DA Form 2627 "Record of Proceedings Under Article 15, Ucmj"

What Is DA Form 2627?

DA Form 2627, Record of Proceedings Under Article 15, UCMJ, is an Army form used to document the details of proceedings under Article 15 of the Uniform Code of Military Justice. Article 15, UCMJ is a federal law that allows applying nonjudicial punishments in cases involving minor offenses. A Soldier has the right to refuse these proceedings and demand a court-martial trial.

The document - sometimes confused with DD Form 2627, Request for Government Approval for Aircrew Qualifications and Training - was released by the Department of the Army (DA) on October 1, 2011. An up-to-date DA Form 2627 fillable version is available for download below or can be found on the Army Publishing Directorate website.

The DA 2627 has two related forms: DA Form 2627-1, Summarized Record of Proceedings under Article 15, UCMJ, and DA Form 2627-2, Record of Supplementary Action under Article 15, UCMJ. The first form is used to document proceedings under Article 15 for enlisted personnel and with limited punishment. The second form is used for recording any supplementary actions connected to a case.

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How to Fill Out DA Form 2627?

Procedural guidelines and additional information can be found in the AR 27-10, Military Justice. DA Form 2627 instructions are as follows:

  1. In case of an offense, the commander of the alleged offendant initiates a preliminary inquiry.
  2. If the alleged offendant is an officer or if the necessary punishments exceed the ones allowed by the summarized Article 15, the commander will complete Items 1 and 2 of the form.
  3. After the form is complete, a copy of the form is delivered to the Soldier with a notification of their rights and the maximum punishment the commander could impose in this particular case.
  4. If the service member decides to demand a trial, they need to initial Block 3a, sign and date the form and hand it in within the decision period, which is about 48 hours. The refusal to sign is assumed as a withdrawal of any demand for trial.
  5. If the Soldier agrees to Article 15 proceedings they need to complete Block 3b.
  6. If the commander determines that nonjudicial punishment is not warranted as the result of the evaluation, all copies of the DA Form 2627 will be destroyed and the Soldier will be notified that the case is closed.
  7. In case the commander is convinced beyond a reasonable doubt that the Soldier is guilty, the determined punishment is identified in Block 6 of the form.
  8. Appellate rights and procedures must be explained to the Soldier. All appeals are made on the same DA 2627 and forwarded through the imposing commander to the superior authority.
  9. The decision of the superior authority on the appeal will be entered in Block 8. The service member is required to acknowledge their compliance with the action taken on the appeal.

Photocopies of the form will be transmitted to the Soldier's Military Personnel Division (MPD) and the Defense Military Pay Office (DMPO). The original DA 2627 will be forwarded to the appropriate custodian for filing in the Official Military Personnel File (OMPF).

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Download DA Form 2627 "Record of Proceedings Under Article 15, Ucmj"

