Commander's Guide to Administrative Eliminations


SUBJECT: Administrative Separation Guide


1. Enclosed is the Administrative Separation (Chapter) Guide produced by the Criminal Law Division, Office of the Staff Judge Advocate. This guide is designed to assist commanders and first sergeants in expediting the processing of chapter actions. The provisions of AR 635-200 discussed throughout this guide apply to enlisted soldiers only. Ensure that you have the most recent version of AR 635-200, dated 26 June 1996. Inquiries concerning officer separations should be directed to the trial counsel at 684-4844.

2. The Criminal Law Division is here to support you in eliminating those soldiers who the command has decided need to be separated from the service. Your personnel section is responsible for producing the documentation necessary to separate soldiers assigned to your unit from the U.S. Army and for moving those documents through the system. The Criminal Law Division is responsible for producing these separation documents for the separate unit commands and for reviewing the packets.

3. The Army standard for processing a chapter action (without an administrative board) from company commander initiation to approval is 15 working days. Incomplete or inaccurate documentation slows this process. This guide will assist in ensuring elimination actions are complete and accurate, and that the due process rights of the soldier are protected.

4. Our office will continue to prepare the paperwork for the 705th MP Bn. For HQ, CAC, MEDDAC, MP Co., and VETCOM; coordinate with this office prior to initiating the chapter action if it is a Chapter 14 and you are recommending the soldier be separated from service with an Other Than Honorable Discharge or the soldier has over six years active duty, making him eligible for an Administrative Separation Board. This will ensure that the administrative separation process runs smoothly.

5. Make sure all of your actions are dated. There has been a recent rash of undated separation actions. While that does not make the action legally objectionable it may raise an issue at a later time.

6. Point of contact is the trial counsel at 4-4931 or the NCOIC, Criminal Law Division, at 4-4844.


ATZL-SJA-CL


MEMORANDUM FOR Commanders and First Sergeants

SUBJECT: Common Questions Involving Chapter Actions


1. Enclosed is the 1st Edition of the Commander's Guide to Administrative Eliminations (Chapters). This Chapter Guide deals both with involuntary chapters and outlines the procedures for several voluntary chapters including Chapter 5-3 for Secretarial Authority ("Once in a Lifetime Opportunity") or Chapter 5-17 for early separation to further education. In addition, examples of the various DA Form 4187s needed for these voluntary chapters are included in the Appendix.

2. Voluntary Separation of Soldiers Denied Reenlistment (Chapter 16-5b). Soldiers with a locally imposed bar to reenlistment are no longer eligible for voluntary early separation on the grounds of inability to overcome the bar. A separation under Chapter 16-5b is no longer available to any soldier, whether they are serving on their first, second, or subsequent enlistment. The purpose of this change is to emphasize that the local bar to reenlistment is intended as a probationary device and rehabilitative tool, rather than a quick means of early separation. Soldiers with an approved bar to reenlistment are expected to serve until ETS.

3. Processing time. 100% of the Chapters not involving separation boards processed by the command should be completed within 15 working days. The clock starts when the soldier acknowledges receipt of the intended separation from the immediate commander. The clock stops after the appropriate approval authority takes action and the soldier is taken to the Transition Point for out-processing. However, commanders must understand that a chapter involving a separation board (i.e., the soldier has over 6 years of active duty and requests a board, the soldier is recommended for an Other Than Honorable discharge, or the soldier is facing elimination under the provisions of Chapter 15) is subject to a 50 day processing standard, from initiation by the immediate commander to approval by the appropriate separation authority. The key to expedient chapter processing is to insure that all required documents are present BEFORE requesting the preparation of the chapter packet.

4. Medical Examinations. Unless waived by HQDA, medical examinations are required for soldiers being processed for involuntary separation (AR 635-200, paragraph 1-34a). Soldiers facing elimination under the following chapters must have a medical examination: Chapters 5-11, 5-18 (if basis for chapter is for physical condition), 8 (must be recorded on Standard Form 88 and 93), 9, 11, 13, 14-12b, 14-12c, 15, and 18. Soldiers cannot "waive" the medical exam for these involuntary separations. Medical exams in these circumstances are to protect the United States and the soldier.

5. Separation Pay. Inquiries concerning separation pay should be directed to the Transition Point, at 4-2428. However four criteria govern separation pay:

     a. Soldiers must have at least six years of active service (Reserve service does not count) at the time of separation.

     b. Soldiers separated for misconduct (Chapter 14) or unsatisfactory performance (Chapter 13) ARE NOT entitled to separation pay.

     c. Soldiers who request voluntary separation from the U.S Army under the provisions of AR 635-200 ARE NOT entitled to separation pay.

     d. Soldiers involuntarily separated under the provisions of Chapter 5-8, 5-13, 5-18, 9, 15 or 18 are entitled to receive separation pay IF they have been on Active Duty for more than 6 years at the time of separation.

