Download the form
The scope here is Department-wide. DD Form 2716-1 — DD Form 2716-1, DoD Certificate of Supervised Release, March 2013 — exists to Department of Defense Certificate of Supervised Release, and it applies across the services rather than inside one. That is what the DD prefix encodes: joint issue, single edition, every branch and defense agency working from identical paper.
not stated is the prescribing publication and not stated the office responsible for the document. Deadlines belong to local implementing guidance, not to either of those, so a submission date is a question for the receiving office.
Edition not stated, status not stated. That comparison is the first thing worth making, because a DD form supersedes centrally and an old copy in a shared drive is out of date for every office, not just yours.
Available: PDF, across 4 pages, roughly 33 fields.
All formats are free. One operational note: save the file locally and open it in a desktop reader. Browser-embedded viewers drop field properties and lose typed data without warning.
What the form asks for
- The term of supervision hereby granted will become effective: (2 digit month, 2 digit day, 4 digit year).
- and will expire on: (2 digit month, 2 digit day, 4 digit year).
- Signed (chairman, parole and clemency board).
- Enter Mandatory Supervised Release or Parole.
- Endorsement: The above named individual was released from confinement and placed on release or parole the: day.
- Month.
- Year.
- Dated: (2 digit month, 2 digit day, 4 digit year).
- Signed (Commander of corrections facility).
- Parole Agreement. 1.a. Probation/parole officer name (last, first, middle).
- b. Telephone number (include area code).
- c. Agency address.
- d. City.
- e. State.
- f. Zip code.
- 2. Probation/parole destination (limitation of travel will be designated by Parole Officer).
- Supervisee's facility address (facility name/state/zip code).
- Supervisee name (last, first, middle initial)
- Social security number (do not include dashes).
- Additional conditions of supervised release (inserted by Clemency and Parole Board).
- Signature of supervisee.
- Date of supervised release (2 digit month, 2 digit day, 2 digit year, no separators).
- Date (2 digit month, 2 digit day, 2 digit year, no separators).
- Social security number (do not include dashes).
Edition check comes first, ahead of any entry. Compare the printed date to not stated and replace anything older. Department-level supersession is simultaneous across the services, so a superseded blank is not merely out of date locally; the office receiving it is already working from the new field structure whichever branch it belongs to.
Field-level questions go to the printed instructions, then to not stated, which is authoritative.
Submit to the office named in not stated or in local instruction; retain a duplicate before it leaves. Joint routing often sends a DD form across organizational boundaries, and tracing one afterward is not a same-day matter.
A number is a complete address in the DD series. Because the sequence is Department-level and not duplicated per service, there is nothing further to specify.
Where a procedure cites both a service form and a DD form, the two are unconnected. Service numbering answers to a service proponent, DD numbering to not stated or another Department office, and the two sequences were never aligned. Matching numbers mean nothing whatever.
Three drivers of revision: directive reissue, altered collection requirements, updated statutory notice text. No notification accompanies any of them, so download fresh and confirm not stated rather than reusing an archived file.
Limits of this page: it distributes a published Department of Defense document and describes it. No legal advice, no procedural ruling, no statement about whether any submission will be accepted. Applicability, eligibility and procedure belong to not stated, to a servicing personnel office, or to the office named in not stated.
Questions and answers
- What is DD Form 2716-1?
- DD Form 2716-1, DoD Certificate of Supervised Release, March 2013
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?