The reason DA Form 5109 looks the way it does is that a file has to speak for itself. Officially REQUEST TO SUPERIOR TO EXERCISE ARTICLE 15, UCMJ, JURISDICTION, it serves to request to superior to exercise article 15, ucmj, jurisdiction, and the record it produces outlasts the people and the circumstances behind it. Edition 09/01/2002, status ACTIVE, is the version published here: 1 page(s), close to 58 fields, each one present because some later reader will need that fact without being able to ask for it.
Behind any Army form sit two separate decisions. What the document asks is settled by TJAG, which maintains and revises it. Whether you raise it, and where it goes once signed, is settled by AR 27-10. That division is the reason a form can outlive several changes in the process it serves.
Identification precedes substance for a structural reason. Name, identification number, organisation and date of preparation are how the finished document is located in a file or a database; the body of the form is what someone reads after the search has succeeded. Spell the name as official records spell it, since the search runs against those records and not against habit.
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.
A signature is what converts entries into a record, which is why it comes last and why an unsigned form remains a draft however complete it looks. Where a reviewing official, an approving authority or a witness also signs, each adds a distinct attestation, and each dates the day of signing rather than the day of preparation — the dates trace the sequence of responsibility. The recurring defects are worth knowing precisely because they defeat that purpose: an empty mandatory field leaves an obligation unmet, transposed identification digits attach the record to nobody, a date with day and month reversed puts events in the wrong order, and entries left in a reused working copy assert facts nobody intended.
Personal information may not be gathered silently, and the Privacy Act statement is how that obligation is met on paper: it names the collection authority, the purpose, the routine uses and whether disclosure is mandatory. Because it exists to inform a decision, it belongs before the fields it covers rather than after them. A filled copy then holds personal data and is stored and transmitted under the corresponding safeguards.
Download the form
The published formats — PDF, XFDL — 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.
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.
Downloads are free and unregistered. The material was published for general use, and the files are passed on unaltered.
What the form asks for
- COMMANDER
- ContentArea1
- DATE
- DATE_SIGN
- ENCLOSURES
- First
- INDICATES
- NARRATE
- PLACE
- Page1
- R46
- R47
- R48
- R49
- R50
- R51
- R52
- R53
- REPORTED
- Rectangle1
- SIGNA
- T14
- T15
- T16
Where the signed form goes is settled by AR 27-10 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.
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.
Editions change because the process changes, and the printed edition date is the only marker of which version a page belongs to. A copy saved locally cannot know it has been superseded, so the date on it is compared against the edition in force before reuse. Records already executed under an earlier edition are left alone — a document is read under the terms it was made, and reopening completed files to match a later form would falsify the account.
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 TJAG or your servicing administrative office.
Questions and answers
- What is DA Form 5109?
- REQUEST TO SUPERIOR TO EXERCISE ARTICLE 15, UCMJ, JURISDICTION
- Which edition is current?
- 09/01/2002
- Who is responsible for this form?
- TJAG
- In which formats can it be downloaded?
- PDF, XFDL, PDF
Publisher notes
- 42-ITEM ONLY PRODUCED IN ELECTRONIC MEDIA