DA Form 5964 "Gunner's Examination Scorecard - Mortars"

What Is DA Form 5964?

This is a military form that was released by the U.S. Department of the Army (DA) on March 1, 2017. The form, often mistakenly referred to as the DD Form 5964, 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 printable DA Form 5964 down below in PDF format or browse hundreds of other DA Forms stored in our online database.

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Download DA Form 5964 "Gunner's Examination Scorecard - Mortars"

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1. MORTARS
GUNNER'S EXAMINATION SCORECARD - MORTARS
(CHECK ONE)
Ground-Mounted
For use of this form see TC 3-22.90, the proponent agency is TRADOC.
Carrier-Mounted
DATA REQUIRED BY THE PRIVACY ACT OF 1974
AUTHORITY:
10 USC 3012 (g), Executive Order 9397.
PRINCIPAL PURPOSE:
To evaluate an individual's training on mortars.
ROUTINE USES:
Information evaluates individual proficiency; Service ID# is used for positive identification purposes only.
DISCLOSURE:
Disclosure of this information is voluntary. However, individuals not providing information cannot be rated/ scored on a
mass basis.
2. ORGANIZATION
3. DATE (YYYYMMDD)
4. NAME (Last, First, MI)
5. GRADE
6. CHECK ONE
60MM
81MM
120MM
TRIAL
TIME
TRIAL SCORE
CREDIT SCORE
INITIALS
ITEMS
(a)
(b)
(c)
(d)
(e)
GROUND -
Mounting the mortar
7.
1st Trial
OR
CARRIER -
Placing the mortar in firing
position from traveling
2nd Trial
position
ALL -
Small deflection and elevation
8.
1st Trial
change
2nd Trial
ALL -
Referring the sight and
1st Trial
9.
realigning aiming posts
2nd Trial
ALL -
Large deflection and
10.
1st Trial
elevation change
2nd Trial
ALL -
Reciprocal laying
11.
1st Trial
2nd Trial
12.
TOTAL CREDIT SCORE
(Check one)
RATING
90 to 100
EXPERT GUNNER
80 to 89
FIRST-CLASS GUNNER
70 to 79
SECOND-CLASS GUNNER
69 or less
UNQUALIFIED
13. VERIFIED BY
a. PRINTED NAME
e. UNIT
b. SIGNATURE
c. GRADE
d. DATE (YYYYMMDD)
DA FORM 5964, MAR 2017
PREVIOUS EDITIONS ARE OBSOLETE.
APD LC v1.00ES
1. MORTARS
GUNNER'S EXAMINATION SCORECARD - MORTARS
(CHECK ONE)
Ground-Mounted
For use of this form see TC 3-22.90, the proponent agency is TRADOC.
Carrier-Mounted
DATA REQUIRED BY THE PRIVACY ACT OF 1974
AUTHORITY:
10 USC 3012 (g), Executive Order 9397.
PRINCIPAL PURPOSE:
To evaluate an individual's training on mortars.
ROUTINE USES:
Information evaluates individual proficiency; Service ID# is used for positive identification purposes only.
DISCLOSURE:
Disclosure of this information is voluntary. However, individuals not providing information cannot be rated/ scored on a
mass basis.
2. ORGANIZATION
3. DATE (YYYYMMDD)
4. NAME (Last, First, MI)
5. GRADE
6. CHECK ONE
60MM
81MM
120MM
TRIAL
TIME
TRIAL SCORE
CREDIT SCORE
INITIALS
ITEMS
(a)
(b)
(c)
(d)
(e)
GROUND -
Mounting the mortar
7.
1st Trial
OR
CARRIER -
Placing the mortar in firing
position from traveling
2nd Trial
position
ALL -
Small deflection and elevation
8.
1st Trial
change
2nd Trial
ALL -
Referring the sight and
1st Trial
9.
realigning aiming posts
2nd Trial
ALL -
Large deflection and
10.
1st Trial
elevation change
2nd Trial
ALL -
Reciprocal laying
11.
1st Trial
2nd Trial
12.
TOTAL CREDIT SCORE
(Check one)
RATING
90 to 100
EXPERT GUNNER
80 to 89
FIRST-CLASS GUNNER
70 to 79
SECOND-CLASS GUNNER
69 or less
UNQUALIFIED
13. VERIFIED BY
a. PRINTED NAME
e. UNIT
b. SIGNATURE
c. GRADE
d. DATE (YYYYMMDD)
DA FORM 5964, MAR 2017
PREVIOUS EDITIONS ARE OBSOLETE.
APD LC v1.00ES