Download the form
DA Form 1119-1 handles one job: certificate of achievement in safety. The official title is CERTIFICATE OF ACHIEVEMENT IN SAFETY. Download it below, fill it in, sign it, send it where your directive says. The edition on this page is 07/01/1989, status ACTIVE, running 1 page(s) with about 21 fields to complete. This edition is superseded — pull the newer one unless your record was already executed on this version.
Two references decide everything about your use of it: CSA maintains the content, not stated sets the trigger and the routing. Consult the directive when your case is not routine; otherwise the printed blocks tell you enough. The person named in the entries fills it, or the administrative office holding the file does it for them.
PDF, XFDL are available and the decision takes one second. Type your entries: fillable pdf. Write them: printable pdf. The published layout is common to both, so the format governs your method and nothing more.
A standalone reader is the safe choice for fillable work. Browser viewers vary in whether entered data survives the session, and there is no warning when it does not; a one-field save test settles it in seconds. Xfdl means IBM Lotus Forms. The Lotus Forms Viewer opens it; pdf readers and word processors do not.
Free, unregistered, unmodified. What arrives is what the publisher released.
What the form asks for
- ContentArea1
- FromDate1
- Name1
- Page1
- PageArea1
- PrintName1
- R12
- R13
- T10
- T11
- T31
- T43
- T44
- TimeAwarded1
- ToDate1
- TypeofOperation1
- creator
- event__docReady
- form
- title
- version
The heading entries carry more weight than the body. Name spelled as in official records, identification number, organisation, date prepared. Retrieval runs on those values, so a transposed digit or a casual spelling costs someone a file search. Fill them before anything else.
Tab through the fields rather than clicking. The tab order was fixed when the form was built and generally follows the page, which catches boxes a mouse skips past. Check boxes and option buttons take a click, and an exclusive group clears the previous selection when you make a new one. Single-line fields do not wrap — text past the field width prints truncated while still showing in full on screen, which is why the loss is discovered after printing. Overflow goes to remarks or a continuation sheet. A field that does not apply gets the mark meaning none; blank space reads as an omission.
Signature comes after every other entry — ink or an approved electronic means, and without it the document is a draft. Where reviewing, approving or witnessing signatures are called for, take them in printed block order, each dated on the day applied. Before release, one pass from the top. The defects worth hunting are always the same four: mandatory fields left empty, identification digits transposed, dates with day and month reversed, and stale data surviving in a copy reused in place of a blank form.
Privacy Act statement first, personal entries second. The notice covers who is authorised to collect, why, who else routinely sees it, and whether you must answer. After completion the file carries personal data and is stored and sent under the corresponding safeguards.
Send it where the directive says: the office it names, the unit administrative channel, or the individual's file. Take your copy before submission. How long the record is held comes from the schedule for the series, not from the office holding it.
Related forms are found by series and number. DA series documents under the same proponent or the same prescribing directive are commonly required as a set, and any form named on the face of this one goes forward with it. Assemble continuations, covers and transmittals before submitting, not after the query comes back.
Edition date is the version number, printed on the page. Hold a locally saved copy against the current edition before reuse, since nothing on your machine signals a revision. Work already executed under a superseded edition remains as filed.
The files are copies of published Department of the Army forms. This site has no official connection, no authority to issue anything, and no basis for saying whether an office will accept a given submission. None of the text is legal advice. Real questions — entry, requirement, eligibility — belong with CSA or the administrative office servicing your unit.
Questions and answers
- What is DA Form 1119-1?
- CERTIFICATE OF ACHIEVEMENT IN SAFETY
- Which edition is current?
- 07/01/1989
- Who is responsible for this form?
- CSA
- In which formats can it be downloaded?
- PDF, XFDL, PDF