DA Form 4449 "Clemency Action Record"

What Is DA Form 4449?

This is a military form that was released by the U.S. Department of the Army (DA) on August 1, 2010. The form, often mistakenly referred to as the DD Form 4449, 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.

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;

Download an up-to-date fillable DA Form 4449 down below in PDF format or browse hundreds of other DA Forms stored in our online database.

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Download DA Form 4449 "Clemency Action Record"

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CLEMENCY ACTION RECORD
For use of this form, see AR 15-130; the proponent agency is OSA
LAST NAME
FIRST NAME
MIDDLE INITIAL
SECTION I - RECOMMENDATIONS OF THE ANALYST
NO CLEMENCY
OTHER
REMIT IN EXCESS OF
YRS
REMIT UNEX PORTION OF SENTENCE
TO CNF
GRANT DISCHARGE
HON
GEN
UTOHC
BCD
TRANSFER RETRAINING BRIGADE
SIGNATURE OF ANALYST
DATE
SECTION II - RECOMMENDATIONS OF THE ARMY CLEMENCY AND PAROLE BOARD
NO CLEMENCY
OTHER
REMIT IN EXCESS OF
YRS
REMIT UNEX PORTION OF SENTENCE
TO CNF
GRANT DISCHARGE
HON
GEN
UTOHC
BCD
TRANSFER RETRAINING BRIGADE
SIGNATURE OF BOARD CHAIRMAN
DATE
SIGNATURE OF MILITARY MEMBER
SIGNATURE OF MILITARY MEMBER
DATE
SECTION III - APPROVING AUTHORITY ACTION
DATE
APPROVED
DISAPPROVED
BY ORDER OF THE SECRETARY OF THE ARMY
DA FORM 4449, AUG 2010
PREVIOUS EDITIONS ARE OBSOLETE.
APD LC v1.00ES
CLEMENCY ACTION RECORD
For use of this form, see AR 15-130; the proponent agency is OSA
LAST NAME
FIRST NAME
MIDDLE INITIAL
SECTION I - RECOMMENDATIONS OF THE ANALYST
NO CLEMENCY
OTHER
REMIT IN EXCESS OF
YRS
REMIT UNEX PORTION OF SENTENCE
TO CNF
GRANT DISCHARGE
HON
GEN
UTOHC
BCD
TRANSFER RETRAINING BRIGADE
SIGNATURE OF ANALYST
DATE
SECTION II - RECOMMENDATIONS OF THE ARMY CLEMENCY AND PAROLE BOARD
NO CLEMENCY
OTHER
REMIT IN EXCESS OF
YRS
REMIT UNEX PORTION OF SENTENCE
TO CNF
GRANT DISCHARGE
HON
GEN
UTOHC
BCD
TRANSFER RETRAINING BRIGADE
SIGNATURE OF BOARD CHAIRMAN
DATE
SIGNATURE OF MILITARY MEMBER
SIGNATURE OF MILITARY MEMBER
DATE
SECTION III - APPROVING AUTHORITY ACTION
DATE
APPROVED
DISAPPROVED
BY ORDER OF THE SECRETARY OF THE ARMY
DA FORM 4449, AUG 2010
PREVIOUS EDITIONS ARE OBSOLETE.
APD LC v1.00ES