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DD Form 2716-1 — a Department of Defense document. Title of record: DD Form 2716-1, DoD Certificate of Supervised Release, March 2013. Stated purpose: Department of Defense Certificate of Supervised Release. Edition date not stated; status not stated.
Issued under not stated, with not stated as proponent. A DD number marks a Department-wide instrument: the same blank form serves every military department and the defense agencies, rather than one service alone.
Users include uniformed members of any branch, DoD civilian employees, contractor personnel where authorized, and the administrative staff who process the completed record.
Timing of submission is fixed by not stated and by the implementing guidance of the submitting organization. What follows describes the blank document, not agency procedure.
Available formats: PDF. The form runs 4 pages and contains approximately 33 fillable fields.
Distribution centres on pdf. Two states exist: fillable, where field boxes accept keyboard input and retain it, and printable, a static blank produced for manual completion. Typed data reproduces cleanly across copies; handwritten data depends on the writer.
What the form asks for
- The term of supervision hereby granted will become effective: (2 digit month, 2 digit day, 4 digit year).
- and will expire on: (2 digit month, 2 digit day, 4 digit year).
- Signed (chairman, parole and clemency board).
- Enter Mandatory Supervised Release or Parole.
- Endorsement: The above named individual was released from confinement and placed on release or parole the: day.
- Month.
- Year.
- Dated: (2 digit month, 2 digit day, 4 digit year).
- Signed (Commander of corrections facility).
- Parole Agreement. 1.a. Probation/parole officer name (last, first, middle).
- b. Telephone number (include area code).
- c. Agency address.
- d. City.
- e. State.
- f. Zip code.
- 2. Probation/parole destination (limitation of travel will be designated by Parole Officer).
- Supervisee's facility address (facility name/state/zip code).
- Supervisee name (last, first, middle initial)
- Social security number (do not include dashes).
- Additional conditions of supervised release (inserted by Clemency and Parole Board).
- Signature of supervisee.
- Date of supervised release (2 digit month, 2 digit day, 2 digit year, no separators).
- Date (2 digit month, 2 digit day, 2 digit year, no separators).
- Social security number (do not include dashes).
The document is filled from the top down. Identification precedes substance, substance precedes certification. Fields lower on the page are commonly keyed to entries made above them.
Edition in use: not stated. Because DD forms are revised at Department level and distributed to all services at once, an obsolete printing may not match the fields an office expects. The date is printed on the form face.
Signature is manual ink on printed copies and digital where the receiving system accepts it. A typed name in a signature field is a name, not a signature. Common Access Card credentials support digital signature in pdf where the form and the reader permit.
Privacy Act notice: DD forms that collect personal data carry a Privacy Act Statement stating the authority for collection, the principal purpose, routine uses and whether disclosure is voluntary or mandatory. The statement is part of the form and should be read before entry, not after.
Frequent defects: obsolete edition, unfilled required boxes, handwriting that fails on reproduction, non-conforming date format, and certification without a corresponding date.
Field-level instructions appear on the form itself and in not stated. The directive is the controlling text.
After completion, the copy goes to the office designated by not stated or by local procedure. Retention of a personal copy is ordinary practice and costs nothing.
Cross-referenced forms are found through the numbering system. The DD sequence is Department-level and unified, which means a number cited on the page identifies one document across the whole Department.
Some procedures pair a DD form with a service form. The two numbering systems are separate — service forms answer to a service proponent, DD forms to not stated or another Department office — and a matching number in each system means nothing.
Revision occurs when the prescribing directive is reissued, when the data collected changes, or when statutory notice language is amended. Verification of the edition date at download addresses all three.
This page distributes a published Department of Defense document and describes it. It is not a source of legal advice and makes no representation about acceptance of any completed form. Questions of applicability, eligibility or procedure belong to not stated, the servicing personnel office, or the office named in not stated.
Questions and answers
- What is DD Form 2716-1?
- DD Form 2716-1, DoD Certificate of Supervised Release, March 2013
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?