6. Medical Evaluation Boards. A soldier cannot be processed for administrative separation if the soldier has been referred to a Medical Evaluation Board (MEB) unless the soldier is recommended for elimination under Chapters 7, 14, or 15. The processing of the chapter paperwork for Chapters 7, 14, and 15 will coincide with processing through the MEB. If an MEB determines that the soldier should be referred to a Physical Evaluation Board (PEB), that determination and the chapter will be referred to the Commander, U.S. Army Combined Arms Center (CG). The CG will either approve the chapter or send the soldier through the PEB (see AR 635-200, paragraph 1-35). Questions regarding the MEB/PEB process should be directed to Medical Boards, 684-6433.

7. Right To Consult TDS Attorney. All solders facing involuntary separation have the right to consult with an attorney unless they waive that right. If a soldier wants to see an attorney, escort the soldier with the entire elimination packet to the Trial Defense Service (TDS). Chapter counseling takes place every Monday 0915-1015 hrs and Wednesday 1500-1600 hrs. TDS is located in building 244, at 415 Custer Avenue, and can be reached at 4-4559.

8. Any further questions regarding any information contained in this guide should be directed to your trial counsel or the NCOIC, Military Justice Section at 4-4844.

CHAPTER 5-3: SECRETARIAL PLENARY AUTHORITY (“ONCE IN A LIFETIME OPPORTUNITY”)

CHAPTER 5-8: INVOLUNTARY SEPARATION DUE TO PARENTHOOD

CHAPTER 5-11: SEPARATION OF PERSONNEL WHO DID NOT MEET PROCUREMENT MEDICAL FITNESS STANDARDS

CHAPTER 5-13: SEPARATION BECAUSE OF PERSONALITY DISORDER

CHAPTER 5-17: EARLY SEPARATION TO FURTHER EDUCATION

CHAPTER 5-18: SEPARATION BECAUSE OF OTHER PHYSICAL OR MENTAL CONDITION

CHAPTER 6: SEPARATION BECAUSE OF DEPENDENCY OR HARDSHIP

CHAPTER 7: FRAUDULENT ENLISTMENT

CHAPTER 8: SEPARATION OF ENLISTED WOMEN - PREGNANCY

CHAPTER 9: ALCOHOL OR OTHER DRUG REHABILITATION FAILURE

CHAPTER 10: SEPARATION IN LIEU OF COURT-MARTIAL

CHAPTER 11: ENTRY LEVEL PERFORMANCE AND CONDUCT

CHAPTER 13:  SEPARATION FOR UNSATISFACTORY PERFORMANCE

CHAPTER 14-5:  CONVICTION BY CIVIL COURT

CHAPTER 14-12B:  ACTS OR PATTERNS OF MISCONDUCT

CHAPTER 14-12C:  COMMISSION OF A SERIOUS OFFENSE

CHAPTER 16:  VOLUNTARY SEPARATION OF SOLDIERS DENIED REENLISTMENT

CHAPTER 18:  FAILURE TO MEET BODY FAT STANDARDS

CHAPTER 5-3: SECRETARIAL PLENARY AUTHORITY (“ONCE IN A LIFETIME OPPORTUNITY”)

This provision of AR 635-200 provides for those soldiers who desire to leave active duty but who do not qualify under any other provision of AR 635-200. Recent guidance (MILPER Message NR 97-095) emphasizes that requests under this provision will not be approved unless discharge is clearly “in the best interests of the Army,” not necessarily in the best interests of the soldier. Individual requests which serve only the interest of the soldier - particularly those involving soldiers with critical military skills or bonus recipients - will not be approved except under exceptional circumstances. Requests for separation more than three months before ETS normally will be disapproved.

Unit Commanders must understand that this chapter is approved at the Secretary of the Army level and must be in writing. This chapter is requested by the soldier on a DA Form 4187 which is forwarded through the chain of command and transmitted via fax (DSN: 221-1965) to HQDA, ATTN: TAPC-PDT-S. Chain of command forwarding endorsements must indicate rationale to support determination that early separation is in the best interest of the Army as well as a statement whether the soldier has received education benefits counseling. In addition, chain of command forwarding endorsements must recommend approval or disapproval and, if recommending approval, include a recommendation concerning characterization of service (either Honorable or General, Under Honorable Conditions).