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RECORD OF PROCEEDINGS UNDER ARTICLE 15, UCMJ
For use of this form, see AR 27-10; the proponent agency is OTJAG-CL.
NAME
GRADE
SSN
UNIT & LOCATION
MONTHLY BASE PAY
1. I am considering whether you should be punished under Article 15, UCMJ, for the following misconduct:
2. You are not required to make any statements, but if you do, they may be used against you in this proceeding or at a trial by court-martial. You have
several rights under this Article 15 proceeding. First I want you to understand I have not yet made a decision whether or not you will be punished. I will not
impose any punishment unless I am convinced beyond a reasonable doubt that you committed the offense(s). You may ordinarily have an open hearing before
me. You may request a person to speak on your behalf. You may present witnesses or other evidence to show why you shouldn't be punished at all
(matters of defense) or why punishment should be very light (matters of extenuation and mitigation). I will consider everything you present before deciding
whether I will impose punishment or the type and amount of punishment I will impose. If you do not want me to dispose of this report of misconduct under
Article 15, you have the right to demand trial by court-martial instead. In deciding what you want to do you have the right to consult with legal counsel
located at
. You now have 48 hours to decide what you want to do.
NAME, GRADE, AND ORGANIZATION OF COMMANDER
SIGNATURE
DATE
3. Having been afforded the opportunity to consult with counsel and understanding my rights listed above and on page three of this form, my decisions are
as follows (Initial appropriate blocks, date, and sign):
I demand trial by court-martial.
a.
I do not demand trial by court-martial and in the Article 15 proceedings:
b.
(1)
I request the hearing be:
Open
Closed
(2) A person to speak in my behalf:
Is requested
Is not requested
(3)
Matters in defense, extenuation, and/or mitigation:
Are not presented
Are attached
Will be presented in person
NAME AND GRADE OF SERVICE MEMBER
SIGNATURE
DATE
Open
Closed
hearing, having considered all matters presented, I hereby make the following finding:
4a. In a (n)
Guilty of All
Not Guilty of All Specifications
Guilty of Some Specifications
Specifications.
(line out all Specifications and sign below).
(line out Not Guilty Specifications).
Based on my findings, I impose the punishments that are officially recorded in Item 6 of this form.
4b. I direct the original DA Form 2627 be filed in the:
NA as soldier was an E-4 or
Performance section of the OMPF
Restricted section of the OMPF
below at start of proceedings
within five (5) calendar days.
4c. You are advised of your right to appeal to the next superior authority:
An appeal made after that time may be rejected as untimely. Punishment is effective immediately unless otherwise stated in Item 6.
NAME, GRADE, AND ORGANIZATION OF COMMANDER
SIGNATURE
DATE
5. (Initial appropriate block, date, and sign)
I do not appeal
I appeal and do not submit additional matters
I appeal and submit additional matters
NAME AND RANK OF SERVICE MEMBER
SIGNATURE
DATE
Page 1 of 5
DA FORM 2627, OCT 2011
PREVIOUS EDITIONS ARE OBSOLETE.
APD LC v1.01
RECORD OF PROCEEDINGS UNDER ARTICLE 15, UCMJ
For use of this form, see AR 27-10; the proponent agency is OTJAG-CL.
NAME
GRADE
SSN
UNIT & LOCATION
MONTHLY BASE PAY
1. I am considering whether you should be punished under Article 15, UCMJ, for the following misconduct:
2. You are not required to make any statements, but if you do, they may be used against you in this proceeding or at a trial by court-martial. You have
several rights under this Article 15 proceeding. First I want you to understand I have not yet made a decision whether or not you will be punished. I will not
impose any punishment unless I am convinced beyond a reasonable doubt that you committed the offense(s). You may ordinarily have an open hearing before
me. You may request a person to speak on your behalf. You may present witnesses or other evidence to show why you shouldn't be punished at all
(matters of defense) or why punishment should be very light (matters of extenuation and mitigation). I will consider everything you present before deciding
whether I will impose punishment or the type and amount of punishment I will impose. If you do not want me to dispose of this report of misconduct under
Article 15, you have the right to demand trial by court-martial instead. In deciding what you want to do you have the right to consult with legal counsel
located at
. You now have 48 hours to decide what you want to do.
NAME, GRADE, AND ORGANIZATION OF COMMANDER
SIGNATURE
DATE
