Fillable Military Forms

DA Form 5017 — CIVILIAN EMPLOYEE CONSENT STATEMENT

civilian employee consent statement

A newer edition of this form has been issued (09/01/2023). Download the current edition.

Begin by matching the form to your task. DA Form 5017 is titled CIVILIAN EMPLOYEE CONSENT STATEMENT, and you reach for it when you need to civilian employee consent statement. Once that matches, check the date. The edition here is 09/01/2023, published with the status ACTIVE. After that, glance at the length: you will be working through 1 page(s) and somewhere near 85 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 PAM 600-85 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.

In the body of the form, tab from field to field instead of clicking around. The tab order follows how the form was constructed, which keeps you from missing a box. For check boxes and option buttons, click them. If you find a set where the choices are exclusive, expect your new selection to clear the previous one. Keep an eye on long entries as you type: fields built for one line will not wrap, and what overflows the width will print truncated even though your screen shows all of it. At that point move the text into remarks or onto a continuation. And when something does not apply to you, say so in the field — write the entry that means "none" rather than leaving white space a reviewer has to interpret.

Leave the signature until everything else is done. Sign by hand or by an approved electronic means, and remember that a form without a signature is a draft, however complete the entries. Where a second and third signature are required — reviewing official, approving authority, witness — go in the order the blocks appear, and each signer dates the form on the day of signing. Then go back to the top and read what you wrote. Look first for a mandatory field you passed over, then for transposed digits in your identification number, then for a date with the day and month inverted. If you started from a file you had used before, look also for entries left from that earlier use; nothing removes them but you.

You will find a Privacy Act statement on the form wherever personal information is collected. Read it at that point rather than skipping past it, because it tells you the authority for the collection, the purpose, the routine uses, and whether answering is mandatory. After you fill the form, remember that your copy contains personal data. Store it and transmit it as your office requires for records of that kind.

Download the form

Then choose a file to download. What you will see offered is PDF, XFDL, and the only question you need to answer is whether you are typing or writing. Type, and you want the fillable pdf, where the entry areas respond to your keyboard. Write, and you want the printable pdf, which you print empty and complete with a pen. The layout does not change between them, so pick whichever fits how you plan to work today.

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.

One last point before you move on: every format is free. No registration stands between you and the file, and what you download is the published form, unaltered.

What the form asks for

  • ContentArea1
  • DATE_A
  • DATE_B
  • DATE_C
  • EMPLOYEE
  • First
  • NAMETITLE
  • Page1
  • R84
  • R85
  • R86
  • R87
  • R88
  • R89
  • R90
  • R91
  • R92
  • R93
  • R94
  • R95
  • R96
  • Rectangle1
  • Second
  • T10

With the form signed, send it where PAM 600-85 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.

Should the package need more than one document, search by series and number. Within the DA series, forms under the same proponent or the same prescribing directive tend to be required as a set, and a form referenced on the page you are filling usually accompanies it. Collect the continuations, covers and transmittals up front so the submission goes complete the first time.

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.

Finally, know where you are. These are copies of published Department of the Army forms, made available for you to download. The site is independent, unconnected to the Department of the Army, and in no position to issue forms or to promise that any office will accept yours. None of this is legal advice. If a specific entry puzzles you, if you are unsure a requirement applies, or if eligibility is in question, put the question to G-1 or to the administrative office serving your unit.

Questions and answers

What is DA Form 5017?
CIVILIAN EMPLOYEE CONSENT STATEMENT
Which edition is current?
09/01/2023
Who is responsible for this form?
G-1
In which formats can it be downloaded?
PDF, XFDL, PDF

Publisher notes

  1. PRIVACY ACT STATEMENT

Other forms in the series