Terminal Learning Objective ACTION: Report Casualties by completing DA Form 1156 (Casualty Feeder Report and DA Form 1155 (Witness Statement on Individual) CONDITIONS: Given DA Form 1156, DA Form 1155, AR , and a pen or pencil. STANDARDS: Record all known data elements accurately and legibly on DA Forms 1156 and 1155, without error, in accordance with AR and FM 12-6.
Types of Reports Initial (INIT) Status Change (STACH) Supplemental (SUPP) Progress (PROG) Health and Welfare
Types of Casualties Death, Killed in Action (KIA) Missing, Missing in Action (MIA) Captured, Prisoner of War (POW) Wounded in Action (WIA) Seriously Wounded, Injured, or Ill (SI)
CASUALTY FEEDER REPORT (AR ) CONTROL NO. CHECK APPLICABLE BOX HOSTILE ACTION NON-HOSTILE ACTION 1. LAST NAME - FIRST NAME - MIDDLE INITIAL 2. SERVICE NO. 3. GRADE 4. HOUR AND DATE OF INCIDENT 5. UNIT 6. GEOGRAPHICAL LOCATION (nearby town) AND GRID COORDINATES
7. TYPE OF CASUALTY (Check applicable box(es)) KILLED IN ACTION DIED OF WOUNDS OR INJURIES DIED NOT AS RESULT OF HOSTILE ACTION BODY RECOVERED YES NO BODY IDENTIFIED YES NO MISSING IN ACTION CAPTURED DETAINED INTERNED EVACUATED TO *To be indicated by medical personnel only. DA Form 1156 WOUNDED OR INJURED IN ACTION LIGHTLY WOUNDED OR INJURED IN ACTION* SERIOUSLY INJURED OR INJURED IN ACTION* SERIOUSLY INJURED NOT AS RESULT OF HOSTILE ACTION LIGHTLY INJURED NOT AS RESULT OF HOSTILE ACTION VGT-5
8. WITNESSES WHO SAW INCIDENT OR IDENTIFIED REMAINS. (Name, grade, service number, and unit.) 9. REMARKS (Additional circumstances, any religious ministrations performed, etc.) 10. FOR USE BY C.O. OR MED OFF (only for casualties not the result of hostile action) LINE OF DUTY: YES NO UNDETM AUTHENTICATED BY (CO or Med. Off.) VERIFIED BY (Pers. Off.) UNITGRADESERVICE NO. DATESIGNATURE OF PERSON PREPARING REPORT DA Form 1156 VGT-6
CASUALTY FEEDER REPORT (AR ) CONTROL NO. CHECK APPLICABLE BOX HOSTILE ACTION NON-HOSTILE ACTION 1. LAST NAME - FIRST NAME - MIDDLE INITIAL BROWN, ELVIS T., JR. 2. SERVICE NO GRADE 1LT 4. HOUR AND DATE OF INCIDENT 1800, 31 Feb 99 (Local) 5. UNIT 8th Plt, 1/22d AG 6. GEOGRAPHICAL LOCATION (nearby town) AND GRID COORDINATES AD Hanau, Germany, Church nearby 7. TYPE OF CASUALTY (Check applicable box(es)) KILLED IN ACTIONMISSING IN ACTION DIED OF WOUNDS OR INJURIES CAPTURED DIED NOT AS RESULT OF HOSTILE ACTION DETAINED BODY RECOVERED YES NO INTERNED BODY IDENTIFIED YES NO WOUNDED OR INJURED IN ACTION LIGHTLY WOUNDED OR INJURED IN ACTION* SERIOUSLY INJURED OR INJURED IN ACTION* SERIOUSLY INJURED NOT AS RESULT OF HOSTILE ACTION LIGHTLY INJURED NOT AS RESULT OF HOSTILE ACTION EVACUATED TO 88th Morgue Unit, Hanau, Germany *To be indicated by medical personnel only. XX DA Form 1156 X X X