3. Having been afforded the opportunity to consult with counsel and understanding my rights listed above and on page three of this form, my decisions are
as follows (Initial appropriate blocks, date, and sign):
I demand trial by court-martial.
a.
I do not demand trial by court-martial and in the Article 15 proceedings:
b.
(1)
I request the hearing be:
Open
Closed
(2) A person to speak in my behalf:
Is requested
Is not requested
(3)
Matters in defense, extenuation, and/or mitigation:
Are not presented
Are attached
Will be presented in person
NAME AND GRADE OF SERVICE MEMBER
SIGNATURE
DATE
Open
Closed
hearing, having considered all matters presented, I hereby make the following finding:
4a. In a (n)
Guilty of All
Not Guilty of All Specifications
Guilty of Some Specifications
Specifications.
(line out all Specifications and sign below).
(line out Not Guilty Specifications).
Based on my findings, I impose the punishments that are officially recorded in Item 6 of this form.
4b. I direct the original DA Form 2627 be filed in the:
NA as soldier was an E-4 or
Performance section of the OMPF
Restricted section of the OMPF
below at start of proceedings
within five (5) calendar days.
4c. You are advised of your right to appeal to the next superior authority:
An appeal made after that time may be rejected as untimely. Punishment is effective immediately unless otherwise stated in Item 6.
NAME, GRADE, AND ORGANIZATION OF COMMANDER
SIGNATURE
DATE
5. (Initial appropriate block, date, and sign)
I do not appeal
I appeal and do not submit additional matters
I appeal and submit additional matters
NAME AND RANK OF SERVICE MEMBER
SIGNATURE
DATE
Page 1 of 5
DA FORM 2627, OCT 2011
PREVIOUS EDITIONS ARE OBSOLETE.
APD LC v1.01
NAME (Last, First, MI)
GRADE
SSN
UNIT & LOCATION
6. The following punishment is imposed:
7. I have considered the appeal and it is my opinion that:
NAME, RANK, AND ORGANIZATION OF REVIEWING JUDGE ADVOCATE
SIGNATURE
DATE
8. After consideration of all matters presented in the appeal, the appeal is:
Denied
Granted as follows:
NAME, RANK, AND ORGANIZATION OF COMMANDER
SIGNATURE
DATE
9. I have seen the action taken on my appeal.
NAME AND RANK OF SERVICE MEMBER
SIGNATURE
DATE
10. Allied Documents and/or Comments:
Page 2 of 5
DA FORM 2627, OCT 2011
APD LC v1.01
ARTICLE 15 RIGHTS, MAXIMUM PUNISHMENTS, AND FILING
Article 15, UCMJ, is a federal law that permits commanding officers to conduct non-judicial proceedings for minor offenses. A Soldier may
refuse Article 15 proceedings and demand trial by court-martial, unless attached to or embarked on a vessel. A Commander may find a Soldier
guilty of an offense at an Article 15 proceeding only after being convinced beyond a reasonable doubt that the Soldier is guilty.
SOLDIERS HAVE THE FOLLOWING RIGHTS AT AN ARTICLE 15 PROCEEDING:
To refuse Article 15 proceedings and demand trial by court-martial. If the Soldier is attached to or embarked on a vessel, he or she is not
a.
permitted to refuse Article 15 proceedings. If a Soldier demands trial by court-martial, the trial could be a Summary, Special, or General
Court-Martial. A Soldier may object to trial by Summary Court-Martial. At a Special or General Court-Martial, a Soldier is entitled to be
represented by qualified military defense counsel, or by civilian counsel at no expense to the government.
b.
To request an open or closed hearing.
c.
To request a person to speak on his or her behalf.
d.
To invoke his or her rights under Article 31(b), UCMJ, to remain silent and to not make any statement regarding the offense(s) for which
the Article 15 hearing is held. If the Soldier makes a statement, that statement may be used as evidence in a later trial by court-martial.
e.
To present matters in defense, extenuation, or mitigation.
f.
To discuss the Article 15 and its proceedings with an attorney in private before making these elections.
g.
To appeal the findings and punishment to the next superior authority.
MAXIMUM PUNISHMENTS UNDER A FORMAL ARTICLE 15 FOR ENLISTED SOLDIERS IF IMPOSED BY:
An oral or written reprimand, restriction for 14 days, extra duty for 14 days, correctional custody for 7 days (if the
A Company Grade Officer:
Soldier is in the grade of E-3 or below and if a correctional custody facility is available), reduction of one grade (if
the Soldier is in the grade of E-4 or below), and forfeiture of 7 days’ pay. The amount of the forfeiture is computed
at the reduced grade, even if suspended, if reduction is part of the punishment imposed.
A Field Grade or General Officer: An oral or written reprimand, restriction for 60 days, extra duty for 45 days, correctional custody for 30 days
(if the Soldier is in the grade of E-3 or below and if a correctional custody facility is available), reduction of one
