free and requires no account. Files are served as published, without alteration to the page image.
What the form asks for
- AGE
- AGENT_A
- AGENT_B
- AGENT_C
- AIRWAY
- ANEIST_A
- ANEIST_B
- ANESIA_A
- ANES_A
- ASSIST_A
- ASSIST_B
- BLOODADM
- BLOOD_RE
- CASE_NUM
- CIR_PERS
- COMPLICA
- ContentArea1
- DICTATOR
- DRAINS
- EMERGENC
- EPISODES
- FLUIDS
- Initial1
- NUR_STAF
The blocks are worked through in the order they appear on the sheet. At the head sit the identifying entries: name, identification number, unit, date. Because the filed record is indexed on these, they precede everything substantive.
Interactive fields are filled by typing into them. Movement between fields is by tab, following the order established when the form was constructed, which usually tracks the page layout. Check boxes and radio groups are set by clicking, and exclusive groups permit one selection at a time. A one-line field has no wrap: text beyond its width prints truncated even when the screen shows it. Overlong content is placed in remarks or on a continuation, not forced into the field.
The signature block is the final entry, made by hand or by an authorised electronic method, and without it the document remains a draft. Countersignatures — review, approval, witness — are added in the sequence printed, dated at the moment of signing and not at preparation. Empty mandatory fields lead the list of defects; an inapplicable field is annotated as such, not passed over. Behind it come digit transposition in identification numbers, day-month inversion in dates, and residual entries surviving from a reused copy in place of a blank form.
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.
The completed form is routed as the governing authority prescribes: to the office named in the directive, through the unit administrative channel, or into the individual's file, depending on the case. A copy is retained by the preparer. Filing and retention follow the records schedule applicable to the series rather than local practice.
Related forms are found by series and number. Documents in the DA series sharing a proponent or a prescribing directive commonly travel together, and a form referenced within the body of another is usually filed with it. Continuation sheets, cover sheets, and transmittal documents belong to this group and are collected before submission rather than after.
Editions are replaced when the proponent revises the content. The edition date printed on the form is the means of telling one version from another, and the date on a downloaded copy is checked against the edition in force before use. Records already executed on a prior edition are not reworked on that account.
The files here are reproductions of published Department of the Army documents, provided for download. This site is not part of the Department of the Army and issues no forms of its own. Nothing on this page is legal advice, and no representation is made as to acceptance of a document by any office. Where an entry, a requirement, or a question of eligibility is in doubt, the proponent or the servicing administrative office answers it.
Questions and answers
- What is DA Form 4107?
- OPERATION REQUEST AND WORKSHEET
- Which edition is current?
- 03/01/1982
- Who is responsible for this form?
- TSG
- In which formats can it be downloaded?
- PDF, PDF
Publisher notes
- 42-ITEM ONLY PRODUCED IN ELECTRONIC MEDIA,