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DA Form 4841-R is a DA series document issued for use across the Department of the Army. Official title: CHILD DEVELOPMENT SERVICES (CDS) PROGRAM/FACILITY REPORT. Purpose: child development services (cds) program/facility report (lra). The current edition carries the date July 1989 and is listed with a publication status of not stated. The form runs to 34 page(s) and contains approximately 200 entry fields.
The office of primary responsibility is ACSIM. Use is prescribed by AR 608-10, which defines when the form is raised and where it goes afterward. The form is normally completed by the subject of the entries or by administrative personnel maintaining the record, then reviewed and signed as the governing authority directs.
Formats offered: PDF, XFDL. All are the same published layout in different containers, and the choice between them is a matter of how the entries will be made rather than what appears on the page. The pdf serves as the authoritative rendering. A fillable pdf exposes editable fields on screen; a printable pdf is the blank form as a flat page for handwriting.
The pdf displays in current browsers and in any reader application. For fillable use a full reader is preferable to a browser viewer, since viewers vary in whether entered data is retained. An xfdl file is available too. The format is IBM Lotus Forms, in use across Army form systems, and it opens only in the Lotus Forms Viewer.
Every format is available at no charge and without sign-up. Files are distributed exactly as published, with no changes to the page.
What the form asks for
- ACTION
- ACTION_1
- ACTION_10
- ACTION_11
- ACTION_2
- ACTION_3
- ACTION_4
- ACTION_5
- ACTION_6
- ACTION_7
- ACTION_8
- ACTION_9
- ACTION_A
- ACTION_A_1
- ACTION_A_10
- ACTION_A_11
- ACTION_A_2
- ACTION_A_3
- ACTION_A_4
- ACTION_A_5
- ACTION_A_6
- ACTION_A_7
- ACTION_A_8
- ACTION_A_9
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.
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.
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.
The documents on this page are reproductions of published Department of the Army forms, offered for download. This is an independent site with no connection to the Department of the Army and no authority to issue forms. Nothing stated is legal advice, and no assurance is given regarding acceptance by any office. Doubts about a specific entry, requirement, or eligibility are resolved by the proponent or by the servicing administrative office.
Questions and answers
- What is DA Form 4841-R?
- CHILD DEVELOPMENT SERVICES (CDS) PROGRAM/FACILITY REPORT
- Which edition is current?
- July 1989
- Who is responsible for this form?
- ACSIM
- In which formats can it be downloaded?
- PDF, XFDL