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DA Form 5111 belongs to the DA series of Department of the Army publications. Its official title is SUMMARY COURT-MARTIAL RIGHTS NOTIFICATION/WAIVER STATEMENT, and its stated purpose is summary court-martial rights notification/waiver statement. Edition in force: 11/01/2009. Publication status: ACTIVE. Length is 1 page(s), with roughly 114 fields available for entry.
The office of primary responsibility is TJAG. Use is prescribed by AR 27-10, 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.
Distributed formats: PDF, XFDL. 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.
A pdf opens in any current browser or in a dedicated reader. Fillable behaviour is more reliable in a full reader than in a browser viewer, where some field types render but do not save. An xfdl file is also published. This is the IBM Lotus Forms format used within Army systems; it requires the Lotus Forms Viewer and will not open in a pdf reader or a word processor.
All formats are free to download and no registration is involved. The files are the published documents, distributed unmodified.
What the form asks for
- ContentArea1
- DATE_ONE
- DATE_TWO
- DEF_COUNSL
- DEF_SIGN
- Fifth
- First
- Fourth
- NAME_ONE
- NAME_THR
- NAME_THR_B
- NAME_TWO
- NAME_TWO_B
- Page1
- R73
- R74
- R75
- R76
- R77
- R78
- R79
- R80
- R81
- R82
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.
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.
A Privacy Act statement appears on the form where personal information is collected. It sets out the authority for collection, the purpose, the routine uses, and whether disclosure is mandatory or voluntary. The statement is read before entry, not after. Completed copies carry personal data and are handled and stored under the safeguards applicable to that data.
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.
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.
An edition stands until the proponent issues a revision. The printed edition date identifies the version, and a copy held locally is checked against the edition now in force before reuse. Prior executions under a superseded edition are not reopened for that reason.
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 5111?
- SUMMARY COURT-MARTIAL RIGHTS NOTIFICATION/WAIVER STATEMENT
- Which edition is current?
- 11/01/2009
- Who is responsible for this form?
- TJAG
- In which formats can it be downloaded?
- PDF, XFDL, PDF
Publisher notes
- 42-ITEM ONLY PRODUCED IN ELECTRONIC MEDIA