Fillable Military Forms

DA Form 4475 — DATA REQUIRED BY THE PRIVACY ACT OF 1974 PERSONAL INFORMATION FROM THE NOK OF A DECEASED SERVICE MEMBER

data required by the privacy act of 1974 personal information from the nok of a deceased service member

A newer edition of this form has been issued (04/30/2026). Download the current edition.

Begin by matching the form to your task. DA Form 4475 is titled DATA REQUIRED BY THE PRIVACY ACT OF 1974 PERSONAL INFORMATION FROM THE NOK OF A DECEASED SERVICE MEMBER, and you reach for it when you need to data required by the privacy act of 1974 personal information from the nok of a deceased service member. Once that matches, check the date. The edition here is 04/30/2026, published with the status ACTIVE. After that, glance at the length: you will be working through 1 page(s) and somewhere near 33 fields. Check this before anything else — a more recent edition is out. Stay on this one only if the record you are handling was already completed on it.

Next, find out whether you are the one who fills it. In most cases you complete the entries yourself, and an administrator in your unit reviews what you wrote before it moves on. If you are the administrator, you will be working from what the individual gives you. Either way, G-1 owns the form and AR 638-8 tells you when to raise it and where it goes afterward, so read the directive first if your situation is not routine.

Begin with the first block and follow the printed order. You will enter your name first, exactly as your official records show it, followed by your identification number, your organisation, and the date of preparation. Resist the urge to jump to the substantive blocks and return to the header later. Those first entries are the index for the whole record, and an error there costs you the ability to retrieve it.

Now for the body. Use tab to advance through the fields; the order was set when the form was built and following it keeps you from leaving gaps. Check boxes and option buttons take a click. Where the options are mutually exclusive, choosing one will clear another, which is how the group is meant to behave. As you type longer entries, watch the field edge. One-line fields do not wrap, and anything past the edge prints missing even when you can still read it on screen — when that happens, put the text in remarks or on a continuation sheet. Leave nothing blank because it does not apply; enter the mark that means it does not apply, so the reviewer knows you read the question.

Sign at the end and not before. Use ink or the electronic method your office accepts; whatever the state of the entries, an unsigned form is still a draft. When a reviewer, approver or witness has to sign as well, collect those signatures in printed block order and make sure each one is dated the day it was applied, not the day you started. Then read the form through once from the beginning. Three faults account for most rejections: a required field left blank, an identification number with two digits swapped, and a date whose day and month are reversed. Add a fourth if you began from an old working copy — data left over from the last time will travel forward untouched.

Read the Privacy Act statement when it appears on the page, before you fill in the personal details it covers. It sets out the authority for collecting the information, the purpose behind it, the routine uses it may be put to, and whether your disclosure is required or voluntary. Then keep in mind what you have created — a completed copy carries personal data, and you handle and store it under the rules that apply to such records.

Download the form

Next comes the download itself. The formats available are PDF, XFDL, and you decide between them by asking how you will enter the information. If you plan to type, take the fillable pdf: the boxes accept keyboard input and you can save the result. If you plan to write by hand, take the printable pdf and run it through your printer while it is still blank. Both show the same published page, so the decision affects your method and nothing else.

After you download, open the file the right way. Double-click a pdf and your browser may take it, which is fine for reading but risky for filling: some browser viewers show you the fields, let you type, and then lose the text when you close the tab. Save the file to your computer first, then open it in a full pdf reader, and check that your entries survive a save before you type the whole form. If you downloaded the xfdl file, do not try a pdf reader on it. That format is IBM Lotus Forms, and you need the Lotus Forms Viewer to open it at all.

Then simply download. There is no charge, no sign-up and no email to hand over, and the file that arrives is exactly what the publisher released.

What the form asks for

  • ContentArea1
  • Line1
  • Line2
  • Line3
  • Page1
  • R40
  • R41
  • R42
  • R43
  • R44
  • R45
  • T11
  • T16
  • T23
  • T26
  • T27
  • T28
  • T29
  • T30
  • T31
  • T32
  • T34
  • T35
  • T37

With the form signed, send it where AR 638-8 tells you to send it — usually to the office it names, or through your unit administrative channel, or straight into your own record, depending on why you raised it. Keep a copy for yourself before it leaves your hands. How long the receiving office holds it is not your decision or theirs; the records schedule for the series settles that, and local habit does not override it.

When another document has to travel with this one, find it by series and number. Forms in the DA series sharing a proponent or a governing directive are commonly used in combination, and anything cited on the face of your form generally goes with it. Assemble continuation sheets, covers and transmittals before you send the package rather than in response to a query.

The next time you open this form from your own files, check the edition date first. Revisions come from the proponent without warning to you, so the only reliable step is to hold your copy against the current edition before filling it in again. Records you already completed under a superseded edition stand, and you do not go back to rework them.

Read this before you go. The file you download is a reproduction of a published Department of the Army document, offered as it was published. We are an independent site with no connection to the Department of the Army and no authority to issue anything, and we make no statement about whether your completed form will be accepted anywhere. Treat what you read here as information, not legal advice. Take real questions — about an entry, a requirement, or your eligibility — to G-1 or to your servicing administrative office.

Questions and answers

What is DA Form 4475?
DATA REQUIRED BY THE PRIVACY ACT OF 1974 PERSONAL INFORMATION FROM THE NOK OF A DECEASED SERVICE MEMBER
Which edition is current?
04/30/2026
Who is responsible for this form?
G-1
In which formats can it be downloaded?
PDF, XFDL, PDF

Publisher notes

  1. 14-REQUIRES PRIVACY ACT STATEMENT (AR 340-21)
  2. 42-ITEM ONLY PRODUCED IN ELECTRONIC MEDIA

Other forms in the series