DA Form 1622-1-R: Affidavits of Individual Sureties Guide

DA Form 1622-1-R: Affidavits of Individual Sureties Guide – U.S. Army form used to document the financial responsibility of individual sureties supporting bonds for government property. “LRA” refers to its use in contexts involving lien release authority or related accountability procedures.

This form provides sworn affidavits from individuals (sureties) stating they possess sufficient net worth—over and above all debts and liabilities—to back a bond. It is typically required when individual sureties (natural persons, not companies) guarantee obligations related to Army property loans or accountability.

The form dates to July 1989 (DA FORM 1622-1-R, JUL 1989) and remains referenced in current Army regulations for specific bonding scenarios.

Download the official DA Form 1622-1-R PDF here: https://armypubs.army.mil/pub/eforms/DR_a/pdf/A1622_1_R.pdf

Purpose of DA Form 1622-1-R

The primary purpose is to support legal bonds for the safekeeping or accountability of U.S. government property, especially when issued to educational institutions, such as in ROTC programs.

Key uses include:

  • Accompanying bonds (e.g., DA Form 1622-R) when individual sureties are provided instead of corporate surety bonds.
  • Verifying that each surety is financially capable of covering the bond amount if the principal defaults.
  • Ensuring compliance with property accountability rules under AR 735-5 (Policies and Procedures for Property Accountability).

It helps protect Army interests by confirming sureties’ net worth through notarized affidavits and certifications.

When Is DA Form 1622-1-R Required?

You typically need this form in these scenarios:

  • Loans of government property to non-Army entities (e.g., schools or universities participating in ROTC/JROTC programs).
  • Situations where individual sureties back a bond for property safekeeping.
  • As part of bonding requirements outlined in AR 735-5, Chapter 10 (Loans, Bonding, and Other Accounting Procedures).

Note: Corporate surety bonds are often preferred, but when individual sureties are used, a completed DA Form 1622-1-R is mandatory for each surety.

How to Fill Out DA Form 1622-1-R: Step-by-Step?

The form includes affidavits for up to two individual sureties, plus certification sections. It must be completed accurately and notarized.

Main Affidavit Sections (for each surety):

  1. State and County — Where the affidavit is sworn.
  2. Surety’s Name — Full legal name of the individual surety.
  3. Bond Reference — Identify the associated bond (e.g., amount and purpose).
  4. Net Worth Statement — Swear that the surety is “pecuniarily worth” a specific dollar amount “over and above all my debts and liabilities.”
  5. Signature and Date — Signed before a notary public or authorized officer.
  6. Notary Section — Official seal, signature, and commission details.

Certification of Sufficiency (Reverse Side):

  • Completed by a qualified third party (e.g., bank officer, judge, clerk of court, U.S. district attorney, postmaster, or IRS collector).
  • Certifies personal knowledge of the surety and belief in the stated net worth.

Important Tips:

  • Each individual surety needs their own complete affidavit.
  • All signatures must be original; reproduced signatures are generally not accepted.
  • Attach supporting documentation if required by the specific command or regulation.
  • False statements can result in legal penalties.

For detailed instructions, refer to AR 735-5 and consult your local Army legal or logistics office.

Who Can Serve as an Individual Surety?

  • Must be a natural person (U.S. citizen or qualified individual) of full age and sound mind.
  • Cannot be a corporation, partnership, or firm.
  • Must demonstrate sufficient net worth via the affidavit and certification.
  • Should have no conflicting interests with the principal or bond.

Similar federal requirements appear in Standard Form (SF) 28 for government contracts, emphasizing individual (not corporate entity) sureties.

  • DA Form 1622-R — Bond for Safekeeping of Government Property Issued to Educational Institutions.
  • AR 735-5 — Primary regulation governing property accountability and bonding.
  • SF 28 — Affidavit of Individual Surety (used more broadly for federal contracts).

Download and Resources

Official Download: DA Form 1622-1-R PDF from Army Publishing Directorate.

Always use the latest version from official Army sources. Contact your unit’s S-4, contracting officer, or legal assistance for guidance specific to your situation.

Disclaimer: This article provides general information based on publicly available sources. It is not legal advice. Regulations and form requirements can change—verify with official Army channels for your specific needs.

Keywords: DA Form 1622-1-R, Affidavits of Individual Sureties, Army surety bond, AR 735-5, ROTC property bond, individual surety affidavit.