DA Form 4459 Parole Action Record

DA Form 4459 - also known as the "Parole Action Record" - is a Military form issued and used by the United States Department of the Army.

The form - often mistakenly referred to as the DD form 4459 - was last revised on August 1, 2010. Download an up-to-date fillable PDF version of the DA 4459 below or request a copy through the chain of command.

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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.

Download DA Form 4459 Parole Action Record

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