1-18 counseling Required: No (1-18a)

Medical Required: Only for involuntary separation (1-34a)

Mental Required: No (l-34b)

Approval Authority: HQDA (TAPC-PDT-S) (5-3e)

Type of discharge authorized: Honorable or General, Under Honorable Conditions (5-1)

Documents Required for Chapter:

( ) DA Form 4187 from soldier (See example - Appendix I). The DA Form 4187 will be approved/disapproved by the Company Commander and forwarded through the chain of command by endorsement to the approval authority. The intermediate commander(s) will either disapprove the request or recommend approval and if recommending approval, will specify which characterization of discharge is appropriate, either Honorable, or General, Under Honorable Conditions.

( ) Statement from soldier explaining in detail why approval of request would be in "the best interest of the military".

( ) Affidavit or statement from agency substantiating soldier's stated reason for elimination (i.e. letter from employer detailing better job opportunity to include intent to hire, better salary or affidavit detailing lottery winnings).

( ) Education benefits counseling (Appendix C)

( ) Debt avoidance counseling (Appendix D)

( ) DA Form 2A

( ) DA Form 2-l or ERB

CHAPTER 5-8: INVOLUNTARY SEPARATION DUE TO PARENTHOOD

(LACK OF AN ADEQUATE FAMILY CARE PLAN)

Soldiers must arrange for the care of their family members so as to be available for duty when and where the needs of the Service dictate; be able to perform assigned military duties without interference; and remain eligible for worldwide assignment. Soldiers will be considered for involuntary separation when parental obligations interfere with fulfillment of military responsibilities. IAW para 5-5, AR 600-20, the following soldiers are required to maintain an adequate family care plan:

1. If the soldier is MARRIED to another member of the Army or a member of another service and IF:

a. Soldier has joint physical or legal custody of one or more children under age 18 OR

b. Soldier has a family member incapable of self-care regardless of age.

2. If the soldier is SINGLE and IF:

a. Soldier has physical and legal custody of one or more children under age 18 OR

b. Soldier has family members incapable of self-care regardless of age.

1-18 Counseling Required: Yes, (5-8b)(l-l8a(l))

Medical Required: No (1-34a)

Mental Required: No (l-34b)

Approval Authority: Garrison Commander or Commandant, USDB (1-21c(l))

Type of Discharge Authorized: Honorable or General, Under Honorable Conditions (5-la)

Note: Command does not have to wait the full amount of time (30 days) before initiating IF soldier provides statement stating inability to provide an adequate family care plan now or in the future.

Documents Required for Chapter:

( ) Request for separation

( ) DA Form 5304-R, Family Care Counseling Checklist (See example - Appendix E)

( ) DA Form 5305-R, Family Care Plan (See example - Appendix F)

( ) All counseling statements including 1-18 “magic” counseling statement (See example -

Appendix B) regarding inability to perform due to parenthood

( ) Education benefits counseling (Appendix C)

( ) Debt avoidance counseling (Appendix D)

( ) DA Form 2A

( ) DA Form 2-l or ERB

( ) FLAG for elimination

CHAPTER 5-11: SEPARATION OF PERSONNEL WHO DID NOT MEET PROCUREMENT MEDICAL FITNESS STANDARDS

Soldiers who were not medically qualified under procurement medical fitness standards at enlistment will be separated. Medical proceedings must show that an appropriate military medical authority (Physicians Assistant or Doctor) identified a medical condition within 6 months of the soldier's initial entrance on Active Duty, which:

1. Would have disqualified the soldier for entry into the military had it been detected in time; and

2. Does not disqualify the soldier for retention in the military UP AR 40-501, Chapter 3 (If a medical authority identifies a soldier with a disqualifying condition for retention in the military, that did not exist at the time of enlistment, the soldier will not be processed for elimination under this provision. Rather, the soldier will be processed under MEB/PEB procedures).

1-18 counseling Required: No (1-18a)

Medical Required: Yes (must show disqualifying condition identified within 6 months of entry)

Mental Required: No (1-34b)

Approval Authority: Garrison Commander or Commandant, USDB (1-21c(1))

Type of discharge authorized: Honorable or General, Under Honorable Conditions (5-1(a))

Documents Required for Chapter:

( ) Request for separation

( ) Evidence of medical proceedings that shows the soldier has a disqualifying condition that was identified within 6 months of entry on AD.

( ) Entrance medical showing no waiver of disqualifying condition was granted.

( ) Statement from medical officer that the identified medical condition does not disqualify the soldier for retention in the military UP AR 40-501, chapter 3.

( ) Education benefits counseling (Appendix C)

( ) Debt avoidance counseling (Appendix D)

( ) DA Form 2A

( ) DA Form 2-1 or ERB

( ) FLAG for elimination

CHAPTER 5-13: SEPARATION BECAUSE OF PERSONALITY DISORDER

Soldiers will be considered for involuntary separation when diagnosed with a personality disorder that interferes with assignment to or performance of duty.

