DA Form 2669: Certificate of Death – Guide & PDF

DA Form 2669: Certificate of Death – Guide & PDF – DA Form 2669, officially titled Certificate of Death, is a standardized US Army form used to officially document and certify the death of individuals in specific military contexts, primarily related to enemy prisoners of war (EPW), retained personnel, civilian internees, or other detainees under US Army custody.

What Is DA Form 2669?

DA Form 2669 is a Department of the Army form titled Certificate of Death. Its current version is dated December 2004, with the proponent agency being the Provost Marshal General (PMG). It is prescribed for use under AR 190-8 (Enemy Prisoners of War, Retained Personnel, Civilian Internees and Other Detainees).

This form serves as an official record to certify key details surrounding a death, including personal identification, circumstances of death, burial information, and medical certification. It helps ensure compliance with international obligations, such as those under the Geneva Conventions, for proper documentation, notification, and handling of deceased individuals in military custody.

Note: This is distinct from civilian death certificates issued by state vital records offices or other military casualty forms like DD Form 1300 (Report of Casualty).

Purpose of DA Form 2669

The primary purpose of DA Form 2669 is to create a formal, verifiable record of death for administrative, legal, humanitarian, and reporting requirements. Key uses include:

  • Documenting deaths of detainees, EPWs, or other protected persons in US Army custody.
  • Facilitating notification to next of kin and relevant authorities.
  • Supporting accurate record-keeping for graves registration, personal effects, and international reporting.
  • Ensuring medical certification of cause of death and details of burial or cremation.

It is completed by medical officers, commanding officers, and witnesses, with strict requirements for accuracy and authentication.

Who Uses DA Form 2669?

This form is primarily used by:

  • US Army medical officers attending to the deceased.
  • Camp or facility commanders responsible for detainees or internees.
  • Personnel involved in mortuary affairs, legal, or provost marshal functions in theater operations.

It applies in operational environments involving internment and resettlement, such as during conflicts. Civilians and standard active-duty Army deaths typically use different processes and forms.

Key Sections of DA Form 2669

The form captures comprehensive details in a structured layout. Main sections include:

  • Deceased Information: Name, nationality, power served, place and date of capture/internment, place and date of birth, service number/grade.
  • Next of Kin: Name, address, and relationship.
  • Death Details: Place, date, and cause of death.
  • Burial Information: Place and date of burial, identification of grave.
  • Personal Effects: Disposition (retained or forwarded).
  • Narrative: Brief details of death/burial provided by the attending person (doctor, nurse, etc.). If cremated, reasons must be stated.
  • Certifications: Signatures from the medical officer, commanding officer, and witnesses.
  • Administrative Blocks: Internment serial number, forwarding instructions, and “Certified a True Copy” area.

The form includes instructions not to write in certain spaces and notes that previous editions are obsolete.

How to Fill Out DA Form 2669?

While no standalone public instructions pamphlet exists, the form itself and AR 190-8 provide guidance. Essential steps generally include:

  1. Complete all identifying information for the deceased accurately.
  2. Record factual details of death and burial.
  3. Have the attending medical officer certify the cause of death and sign.
  4. Obtain commanding officer and witness signatures.
  5. Handle personal effects and grave identification per policy.
  6. Distribute copies as required (e.g., forward with death certificate to appropriate authorities).

Important: Accuracy is critical for legal, humanitarian, and family notification purposes. Forms are often produced locally or electronically.

Download DA Form 2669 PDF

You can download the official fillable or printable version directly from the US Army Publications site:

Download DA Form 2669 Here

Always use the most current version from armypubs.army.mil for official use.

  • AR 190-8: Primary regulation governing use of the form in detainee operations.
  • Mortuary Affairs Guidance: See AR 638-2 and Joint Publication 4-06 for broader casualty and remains handling.
  • Casualty Reporting: Often used alongside forms like DA Form 1156 (Casualty Feeder Card) in operational settings.

For standard US Army fatalities (not detainees), consult your unit Casualty Assistance Officer or S1 for appropriate procedures.

Importance of Proper Death Documentation in the Military

Accurate completion of DA Form 2669 supports:

  • Respect for the deceased and their families.
  • Compliance with international law and Geneva Conventions.
  • Proper management of personal effects and gravesites.
  • Historical and investigative records.

In US military operations, thorough documentation upholds ethical standards and facilitates closure for next of kin.

For questions about this form or related casualty procedures, contact your unit chain of command, Provost Marshal, or Casualty Assistance personnel. Official guidance should always come from current Army regulations and authorized channels.

This article is for informational purposes only and is based on publicly available military publications. Always refer to official sources for the latest requirements.