Military Forms Guide

DA Form 4475 — DATA REQUIRED BY THE PRIVACY ACT OF 1974 PERSONAL INFORMATION FROM THE NOK OF A DECEASED SERVICE MEMBER

data required by the privacy act of 1974 personal information from the nok of a deceased service member

A newer edition of this form has been issued (04/30/2026). Download the current edition.

Every entry on DA Form 4475 exists because a record system needs it in writing. The form's official title is DATA REQUIRED BY THE PRIVACY ACT OF 1974 PERSONAL INFORMATION FROM THE NOK OF A DECEASED SERVICE MEMBER, and it is raised whenever an office must data required by the privacy act of 1974 personal information from the nok of a deceased service member in a way that survives the departure of everyone involved. Memory does not transfer between assignments; a filed document does. The edition dated 04/30/2026, status ACTIVE, is what stands here, spread across 1 page(s) and about 33 fields — a count that reflects how much detail the receiving system requires, not how much the drafter wishes to give. A later edition has since been published, which is why this one remains: records executed against it must still be readable in the terms they were written.

The form has an author and an occasion, held by different authorities. G-1 owns the content and reshapes it when what is being recorded changes. AR 638-8 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.

The heading blocks come first because the record is retrieved by them, not read into. Name as official records spell it, identification number, unit, date of preparation — those four are the index, and everything below them is content that only surfaces once the index has done its work. A form filed under a name written casually is not lost in principle, only in practice, which amounts to the same thing.

Much of the form's behaviour follows from its being a fixed page. Tab order was set at build time along the reading sequence, which is why tabbing catches boxes a pointer passes over. Exclusive groups release one choice when another is made because a record cannot carry two answers to a single question. Single-line fields refuse to wrap because every entry must print where the layout expects it — text beyond the width is lost at the margin, visible on screen to the end. That is what remarks areas and continuation sheets are for. Marking a field that does not apply matters for a related reason: emptiness is ambiguous, and a reviewer reading the file later cannot distinguish an omission from a decision.

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.

Behind the Privacy Act statement is a requirement that anyone asked for personal data be told, in advance, under what authority it is sought, for what purpose, who else routinely sees it, and whether refusal is possible. Reading it after completing the fields defeats its function. And the completed form is itself a personal record from that point on, subject to the handling rules such records carry.

Download the form

Formats exist because completion happens under different conditions, not because anyone wanted variety. The published set is PDF, XFDL. A fillable pdf carries live entry objects, so typed text lands in fixed positions and stays legible whoever reads it later. A printable pdf drops those objects and leaves the page as an image, which is what an office needs where a screen is unavailable and a pen is not. The document itself is unchanged between them; what differs is the circumstance each anticipates.

Software determines whether an entry lasts. A browser viewer is designed for reading, and several will take typed input into fields without any means of writing it back — the text is simply absent when you reopen. A standalone reader handles the form structure properly. The xfdl file is IBM Lotus Forms, carried in Army systems for the routing and signature support it provides, which is why the Lotus Forms Viewer is its only reader.

No charge and no account apply: these are published documents, and access to them is not something a distributor is entitled to price.

What the form asks for

  • ContentArea1
  • Line1
  • Line2
  • Line3
  • Page1
  • R40
  • R41
  • R42
  • R43
  • R44
  • R45
  • T11
  • T16
  • T23
  • T26
  • T27
  • T28
  • T29
  • T30
  • T31
  • T32
  • T34
  • T35
  • T37

The routing in AR 638-8 decides where the document goes — a named office, the administrative channel, or the individual's file — and the records schedule for the series decides how long it stays. Neither is a local judgement, because a record system loses its meaning if each office keeps things for its own preferred interval. Copy the form before submitting it.

Forms cluster by series and number for the same reason files do: shared proponency and a shared prescribing directive usually mean a shared process. So a document in the DA series referenced on the face of another is generally part of the same transaction, and continuation sheets, cover sheets and transmittals belong to the package from the outset rather than arriving after a query.

An edition marks the form at a point in a process that keeps moving, and the date printed on the page is what distinguishes one from another. Since a saved file never announces its own obsolescence, compare its date against the current edition before using it again. Prior executions remain valid: the change applies forward, and a record is read against the edition it was written under.

One boundary should be stated clearly. What is distributed here are copies of published Department of the Army forms; the site is independent, issues nothing of its own, and holds no position in the system it describes. Proponency, prescribing directives and retention schedules operate without reference to it. Consequently nothing here is legal advice and no assurance about acceptance is possible. Questions about a particular entry, a requirement or eligibility belong with G-1 or your servicing administrative office.

Questions and answers

What is DA Form 4475?
DATA REQUIRED BY THE PRIVACY ACT OF 1974 PERSONAL INFORMATION FROM THE NOK OF A DECEASED SERVICE MEMBER
Which edition is current?
04/30/2026
Who is responsible for this form?
G-1
In which formats can it be downloaded?
PDF, XFDL, PDF

Publisher notes

  1. 14-REQUIRES PRIVACY ACT STATEMENT (AR 340-21)
  2. 42-ITEM ONLY PRODUCED IN ELECTRONIC MEDIA

Other forms in the series