DA FORM 5017 Fillable – Army Pubs 5017 PDF

DAFORMFILLABLE.COM | DA FORM 5017 Fillable – Army Pubs 5017 PDFDA FORM 5017 – Civilian Employee Consent Statement is a vital document for civilian employees working with the U.S. Army. This article provides a comprehensive overview of the form, including its purpose, structure, and relevant details to ensure users can effectively understand and utilize it.

DA FORM 5017 – Civilian Employee Consent Statement

Form Number DA Form 5017
Form Title Civilian Employee Consent Statement
Form Date 09/01/2023
Form Proponent G-1

What is DA FORM 5017?

DA FORM 5017, also known as the Civilian Employee Consent Statement, is a document that enables civilian employees to provide consent for various actions and procedures related to their employment with the U.S. Army. This form is maintained under the authority of PAM 600-85 and ensures that employees’ rights and privacy are protected.

Key Details of DA FORM 5017

  • Pub/Form Number: DA FORM 5017
  • Pub/Form Date: 09/01/2023
  • Pub/Form Title: CIVILIAN EMPLOYEE CONSENT STATEMENT
  • Pub/Form Proponent: G-1
  • Pub/Form Status: ACTIVE
  • Prescribed Forms/Prescribing Directive: PAM 600-85
  • Security Classification: UNCLASSIFIED
  • Dist Restriction Code: A (Approved for public release; distribution is unlimited)
  • Pub/Form IDN: 990001
  • Pub/Form PIN: 050262

Purpose of DA FORM 5017

The primary purpose of DA FORM 5017 is to obtain the consent of civilian employees for specific activities related to their employment. This can include consent for medical examinations, background checks, and other administrative procedures necessary for their role within the Army.

Privacy Act Statement

The form includes a Privacy Act Statement that outlines the authority under which the information is collected, the purpose of the collection, and how the information will be used. This statement is crucial in ensuring that employees are aware of their rights and the use of their personal information.

Historical Context

The current version of DA FORM 5017 was published on September 1, 2023, replacing the previous version from November 1, 2001. This update reflects changes in regulatory requirements and ensures that the form remains relevant and effective in protecting the rights of civilian employees.

Superseded Form

  • Replaced DA FORM 5017, dated 11/01/2001

Usage and Distribution

The Civilian Employee Consent Statement is classified as UNCLASSIFIED, meaning it is not restricted by security classifications and is available for public access. The distribution code A indicates that the form is approved for public release, with no limitations on its distribution.

Filling Out DA FORM 5017

To complete DA FORM 5017, employees must provide personal information and indicate their consent for specific procedures. The form must be signed and dated to be valid. Detailed instructions are typically provided within the form to guide users through the process.

Key Sections of the Form

  1. Personal Information: This section collects the employee’s name, contact details, and other relevant personal information.
  2. Consent Statement: Here, the employee reads and agrees to the terms outlined, providing consent for various procedures.
  3. Signature and Date: The employee’s signature and the date of signing are required to validate the consent.

Importance of DA FORM 5017

The Civilian Employee Consent Statement is crucial for maintaining transparency and protecting the rights of civilian employees. By providing informed consent, employees can ensure that they are fully aware of and agree to the procedures and actions taken by their employer.

Benefits for Employees and Employers

  • For Employees: Ensures awareness and agreement to necessary procedures, protecting personal rights and privacy.
  • For Employers: Facilitates compliance with regulatory requirements and maintains transparency in administrative processes.

Conclusion

DA FORM 5017 – Civilian Employee Consent Statement is a key document for civilian employees in the U.S. Army, ensuring that their consent is obtained for various employment-related procedures. Understanding the form’s purpose, structure, and importance can help both employees and employers effectively utilize it to maintain compliance and protect personal rights.

By adhering to SEO best practices, this article aims to provide clear and valuable information for individuals seeking to understand and use DA FORM 5017 in their professional activities.

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