Every entry on DA Form 4213 exists because a record system needs it in writing. The form's official title is SUPPLEMENTAL DATA FOR ARMY MEDICAL SERVICE RESERVE OFFICERS, and it is raised whenever an office must supplemental data for army medical service reserve officers in a way that survives the departure of everyone involved. Memory does not transfer between assignments; a filed document does. The edition dated 04/01/1976, status ACTIVE, is what stands here, spread across 2 page(s) and about 200 fields — a count that reflects how much detail the receiving system requires, not how much the drafter wishes to give.
The form has an author and an occasion, held by different authorities. TSG owns the content and reshapes it when what is being recorded changes. AR 135-133 governs the event that calls for the form and the route the finished document takes afterwards. Keeping those two apart is what allows a procedure to be amended without the page being rebuilt each time.
Retrieval governs the order of entry. The head of the form takes name, identification number, unit and date, and those values become the handles by which the record is found later — the substantive blocks are never searched on. This is why the spelling must match official records exactly rather than approximately.
The rules of entry all trace back to the page being fixed in advance. Tabbing follows the order built into the form, which usually matches how the page reads and misses less than clicking. An exclusive group discards the earlier selection because contradictory entries would make the record unusable. One-line fields have no wrap because print positions are predetermined, so an overlong entry displays fully and prints truncated. Longer text goes to the remarks area or a continuation, both provided for exactly that. Where nothing applies, the nil mark is entered — a blank leaves the reader unable to tell a considered answer from a skipped one.
The signature is the point at which entries become an assertion someone stands behind, so it follows everything else and its absence leaves a draft. Countersignatures by reviewing, approving or witnessing officials each carry their own weight and are dated at signing, which is how the file preserves the order of responsibility. Seen that way, the familiar errors are not clerical trivia: an unanswered mandatory field, digits transposed in an identification number, day and month reversed, and residue from a reused file each put something false or unresolved into a document that will be relied upon.
The Privacy Act statement is on the page because collecting personal information requires the collector to disclose the terms first — the authority relied on, the purpose, the routine uses, and whether an answer is required or may be withheld. That order is the point: the statement is read before the entries it governs, since consent given afterwards is not consent. Once completed, the copy is a personal record and carries the handling obligations that attach to one.
Download the form
The published formats — PDF — reflect the range of places a form gets filled in. Where there is a computer, the fillable pdf supplies live fields that keep entries positioned and readable. Where there is not, the printable pdf gives the identical page as flat artwork for pen entry. The distinction is one of setting rather than of authority; the page is the same document in both.
Where a file opens matters more than it appears to. A browser will display a pdf, but browser viewers were built to read documents, and some accept keystrokes into fields they never intended to store — the entries are gone at tab close, without warning, because saving was never part of what that viewer does. A dedicated reader is built around the file's own structure and keeps what you enter.
Downloads are free and unregistered. The material was published for general use, and the files are passed on unaltered.
What the form asks for
- Address
- AppDate
- AppFrom
- AppFrom_1
- AppFrom_2
- AppThru
- AppThru_1
- AppThru_2
- AssnType
- AssnType_1
- AssnType_2
- Branch
- CertBy
- CertDate
- CertN
- CertY
- CertifiedN
- CertifiedY
- Commision
- ContentArea1
- CurrLice
- DOB
- DateA
- DateB
Disposition is prescribed, not chosen. AR 135-133 names the destination, whether that is a specific office, the unit administrative channel or the personal record, and the applicable records schedule governs how long it survives there. Both rules exist to keep the file consistent across offices with different habits. Take your copy before the document leaves, since it will not come back.
Series and number are how the DA series signals which documents belong together, and the grouping follows real process boundaries: a shared proponent or directive usually means a shared purpose. A form cited on the face of another is part of that same transaction, and continuation sheets, covers and transmittals complete it.
Revision follows the process, which is why editions appear without a fixed interval, and the printed date rather than any version number identifies them. Nothing on a stored copy signals that it has aged; the check is manual. Work already completed under a superseded edition stands as filed, because the record was made under those terms and is properly interpreted under them.
A word on where this page sits. These are reproductions of published Department of the Army documents, made available by an independent site with no official role and no authority to issue forms. The structure described above — proponent, prescribing directive, records schedule — exists apart from this site entirely, which is why nothing written here is legal advice and why acceptance by any office is not something that can be promised. Put questions of entry, requirement or eligibility to TSG or to the administrative office servicing your unit.
Questions and answers
- What is DA Form 4213?
- SUPPLEMENTAL DATA FOR ARMY MEDICAL SERVICE RESERVE OFFICERS
- Which edition is current?
- 04/01/1976
- Who is responsible for this form?
- TSG
- In which formats can it be downloaded?
- PDF, PDF