Begin by matching the form to your task. DA Form 4665 is titled PATIENTS` TRUST FUND - DAILY SUMMARY RECORD, and you reach for it when you need to patients` trust fund - daily summary record. Once that matches, check the date. The edition here is 03/01/2000, published with the status ACTIVE. After that, glance at the length: you will be working through 2 page(s) and somewhere near 200 fields.
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, TSG owns the form and AR 40-400 tells you when to raise it and where it goes afterward, so read the directive first if your situation is not routine.
Start at the top of the page and work down. The heading blocks come first: write your name as it appears on your official records, then your identification number, then your unit or organisation, then the date you are preparing the form. Do not skip ahead to the interesting parts and come back — these heading entries are how your form is found in the file afterwards, and a form filed under a misspelled name is a form nobody can locate.
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.
Save the signature for last. Sign by hand, or by whatever electronic method your office accepts, and understand that until you do the document is a draft no matter how complete it looks. If the form calls for a reviewing official, an approving authority, or a witness, take those signatures in the order the blocks print, and have each signer date it on the day they sign rather than the day you prepared it. Before you hand it over, read it once more from the top. You are looking for three things in particular: a mandatory field you left empty, digits transposed in your identification number, and a date written with day and month the wrong way round. Check one more thing if you built this form from a copy you had lying around — old entries survive in a reused file, and they will go forward as though you meant them.
At some point while filling the form you will meet a Privacy Act statement, and you should read it when you reach it rather than after you finish. It tells you who is authorised to collect the information, what it will be used for, who else may see it, and whether you are obliged to answer or may decline. Once you have entered your details, treat the file accordingly: it now holds personal information about you, so store it and send it the way your office handles such records.
Download the form
Now pick your file. You have PDF, XFDL to choose from, and the choice depends on one thing: whether you will type the entries or write them by hand. Choose the fillable pdf when you want to type, tab between fields and keep a clean copy on your computer. Choose the printable pdf when you intend to print the blank first and write on paper. The pages look identical either way, so you are not giving anything up by picking the wrong one — you are only choosing how you work.
Then take care with how you open what you downloaded. Your browser will happily display a pdf, and for reading that is enough — but for typing it is not, because some in-browser viewers accept keystrokes and then throw them away when the tab closes. Put the file somewhere on disk, open it in a proper reader, type into one field and save, and confirm the text is still there when you reopen. If you picked up the xfdl copy, get the IBM Lotus Forms Viewer before you go any further, because nothing else will open the file.
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
- BEGINBAL_A
- BEGINBAL_B
- CASH_A
- CASH_AA
- CASH_AA_1
- CASH_AA_10
- CASH_AA_11
- CASH_AA_12
- CASH_AA_13
- CASH_AA_14
- CASH_AA_15
- CASH_AA_16
- CASH_AA_17
- CASH_AA_18
- CASH_AA_19
- CASH_AA_2
- CASH_AA_20
- CASH_AA_21
- CASH_AA_22
- CASH_AA_23
- CASH_AA_24
- CASH_AA_25
- CASH_AA_3
- CASH_AA_4
Once you have signed, route the form. The prescribing directive names the destination: an office, your unit administrative channel, or your personal file, according to the case. Make yourself a copy first, because you will not get the original back. After that, retention is out of your hands — the applicable records schedule fixes how long the document is kept, whatever the practice in a particular office.
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.
Check the edition date again the next time you reach for this form. Editions change when the proponent revises the content, and a copy you saved months ago may no longer be current — compare the date printed on your file against the edition in force before you type anything into it. What you do not need to do is redo work already finished: a form you completed and submitted under an earlier edition stays as it is.
One last thing to be clear about before you download. What you get here is a copy of a published Department of the Army document. This site is not part of the Department of the Army, issues no forms of its own, and cannot tell you that any office will accept what you submit. Nothing written on this page is legal advice. When you are unsure about a particular entry, a requirement or whether you are eligible at all, ask TSG or the administrative office that services your unit — they answer those questions and we do not.
Questions and answers
- What is DA Form 4665?
- PATIENTS` TRUST FUND - DAILY SUMMARY RECORD
- Which edition is current?
- 03/01/2000
- Who is responsible for this form?
- TSG
- In which formats can it be downloaded?
- PDF, XFDL, PDF
Publisher notes
- 42-ITEM ONLY PRODUCED IN ELECTRONIC MEDIA