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DA Form 5168-R is a Department of the Army form in the DA series. Title of record: SAFETY CLEARANCE ORDER (ELECTRICAL FACILITIES) (LRA). Function: safety clearance order (electrical facilities) (lra). The edition presently published bears the date 06/01/1999, with a status of ACTIVE. Physical extent is 1 page(s) and about 140 fillable fields.
The office of primary responsibility is USACE. Use is prescribed by TM 5-682, 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.
Available formats: PDF, XFDL. 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.
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.
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
- ACCEPT
- ContentArea1
- DATEA
- DETAILS
- DETAILS_1
- DETAILS_10
- DETAILS_11
- DETAILS_12
- DETAILS_13
- DETAILS_14
- DETAILS_15
- DETAILS_16
- DETAILS_17
- DETAILS_18
- DETAILS_19
- DETAILS_2
- DETAILS_3
- DETAILS_4
- DETAILS_5
- DETAILS_6
- DETAILS_7
- DETAILS_8
- DETAILS_9
- EQUIP
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.
The signature block is completed last and by hand or by an accepted electronic means. An unsigned form is a draft. Where a second signature is called for — reviewing official, approving authority, witness — each is applied in the order the blocks appear and dated as of application, not as of preparation. Blank mandatory fields are the most frequent defect; a nil entry is marked as such rather than left empty. Other recurring faults: transposed digits in identification numbers, dates in the wrong order of day and month, and stale copies retaining prior data because a working file was reused instead of a fresh blank form.
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.
Disposition of the completed document follows the prescribing authority — delivery to the office it names, transmission through the unit administrative channel, or placement in the individual's record, according to circumstance. The preparer keeps a copy. Retention is governed by the applicable records schedule, not by office custom.
Companion forms are traced by series and number. Within the DA series, documents sharing a proponent or a governing directive are frequently required together, and a form cited on the face of another is generally submitted alongside it. Continuation sheets, covers, and transmittal forms are part of that set and are assembled in advance of submission.
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.
What is offered here are copies of published Department of the Army documents, made available for download. The site is independent of the Department of the Army and publishes no forms of its own. The material is informational and not legal advice, and no statement is made about whether any office will accept a given document. Questions of entry, requirement, or eligibility go to the proponent or the servicing administrative office.
Questions and answers
- What is DA Form 5168-R?
- SAFETY CLEARANCE ORDER (ELECTRICAL FACILITIES) (LRA)
- Which edition is current?
- 06/01/1999
- Who is responsible for this form?
- USACE
- In which formats can it be downloaded?
- PDF, XFDL, PDF
Publisher notes
- 41-ITEM ALSO PRODUCED IN ELECTRONIC MEDIA,