What does this form do? DA Form 4170 is titled STATEMENT OF GAINS AND LOSSES, and its job is to statement of gains and losses. Anyone sent to find "the 4170" is being sent here. Everything below expands on that one function.
Which edition is on this page? The one dated 07/01/2002, status ACTIVE. On army forms the edition date is the version, printed on the page itself so any copy can be checked.
Do I fill this in myself? Usually yes, unless an administrative office keeps the record for you, in which case they enter what you supply. The form itself belongs to G-4 and is prescribed by PAM 30-22. It runs to 1 page(s) and about 133 fields.
What the form asks for
- ACCOUNT
- ACCOUNT_1
- ACCOUNT_2
- ACCOUNT_3
- ACCOUNT_4
- ACCOUNT_5
- ACCOUNT_6
- ACCOUNT_7
- ACCOUNT_8
- ACCOUNT_9
- ALLOWANC
- ALLOWANC_1
- ALLOWANC_2
- ALLOWANC_3
- ALLOWANC_4
- ALLOWANC_5
- ALLOWANC_6
- ALLOWANC_7
- ALLOWANC_8
- ALLOWANC_9
- AUTHORIZ
- AUTHORIZ_1
- AUTHORIZ_2
- AUTHORIZ_3
Download the form
What file types are offered? PDF. The page image is the same in every one of them; only the way you complete it changes from format to format.
What is the difference between fillable and printable? A fillable pdf has live fields that accept typing and can be saved with your entries in place. A printable pdf is the same blank page with no live fields, meant to come out of a printer and be completed with a pen. Both print identically once filled.
What do I open a pdf with? Any current browser will display one, and any dedicated reader will do better. For fillable use the reader is the safer choice, because some browser viewers accept typing and then discard it when the tab closes. Test one field and one save before committing.
Is it free? Yes, entirely. No registration stands between you and the file, and what arrives is exactly what the publisher released.
Which entries come before the rest? The identifying ones at the head of the page: name, identification number, unit, date of preparation. Does it matter that they come first? Yes — everything downstream retrieves the record by those values, so they are worth getting right before you touch the substantive blocks.
How should you work through the entry fields? With the tab key. It follows the order the form was constructed in, which is usually the order the page reads, so nothing gets passed over. Do check boxes work the same way? They are clicked rather than tabbed into. In an exclusive group, a second click elsewhere clears your first choice, as intended.
Why does my text vanish when I print? Because one-line fields have no wrap, and anything past the field width is truncated on paper even though the screen shows all of it. Where should the overflow go? Into remarks, or onto a continuation. What about entries that do not apply? Enter the mark meaning "none". Blank space is ambiguous; a reviewer cannot tell an omission from a considered nil.
Where does the signature belong in the sequence? At the very end, by hand or by an accepted electronic means. An unsigned form is a draft regardless of how full it is. Are countersignatures needed? Where the form provides for them — reviewing official, approving authority, witness — taken in printed order and dated on the day applied. What should you check before releasing it? Empty mandatory fields, digit transposition in identification numbers, day-month inversion in dates, and residue from an old copy used in place of a blank one.
Why does the form carry a Privacy Act statement? Because personal information is being collected, and the statement declares the authority, the purpose, who else routinely sees the data, and whether answering is required or optional. Is it worth reading? Read it before you fill the fields it governs, not after. Does it change how you keep the file? It should — a filled copy is a personal record and gets the handling such records receive.
What happens after signing? The form is routed as the prescribing directive requires: to a named office, through the unit administrative channel, or into the personal file. Do you get the original back? No, so make a copy first. Who sets the retention period? The applicable records schedule, not the office holding the document.
Which other forms travel with this one? Those found by series and number: DA series documents sharing a proponent or a governing directive are frequently needed in combination, and a form referenced on the face of another generally accompanies it. Do you assemble them before or after sending? Before. Continuation sheets, cover sheets and transmittals are part of the same package.
When is an edition replaced? When the proponent revises the form and publishes a new edition date. What should you do with a copy kept on your own machine? Check its date against the edition in force before reusing it. Does the change reach backwards? It does not; work already completed on an earlier edition remains valid as filed.
Is this an official Department of the Army site? No. It is an independent site distributing reproductions of published Department of the Army documents for download, with no authority to issue forms. Does it guarantee acceptance of anything you submit? It does not, and nothing on the page is legal advice. Who should you ask instead? G-4 or your servicing administrative office, whenever an entry, a requirement or your eligibility is in doubt.
Questions and answers
- What is DA Form 4170?
- STATEMENT OF GAINS AND LOSSES
- Which edition is current?
- 07/01/2002
- Who is responsible for this form?
- G-4
- In which formats can it be downloaded?
- PDF, PDF
Publisher notes
- 42-ITEM ONLY PRODUCED IN ELECTRONIC MEDIA,