Download the form
Use DA Form 5017 when you need to civilian employee consent statement. Full title: CIVILIAN EMPLOYEE CONSENT STATEMENT. Everything you need is on this page — the file, the entry rules, the routing. Edition 09/01/2023, status ACTIVE, 1 page(s), roughly 85 fields. Note the supersession: a later edition exists, and this one applies only to records already completed on it.
G-1 is the proponent, PAM 600-85 the prescribing authority. Read the directive only if something about your situation departs from the standard case. Otherwise the form is filled by the individual it describes, or by the records clerk keeping the file, and reviewed through the printed signature blocks.
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
- ContentArea1
- DATE_A
- DATE_B
- DATE_C
- EMPLOYEE
- First
- NAMETITLE
- Page1
- R84
- R85
- R86
- R87
- R88
- R89
- R90
- R91
- R92
- R93
- R94
- R95
- R96
- Rectangle1
- Second
- T10
Header first, always. Name as your official records spell it, identification number, unit, date of preparation — these four index the finished record, and an error in them hides the document from anyone searching for it later. The substantive blocks can wait thirty seconds.
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.
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.
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.
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.
A stored file goes stale silently. The proponent revises, a new edition date is published, and your copy says nothing about it — so compare the printed date against the edition in force before typing into it again. Completed submissions on an earlier edition are not reopened.
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 G-1 or your servicing administrative office.
Questions and answers
- What is DA Form 5017?
- CIVILIAN EMPLOYEE CONSENT STATEMENT
- Which edition is current?
- 09/01/2023
- Who is responsible for this form?
- G-1
- In which formats can it be downloaded?
- PDF, XFDL, PDF
Publisher notes
- PRIVACY ACT STATEMENT