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DA Form 2675-r Certification of Work Incurred Injury or Disability
What Is DA Form 2675-r?
This is a military form that was released by the U.S. Department of the Army (DA) on May 1, 1982. The form, often mistakenly referred to as the DD Form 2675-r, is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DA.
FAQ
Q: What is DA Form 2675-r?
A: DA Form 2675-r is a Certification of Work Incurred Injury or Disability.
Q: What is the purpose of DA Form 2675-r?
A: The purpose of DA Form 2675-r is to certify and document work-incurred injuries or disabilities.
Q: Who uses DA Form 2675-r?
A: DA Form 2675-r is used by individuals who have suffered work-incurred injuries or disabilities.
Q: How do I fill out DA Form 2675-r?
A: To fill out DA Form 2675-r, you will need to provide information about the injury or disability, including the date, location, and details of the incident.
Form Details:
- A 1-page document available for download in PDF;
- The latest version available from the Army Publishing Directorate;
- Editable, free, and easy to use;
- Fill out the form in our online filing application.
Download an up-to-date fillable DA Form 2675-r down below in PDF format or browse hundreds of other DA Forms stored in our online database.
