DA Form 4459 "Parole Action Record"

What Is DA Form 4459?

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 4459, 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 4459 down below in PDF format or browse hundreds of other DA Forms stored in our online database.

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Download DA Form 4459 "Parole Action Record"

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PAROLE 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
DISAPPROVE PAROLE
OTHER
RESCIND PAROLE
REVOKE PAROLE
APPROVE PAROLE
REINSTATE PAROLE
SUSPEND PAROLE
ADVANCEMENT OF PAROLE ELIGIBILITY
REASON (S) FOR RECOMMENDATION OF ANALYST:
SIGNATURE OF ANALYST
DATE
SECTION II - DETERMINATION OF THE ARMY CLEMENCY AND PAROLE BOARD
DISAPPROVE PAROLE
OTHER
RESCIND PAROLE
REVOKE PAROLE
APPROVE PAROLE
REINSTATE PAROLE
SUSPEND PAROLE
ADVANCEMENT OF PAROLE ELIGIBILITY
BY ORDER OF THE SECRETARY OF THE ARMY
SIGNATURE OF BOARD CHAIRMAN
SIGNATURE OF MILITARY MEMBER
SIGNATURE OF MILITARY MEMBER
DATE
DA FORM 4459, AUG 2010
APD LC v1.00ES
PREVIOUS EDITIONS ARE OBSOLETE.
PAROLE 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
DISAPPROVE PAROLE
OTHER
RESCIND PAROLE
REVOKE PAROLE
APPROVE PAROLE
REINSTATE PAROLE
SUSPEND PAROLE
ADVANCEMENT OF PAROLE ELIGIBILITY
REASON (S) FOR RECOMMENDATION OF ANALYST:
SIGNATURE OF ANALYST
DATE
SECTION II - DETERMINATION OF THE ARMY CLEMENCY AND PAROLE BOARD
DISAPPROVE PAROLE
OTHER
RESCIND PAROLE
REVOKE PAROLE
APPROVE PAROLE
REINSTATE PAROLE
SUSPEND PAROLE
ADVANCEMENT OF PAROLE ELIGIBILITY
BY ORDER OF THE SECRETARY OF THE ARMY
SIGNATURE OF BOARD CHAIRMAN
SIGNATURE OF MILITARY MEMBER
SIGNATURE OF MILITARY MEMBER
DATE
DA FORM 4459, AUG 2010
APD LC v1.00ES
PREVIOUS EDITIONS ARE OBSOLETE.