DA Form 4925 Chaplains' Fund Statement of Assets

DA Form 4925 - also known as the "Chaplains' Fund Statement Of Assets" - is a United States Military form issued by the Department of the Army.

The form - often mistakenly referred to as the DD form 4925 - was last revised on September 1, 1999. Download an up-to-date fillable PDF version of the DA 4925 down below or look it up on the Army Publishing Directorate website.

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CHAPLAINS' FUND STATEMENT OF ASSETS
For use of this form, see DA PAM 165-18; the proponent agency is CCH
SECTION A - FINANCIAL STATEMENT OF RETIRING FUND MANAGER
The account for the period ending
, is a true and complete statement of all receipts and
expenditures, and the balance for which I am responsible is accounted for as follows:
1. Checking account deposited with
(Name of Bank)
To the credit of
$
(Fund)
2. Savings account deposited with
(Name of Bank)
To the credit of
$
(Fund)
3. Cash in my personal possession (Petty Cash Fund)
$
4. Other:
$
5. TOTAL
$
SECTION B - JOINT INVENTORY
6. The Fund property listed in the Chaplains' Fund Property Record (DA Form 4924) as of
,
with a total value of
$
, has been jointly inventoried and is correct with the following exceptions:
7a. SIGNATURE OF RETIRING MANAGER
7b. DATE (YYYYMMDD)
8a. SIGNATURE OF SUCCESSOR MANAGER
8b. DATE (YYYYMMDD)
SECTION C - STATEMENT OF INSPECTOR OR AUDITOR
9. In accordance with the requirements of current regulations, I have this date
,
Inspected
Audited the
Chaplains'
(Check one)
Fund for the period from
to
inclusive, and find it
correct with the following exceptions:
10a. PRINTED NAME AND TITLE
10b. SIGNATURE
10c. DATE (YYYYMMDD)
DA FORM 4925, SEP 1999
APD LC v1.01ES
DA FORM 4925-R, MAY 89, IS OBSOLETE.

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