DA Form 2627-2 Record Of Supplementary Action Under Article 15, Ucmj

What Is DA Form 2627-2?

DA Form 2627-2, Record of Supplementary Action Under Article 15, UCMJ, is a form used to document any supplementary action taken by an appropriate authority to vacate, mitigate, suspend, remit, or set aside a punishment. The exception is punishment imposed under summarized proceedings.

The latest version of the document – often confused with the DD Form 2627, Request for Government Approval for Aircrew Qualifications and Training – was released by the Department of the Army in October 2011. A new DA Form 2627-2 fillable version is available for digital filing and download below or can be found through the Army Publishing Directorate website.

The DA Form 2627 and the DA Form 2627-1 are two documents related to the DA 2627-2. The DA 2627-1 is used to record the summarized proceedings under Article 15 and the DA 2627 is utilized for documenting formal proceedings under the same Article.

RECORD OF SUPPLEMENTARY ACTION UNDER ARTICLE 15, UCMJ
For use of this form, see AR 27-10, Chapter 3; the proponent agency is OTJAG-CL.
NAME
GRADE
SSN
UNIT & LOCATION
TYPE OF SUPPLEMENTAL ACTION
(OTHER THAN SUPERIOR AUTHORITY ACTING ON APPEAL) (CHECK APPROPRIATE BOX)
SUSPENSION
(Complete Item 1 below)
REMISSION
(Complete Item 3 below)
MITIGATION
(Complete Item 2 below)
SETTING ASIDE (Complete Item 4 below)
VACATION OF SUSPENSION
(Complete Item 5 below)
1. SUSPENSION
The punishment(s) of:
imposed on the above service member on
(date of punishment)
suspended and will automatically be remitted if not vacated before
.
(date)
2. MITIGATION
The punishment(s) of:
imposed on the above service member on
mitigated to
(date of punishment)
3. REMISSION
The punishment(s) of:
imposed on the above service member on
remitted.
(date of punishment)
4. SETTING ASIDE
The punishment(s) of:
imposed on the above service member on
set aside on the basis of
(date of punishment)
All rights, privileges, and property affected are hereby restored.
5. VACATION OF SUSPENSION
a. The suspension of the punishment(s) of:
imposed on the above service member on
hereby vacated. The unexecuted portion(s) of the punishment(s) will be
(date of punishment)
duly executed (date of punishment).
b. Vacation is based on the following offense(s):
c. The service member
given an opportunity to rebut (see para. 3-25, AR 27-10).
(was / was not)
d. The service member
present at the vacation proceeding (see para. 3-25, AR 27-10).
(was / was not)
6. THE ORIGINAL DA FORM 2627 WAS FILED AS FOLLOWS:
Performance section of the OMPF
Restricted section of the OMPF.
NA as soldier was an E-4 or below at start of proceedings
7. BY MY ORDER:
AS THE OFFICER WHO IMPOSED
AS THE SUCCESSOR IN COMMAND TO THE
AS THE SUPERIOR AUTHORITY
THE PUNISHMENT
IMPOSING OFFICER
NAME, RANK, AND ORGANIZATION OF COMMANDER
SIGNATURE
DATE
DA FORM 2627-2, OCT 2011
PREVIOUS EDITIONS ARE OBSOLETE.
APD LC v1.01

Download DA Form 2627-2 Record Of Supplementary Action Under Article 15, Ucmj

973 times
Rate
4.5(4.5 / 5) 88 votes

How to Fill Out DA Form 2627-2?

Procedural guidelines and additional information can be found in the AR 27–10, Military Justice, released in May 2016. DA Form 2627-2 instructions are as follows:

  1. A soldier’s nonjudicial punishment may be suspended, set aside, mitigated, or remitted. The DA 2627-2 should be filed in any of these cases. Besides, a commander may vacate any suspended punishment. The data about vacation goes in this document too
  2. The form requires personal identifying information about the alleged offendant, including their name, grade, SSN, unit, and location. After that, the officer filing the form must identify the supplemental action and complete the next several corresponding blocks.
  3. Block 1 is filled out when the punishment is suspended. It is usually done to grant the soldier a probation period during which they may demonstrate that they deserve remission.
  4. Any suspended punishment may be vacated by the commander if the soldier has committed misconduct during the suspension period.
  5. If the punishment was disproportionate to the offense or the soldier deserves a reduction for good conduct, the punishment may be mitigated. The action is then recorded in Block 2.
  6. If any part of the unexecuted punishment is canceled, the information about it should be provided in Block 3.
  7. A postponed punishment (whether executed or unexecuted later) has to be identified in Block 4.
  8. A vacation of suspension is described in Block 5. Block 6 identifies the purpose of the original DA Form 2627 connected to the case. Block 7 identifies the official giving out the order.
  9. The name, rank, organization, and signature of the commander are provided at the bottom of the document.