DA Form 5109 or the "Request To Superior To Exercise Article 15, Ucmj, Jurisdiction" is a Department of the Army-issued form used by and within the United States Military.
The form - often incorrectly referred to as the DD form 5109 - was last revised on September 1, 2002. Download an up-to-date fillable DA Form 5109 down below in PDF-format or look it up on the Army Publishing Directorate website.
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