8. WITNESSES WHO SAW INCIDENT OR IDENTIFIED REMAINS. (Name, grade, service number, and unit.) JONES, Jane J., SPC, , 8th Plt, 1/22d AG, Hanau, Germany SMITH, Sam T., SFC, , 8th Plt, 1/22d AG, Hanau, Germany 9. REMARKS (Additional circumstances, any religious ministrations performed, etc.) Our unit was on nightfire when enemy forces attacked. 1LT Brown was shot up pretty bad, we had to identify him with his Dog Tags. SFC Smith said a prayer over him. 10. FOR USE BY C.O. OR MED. OFF (only for casualties not the result of hostile action) LINE OF DUTY: YES NO UNDETM AUTHENTICATED BY (CO OR Med. Off) VERIFIED BY (Pers. Off.) UNIT 8th Plt, 1/22d AG GRADE SPC SERVICE NO DATE 31 February 1999 SIGNATURE OF PERSON PREPARING REPORT Jane J. Jones DA Form 1156 VGT-8
WITNESS STATEMENT ON INDIVIDUAL (AR ) CHECK APPLICABLE BOX MIS MIA CAP DET DEAD (Remains not recovered) 1. LAST NAME - FIRST NAME - MIDDLE NAME2. SERVICE NO. 2A. SSN3. GRADE4. DATE OF DEATH OR WHEN LAST SEEN 5. ORGANIZATION6. GEOGRAPHICAL LOCATION (Include grid coordinates and nearby town) 7. IF ITEMS 1 AND 2 ARE UNKNOWN OR NOT POSSIBLE, COMPLETE ITEMS LISTED BELOW: AGEWEIGHTHEIGHTHAIREYESRACE HOMETOWNCIVILIAN OCCUPATIONNICKNAME WAS HE MARRIED? (If so, give wife’s name, if known) DID HE HAVE ANY CHILDREN/ (If so, give names, if known) OTHER IDENTIFYING MARKS (such as tattoos or birthmarks) OTHER PERSONS WHO MAY HAVE WITNESSED THIS INCIDENT OR HAVE FURTHER INFORMATION
8. CIRCUMSTANCES SURROUNDING INCIDENT (If known, include cause of death or condition when last seen, and how identified) 9. NAME OF PERSON MAKING STATEMENT 10. SERVICE NO./SSN 11. UNIT 12. DATE13. SIGNATURE DA Form 1155
WITNESS STATEMENT ON INDIVIDUAL (AR ) CHECK APPLICABLE BOX MIS MIA CAP DET DEAD (Remains not recovered) 1. LAST NAME - FIRST NAME - MIDDLE NAME BROWN, ELVIS TOM., JR. 2. SERVICE NO. 2A. SSN GRADE 1LT 4. DATE OF DEATH OR WHEN LAST SEEN 31 February ORGANIZATION 8th Plt, 1/22d AG 6. GEOGRAPHICAL LOCATION (Include grid coordinates and nearby town) Hanau, Germany, AD IF ITEMS 1 AND 2 ARE UNKNOWN OR NOT POSSIBLE, COMPLETE ITEMS LISTED BELOW: AGEWEIGHTHEIGHTHAIREYESRACE HOMETOWNCIVILIAN OCCUPATIONNICKNAME WAS HE MARRIED? (If so, give wife’s name if known DID HE HAVE ANY CHILDREN/ (If so, give names if known) OTHER IDENTIFYING MARKS (such as tattoos or birthmarks) OTHER PERSONS WHO MAY HAVE WITNESSED THIS INCIDENT OR HAVE FURTHER INFORMATION SFC Sam Smith VGT-11
8. CIRCUMSTANCES SURROUNDING INCIDENT (If known, include cause of death or condition when last seen, and how identified) We were on nightfire when enemy forces attacked. Lieutenant Brown was hit so bad we had to identify him with his Dog Tags. 9. NAME OF PERSON MAKING STATEMENT JANE J. JONES 10. SERVICE NO./SSN UNIT 8th Plt, 1/22d AG 12. DATE 31 Feb SIGNATURE Jane J. Jones DA Form 1155
Terminal Learning Objective ACTION: Report Casualties by completing DA Form 1156 (Casualty Feeder Report and DA Form 1155 (Witness Statement on Individual) CONDITIONS: Given DA Form 1156, DA Form 1155, AR , and a pen or pencil. STANDARDS: Record all known data elements accurately and legibly on DA Forms 1156 and 1155, without error, in accordance with AR and FM 12-6.