Download the form
DA Form 4658 exists to statement of retirement - eligible soldier - not eligible to reenlist — that is the short version. Title of record: STATEMENT OF RETIREMENT - ELIGIBLE SOLDIER - NOT ELIGIBLE TO REENLIST. The page covers the download, the entries and the disposition, nothing else. Current here: edition August 2010, status not stated, 1 page(s), near 58 fields.
Authority sits in two places. DCS, G-1 owns the form, AR 635-200 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.
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.
Nothing is charged and no sign-up applies. Files are served as published, without changes to the page image.
What the form asks for
- Branch
- ContentArea1
- Date_A
- Date_C
- Date_D
- First
- Grade_A
- Grade_B
- Name_A
- Name_B
- Page1
- R38
- R39
- R40
- R41
- R42
- R43
- R44
- R45
- R46
- Reasons
- Second
- T10
- T11
Start at the top and get the header exactly right. Official spelling of the name, identification number, unit, date. Everything downstream finds the record through those entries; nothing else on the page has that consequence.
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.
The signature closes the form and nothing precedes it. Draft status holds until it is applied, by hand or by an accepted electronic method. Countersignatures go in printed order, each dated at signing. Then one final read from the top, looking for the four recurring defects: empty mandatory fields, swapped digits in identification numbers, day-month inversion in dates, and residue from a reused file that goes forward as though intended.
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.
The prescribing directive names the destination; office custom does not. Depending on the case that means a specific office, the unit administrative channel, or the personal record. Keep a copy first, because the original does not come back. Retention runs on the applicable records schedule.
Look for associated forms by series and number. In the DA series, documents sharing a proponent or a governing directive tend to travel together, and anything referenced on the page normally submits alongside. Collect continuations, covers and transmittals in advance of sending.
Check the edition date before reusing a saved copy. Revisions come from the proponent without notice to you, and the printed date is the only version marker on the page. Already-submitted records under a superseded edition stand as filed; the change does not run backwards.
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 DCS, G-1 or your servicing administrative office.
Questions and answers
- What is DA Form 4658?
- STATEMENT OF RETIREMENT - ELIGIBLE SOLDIER - NOT ELIGIBLE TO REENLIST
- Which edition is current?
- August 2010
- Who is responsible for this form?
- DCS, G-1
- In which formats can it be downloaded?
- PDF, XFDL