To complete a DA Form 2627, you will need to provide the following information:
- Name
- Grade
- SSN
- Unit & location
- Monthly base pay
- Reason soldier is being considered for punishment under Article 15, UCMJ
- List of legal counsel available to soldier
- Name, grade and organization of commander
- Signature
- Indication of whether soldier:
- Demands trial by court martial
- Does not demand trial by court-martial and requests:
- Hearing to be open or closed
- A person to speak on his/her behalf is or is not requested
- Matters in defense, extenuation, and/or mitigation are not presented, are attached, will be presented in person
- Name and grade of service member and signature
- Indication of whether:
- Hearing was open or closed
- Soldier was found guilty of all specifications, guilty of some specifications, or not guilty of all specifications
- Indication of whether the original DA Form 2627 be filed in the performance section of the OMPF or the restricted section of the OMPF or NA as soldier was an E-4 or below at start of proceedings
- Name of next superior authority where soldier may appeal within 5 days
- Name, grade, and organization of commander and signature
- Indication of whether soldier intends to appeal
- Name and rank of service member and signature
- Punishment
- Opinion after consideration of appeal
- Name, rank, and organization of reviewing judge advocate and signature
- Indication of whether appeal is denied or granted
- Name, rank, and organization of commander and signature
- Indication that soldier has seen the action taken on his or her appeal
- Name and rank of service member and signature
- Allied documents and comments
- Article 15 Punishment Worksheet
- Soldier’s data
- Imposing commander
- Type of Article 15
- Maximum punishment
- Deprivation of liberty punishments
- Correctional custody
- Extra duty
- Restriction
- Reprimand
- Any reduction to grade and any suspension
- Any forfeiture of pay and any suspension
- Any correctional duty and any suspension
- Any extra duty and any suspension
- Any restriction and any suspension
- Any reprimand and whether oral or written
- Date punishment imposed and commander’s initials