or more grades (if the Soldier is in the grade of E-4 or below, and if imposed by a Commander of a unit
authorized a Commander in the grade of O-5 or higher), reduction of one grade if the Soldier is in the grade
of E-5 or E-6, and forfeiture of ½ of one month’s pay for two months. The amount of the forfeiture is
computed at the reduced grade, even if suspended, if reduction is part of the punishment imposed. When
restriction is combined with extra duty, the maximum period of restriction is 45 days.
MAXIMUM PUNISHMENTS UNDER ARTICLE 15 FOR COMMISSIONED & WARRANT OFFICERS IF IMPOSED BY:
A Company Grade Officer or Field Grade Officer: A written reprimand and restriction for 30 days.
Note: The authority of company and field grade officers to impose Article 15 punishment on fellow officers is
typically withheld by the General Court-Martial Convening Authority (GCMCA). Check with the command’s Staff
Judge Advocate before attempting to take action.
A General Officer or GCMCA: A written reprimand, arrest in quarters for 30 days, restriction for 60 days, and forfeiture of ½ of one month’s pay
for two months.
THE FILING OF ARTICLE 15 FORMS & REVIEW BY DA CAREER MANAGERS AND SELECTION BOARDS:
If a Commander finds a Soldier in the rank of Sergeant (E-5) or above guilty of one or more offenses at an Article 15 proceeding and imposes
punishment, the Commander must file the Article 15 form in either the Soldier’s Official Military Personnel File (OMPF) performance or
restricted fiche. MOS/specialty career managers and DA Selection Boards routinely use the OMPF performance fiche. The OMPF restricted
fiche is not given to MOS/specialty career managers or DA selection boards without the approval of the Commander, HRC or selection board
proponent. If the Soldier is in the grade of E-4 or below at the start of an Article 15 proceeding and punishment is imposed, the form will be
maintained locally and no filing in the OMPF, either in the performance or the restricted fiche, is authorized. AR 27-10, Chapter 3 provides
detailed rules governing requests to transfer an Article 15 from a Soldier’s performance fiche to his or her restricted fiche.
THE NEED TO IMPROVE STANDARDS OF PERFORMANCE AND CONDUCT:
Soldiers found guilty at an Article 15 proceeding are considered to be on notice that they must improve their conduct and performance. An
Article 15 may form the basis, either in whole or in part, for an administrative separation action that results in a less than honorable discharge.
Soldiers are strongly encouraged to exhibit the behavior necessary to receive an Honorable Discharge. If not, one or more of the following
situations may occur:
a.
The Soldier may be separated with a General Discharge under Honorable Conditions or with an Other Than Honorable Discharge.
A Soldier separated with less than an honorable discharge may be barred from ever enlisting again, may encounter problems securing
b.
civilian employment, and may forfeit the many benefits generally associated with an Honorable Discharge.
c.
The Soldier should be aware that the likelihood of upgrading a less than honorable discharge, while possible, is unlikely.
Page 3 of 5
DA FORM 2627, OCT 2011
APD LC v1.01
ARTICLE 15 PUNISHMENT WORKSHEET
(Generated by MJOnline)
Soldier's Data:
,
,
Imposing Commander:
Type of Article 15:
The following maximum allowable punishment may be imposed:
Reduction:
Forfeiture
Deprivation of Liberty Punishments:
Correctional Custody: Maximum of 30 days. Note: This punishment may be imposed only if a CCF is available. Only Soldiers
in grades E-1 to E3 can be placed in a CCF. May not be combined with Extra Duty or Restriction.
Extra Duty:
Restriction:
May be an oral or written reprimand. (Must be in writing if an officer.)
Reprimand:
Any punishment may be suspended for up to 6 months.
Reduction to the Grade of:
. If suspended, then (suspended for
or (reduction below the Grade of
suspended for
days)
days/months).
Forfeiture of
pay per month for
of the forfeiture for the number of months selected for a period of
(suspend
(one month)
(two months)
days/months).
Correctional Custody for
(suspended for
days/months).
days,
Extra duty for
(suspended for
days/months).
days,
(suspended for
days/months).
days,
Restriction for
(Normal limits are Company area, Dining/Medical Facility, Place of Worship, and Place of Duty.)
).
Reprimand
(Oral
) (Written
(Reprimands for enlisted Soldiers may be oral or written and oral is typically appropriate. Reprimands of commissioned or warrant
officers must be in writing.)
Date Punishment Imposed:
Commander's Initials:
Page 4 of 5
DA FORM 2627, OCT 2011
APD LC v1.01
RECORD OF PROCEEDINGS UNDER ARTICLE 15, UCMJ
Continuation Sheet
Item 1, Continued:
Page 5 of 5
DA FORM 2627, OCT 2011
APD LC v1.01
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