Download the form
DA Form 4655-R handles one job: target list worksheet. The official title is TARGET LIST WORKSHEET. Download it below, fill it in, sign it, send it where your directive says. The edition on this page is August 2013, status not stated, running 1 page(s) with about 200 fields to complete.
Authority sits in two places. TRADOC owns the form, ATP 3-09.30 says when it is raised and where it goes. Routine cases need neither read in full — the page itself carries the sequence. The entries are completed by their subject or by unit administrative staff working from what that person supplies.
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.
Save the download and open it in a dedicated reader. That single step prevents the common failure: an in-browser viewer accepts your typing and discards it at tab close. Confirm with one field and one save cycle before committing the whole form. The xfdl copy needs the IBM Lotus Forms Viewer. That format runs in Army systems and nothing else reads it.
Nothing is charged and no sign-up applies. Files are served as published, without changes to the page image.
What the form asks for
- ALT
- ALT_1
- ALT_10
- ALT_11
- ALT_12
- ALT_13
- ALT_14
- ALT_15
- ALT_16
- ALT_17
- ALT_18
- ALT_19
- ALT_2
- ALT_20
- ALT_3
- ALT_4
- ALT_5
- ALT_6
- ALT_7
- ALT_8
- ALT_9
- ATT
- ATT_1
- ATT_10
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.
Move between fields with tab; the build-time order follows the page and misses nothing. Click check boxes and option buttons, and expect an exclusive group to release the old choice when you set a new one. The trap is field width. Single-line fields do not wrap, so an overlong entry displays complete on screen and prints cut at the margin — put it in remarks or on a continuation instead. Mark inapplicable fields rather than leaving them blank, since an empty box carries no information about whether the question was read.
Sign last. An unsigned form is a draft whatever else is on it, and additional signatures — reviewer, approver, witness — follow printed block order with each signer dating the day they sign, not the day of preparation. Four faults account for most returns: a blank mandatory field, transposed digits in an identification number, day and month reversed in a date, and leftover entries in a working copy reused instead of a fresh blank. Read the form once from the top before releasing it.
The Privacy Act statement is read before the personal entries, not after. It gives the collection authority, the purpose, the routine uses and whether disclosure is mandatory or voluntary. Once filled, your copy is a personal record and gets stored and transmitted accordingly.
Routing follows ATP 3-09.30 and nothing else — a named office, the unit administrative channel, or the individual's file, according to why the form was raised. Copy it before it leaves. Retention is fixed by the records schedule for the series, which local practice does not shorten or extend.
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.
What is distributed here are reproductions of published Department of the Army documents. Independent site, no official standing, no forms of its own. Nothing on the page constitutes legal advice, and acceptance by any office is outside what can be stated. Put questions about entries, requirements or eligibility to TRADOC or your servicing administrative office.
Questions and answers
- What is DA Form 4655-R?
- TARGET LIST WORKSHEET
- Which edition is current?
- August 2013
- Who is responsible for this form?
- TRADOC
- In which formats can it be downloaded?
- PDF, XFDL