PDF
Word
DA Form 3964 Classified Document Accountability Record
What Is DA Form 3964? {id="mcetoc_1cstsc1cc0"}
DA Form 3964, Classified Document Accountability Record , is an official form used by the Department of the Army Information Security Program and designed as a single-entry active or inactive document-control register. The form will commonly accompany a classified document and is used to bring a document "under control" according to local procedures. The record is usually used either as a documented receipt, a certificate of destruction, or a document-control copy.
The latest version of the document - sometimes incorrectly referred to as DD Form 3964 - was released by the U.S. Department of the Army (DA) on July 1, 1979 , and replaces the November 1972 edition of the form. An up-to-date DA Form 3964 fillable version can be downloaded below or can be found on the Army Publishing Direcorate website.
Additionally, DA Form 4011, Telecommunications Center Delivery List , is used by message centers as a multiple-entry control register. AE Form 380-5A, Multiple Classification Message Destruction Record, may be used as a multiple CD for messages.
How to Fill Out DA Form 3964?
Procedural information and additional tips can be found in the AR 380-5, Department of the Army Information Security Program, released in September 2000. DA Form 3964 instructions are as follows:
-
Either DA Form 3964 or DA Form 455, Mail and Document Register, may be used as active or inactive control registers. All registers will be maintained in serial control-number sequences by calendar year. Personnel filing the form must prepare enough copies.
-
The current date is specified in the block labeled "Date" in the upper right corner of the page. The complete address of the agency where the classified document, will be sent is entered in the block labeled "To," and the address of the issuing organization is provided in the block labeled "From".
-
The "Control, Log or File No." block requires a number specified on the classified document.
-
The "Classification" block should be completed with a code to reflect the overall security rating of the document: "TS" - for "Top Secret," "S" - for "Secret," "C" - for "Confidential."
-
The exact number of copies of each document being transferred is listed in the "Number of Copies" block.
-
The "Description" block requires specifying the type of classified document, the file reference symbol, the unclassified subject or a short title of the document, and the number of endorsements or enclosures.
-
The date of origin and the name of the originator of the document is specified in the last two columns in the first part of the form. The other four sections of the form are mostly self-explanatory:
- Section B ("Routing") describes the transfer of the form and documents;
- Section C ("Destruction Certificate") is filed if the classified material is destructed or disposed of;
- Section D ("Reproduction Authority") is filed if the original document needs to be copied. Reproduction of classified material requires the approval of an originator or the higher Department of Defense (DoD) authority;
- Section E ("Receipt/Tracer Action") specifies whether or not the classified documents were delivered and received.
