Start here if you have been told to submit DD Form 2716-1. First, know what you are filling: Department of Defense Certificate of Supervised Release. The document is titled DD Form 2716-1, DoD Certificate of Supervised Release, March 2013.
Then look at the edition date: not stated, publisher status not stated. After that, ask whether the form covers your situation. It almost certainly does regardless of your branch — DD forms run Department-wide rather than through a single service.
Then settle the schedule. You are working under not stated, with not stated responsible for the document, and your organization layers its own deadlines on that. Ask before you assume a date.
Finally, decide how you will complete it. You can type into a fillable file or print a blank and write by hand, and the rest of this page walks you through both paths in order.
Now fill it in. Work from the top of the page downward, and do not jump ahead — the identifying block comes first, the substance of your entry second, the certification last. Later boxes often depend on what you put at the top.
Before your first entry, look at the corner of the page and compare the printed date with not stated. If they do not match, stop and download again. Old copies circulate in shared drives for years, and a DD form is revised centrally for every service at once, so a superseded blank may not carry the fields your reviewer expects.
Work through the fields one at a time and leave nothing blank. When a box does not apply to you, write N/A rather than skipping it, so the reviewer can see you read the question. Follow the date format printed beside each date field instead of the one you normally use.
Stop at the Privacy Act Statement and read it through. You will find the authority for the collection, the principal purpose, the routine uses, and whether disclosure is voluntary or mandatory. Read it now, while you still have the choice of what to disclose.
Sign only after every other entry is complete. Use ink on a printed copy, or a credentialed digital signature — CAC-based, in a reader that handles it — on an electronic one. A typed name satisfies neither method. Enter the date next to it before you close the file.
Run a final pass over the form. The errors that send it back are the same ones every time: old edition, gaps in required fields, unreadable handwriting on a scan, non-conforming dates, no signature or no date.
If a particular field puzzles you, read the instructions printed on the form first, then go to not stated. When the two disagree, follow the directive.
Download the form
First, look at what you can download. The set covers PDF, the form runs 4 pages, and you will complete roughly 33 fields.
Choose pdf as your default. Next, click inside a box. A fillable pdf responds by outlining the field and letting you type; the text stays in the document when you save it. A printable pdf does not respond, which tells you to print the page and complete it by hand.
Type when you can. Printed entries stay legible after the form is scanned, copied and forwarded, and handwriting often does not survive that trip. If you must write by hand, use block capitals and press firmly.
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).
Now that it is complete, send it where not stated or your local procedure says it goes. Before you do, make yourself a copy — scan it or save the file elsewhere. It costs you nothing and saves you the whole exercise if the original goes missing.
Should you need a related form, look it up by its number. The DD sequence is Department-wide, which makes your search simple: no service qualifier, no branch-specific variant to track down.
Watch out for one trap here. If your instructions cite a DA form as well, do not assume the numbers are connected. DA numbering belongs to the Army alone; DD numbering belongs to the Department and is administered by not stated or another Department office. The same number in each system means two unrelated forms, so read the prefix before you download.
Come back and check the edition next time you need this form. Editions change when the prescribing directive is reissued, when the information collected changes, or when the required notice language is updated, and none of those events reaches you directly. Verifying not stated at the moment you download is the whole defence.
One thing this page does not do: tell you whether your submission will be accepted. We publish the document and explain how to complete it, and that is where our role ends. Nothing here is legal advice. Take questions about eligibility, applicability or procedure to not stated, to your servicing personnel office, or to 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?