Every entry on DA Form 4569-1 exists because a record system needs it in writing. The form's official title is SECURITY ASSISTANCE PUBLICATION REQUISITION CODE SHEET, and it is raised whenever an office must security assistance da publication requisition code sheet in a way that survives the departure of everyone involved. Memory does not transfer between assignments; a filed document does. The edition dated 06/01/2021, status ACTIVE, is what stands here, spread across 1 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. 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.
Behind any Army form sit two separate decisions. What the document asks is settled by CIO, which maintains and revises it. Whether you raise it, and where it goes once signed, is settled by PAM 25-38. That division is the reason a form can outlive several changes in the process it serves.
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.
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.
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
Why several files for one page? Because the form has to be completed in a headquarters and in places without a workstation, and PDF covers both. The fillable pdf holds interactive fields that fix each entry in place and remove handwriting from the equation. The printable pdf is the same layout without those fields, meant for a printer and a pen. Neither is a lesser copy of the other; each answers a condition the other cannot.
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.
Downloads are free and unregistered. The material was published for general use, and the files are passed on unaltered.
What the form asks for
- CaseDesigna
- Chg_Reqa1
- Chg_Reqa10
- Chg_Reqa11
- Chg_Reqa12
- Chg_Reqa13
- Chg_Reqa14
- Chg_Reqa15
- Chg_Reqa16
- Chg_Reqa17
- Chg_Reqa18
- Chg_Reqa19
- Chg_Reqa2
- Chg_Reqa20
- Chg_Reqa3
- Chg_Reqa4
- Chg_Reqa5
- Chg_Reqa6
- Chg_Reqa7
- Chg_Reqa8
- Chg_Reqa9
- Chg_Reqb1
- Chg_Reqb10
- Chg_Reqb11
Where the signed form goes is settled by PAM 25-38 rather than by the office holding it — a named recipient, the unit administrative channel, or the individual's own file, depending on why it was raised. Retention likewise belongs to the records schedule for the series, which exists so documents are kept for as long as anyone might need them and no longer. Keep a copy before release; the original serves the file from then on, not you.
Related documents are located by series and number, and the relation is rarely accidental — forms under one proponent or one directive tend to serve steps of a single procedure. Anything the DA series form names on its face normally travels with it, as do the continuations, covers and transmittals the process generates. Assembling them together is what makes the submission a complete account.
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.
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 CIO or your servicing administrative office.
Questions and answers
- What is DA Form 4569-1?
- SECURITY ASSISTANCE PUBLICATION REQUISITION CODE SHEET
- Which edition is current?
- 06/01/2021
- Who is responsible for this form?
- CIO
- In which formats can it be downloaded?
- PDF, PDF