1-18 counseling Required: Yes (1-18a(2))

Medical Required: No (l-34a)

Mental Required: Yes (1-34e)

Approval Authority: Garrison Commander or Commandant (l-21c(1))

Type of discharge authorized: Honorable (5-13h)

Note: The soldier will be given 30 days to overcome deficiencies (DA Guidance). Commanders need to ensure that the soldier has not overcome the personality disorder before initiation of this chapter.

Documents Required for Chapter:

( ) Request for separation

( ) Mental Examination signed by Psychiatrist or Licensed Clinical Psychologist recommending separation under AR 635-200, Chapter 5-13 because the soldier has a mental condition which is a deeply-ingrained maladaptive pattern of behavior of long duration.

( ) All counseling statements including 1-18 “magic” counseling statement (See example - Appendix B) describing inability to perform because of personality disorder

( ) Education benefits counseling (Appendix C)

( ) Debt avoidance counseling (Appendix D)

( ) DA Form 2A

( ) DA Form 2-1 or ERB

( ) FLAG for elimination

CHAPTER 5-17: EARLY SEPARATION TO FURTHER EDUCATION

Soldiers may be discharged or released from active duty for the convenience of the Government, up to 90 days before ETS, in order to attend a specific term at a college, university, vocational school, or technical school. However, soldiers serving their initial enlistment of less than 3 years are ineligible for separation under this chapter. IAW para. 5-17, AR 635-200, to qualify for early separation, eligible soldiers must:

1. Not be mission essential to their assigned organization, as determined by their immediate commanders.

2. Clearly establish that the specific school term for which they seek early separation is academically the most opportune time for them to begin or resume their education, and that delay of school enrollment until normal ETS would cause undue personal hardship.

3. Provide a statement from an appropriate school official (for example, a registrar or director of admissions) indicating acceptance for enrollment (as opposed to enrollment on a stand-by basis, or enrollment on a probationary status) in a full-time resident course of instruction.

4. Show that they are able to pay, or have already paid, any school entry fees.

This chapter action is processed at the unit level. This chapter is requested by the soldier on a DA Form 4187 which is forwarded through the chain of command for action by the Garrison Commander or USDB Commandant.

1-18 counseling Required: No (1-18a)

Medical Required: No (1-34a)

Mental Required: No (1-34b)

Approval Authority: Garrison Commander or USDB Commandant (1-21c(l))

Type of Discharge Authorized: Honorable or General, Under Honorable Conditions (5-la)

Documents Required for Chapter:

( ) DA Form 4187 from soldier (See example - Appendix J). The DA Form 4187 will be approved/disapproved by the Company Commander and forwarded through the chain of command by endorsement to the approval authority. The intermediate commander(s) will either disapprove the request or recommend approval and if recommending approval, will specify which characterization of discharge is appropriate, either Honorable, or General, Under Honorable Conditions.

( ) Statement from soldier informing chain of command of the reasons why they should approve request to leave the military 90 days before the scheduled ETS date.

( ) Affidavit or statement from school registrar or director of admissions stating that soldier is enrolled as a full time student. If affidavit shows that soldier is enrolled on a stand-by basis or enrolled in a probationary status, chapter cannot be approved and soldier will have to wait for normal ETS before attending school.

( ) Financial evidence (i.e., enrollment receipts, bank statement) which demonstrate that the soldier can or already has paid for any school entry fees.

( ) Education benefits counseling (Appendix C)

( ) Debt avoidance counseling (Appendix D)

( ) DA Form 2A

( ) DA Form 2-l or ERB

CHAPTER 5-18: SEPARATION BECAUSE OF OTHER PHYSICAL OR MENTAL CONDITION

Soldiers will be considered for involuntary separation under this paragraph on the basis of other physical or mental conditions not amounting to disability (AR 635-40) (excluding conditions appropriate for separation processing under paragraph 5-11 or 5-13), that potentially interfere with assignment to or performance of duty. IAW para. 5-18a, AR 635-200, such conditions may include, but are not limited to, suicidal tendencies, chronic airsickness or seasickness, sleepwalking, dyslexia, severe nightmares, claustrophobia, and other disorders manifesting disturbances of perception, thinking, emotional control or behavior sufficiently severe that the soldier's ability to effectively perform military duties is significantly impaired.

1-18 counseling Required: Yes (1-18a(2))

Medical Required: Yes (1-34a) (if separation based on physical condition)

Mental Required: Yes (1-34b) (if separation based on mental condition)

Approval Authority: Garrison Commander or USDB Commandant (l-21c(1))

Type of discharge authorized: Honorable or General, Under Honorable Conditions (5-1a)

Note: Soldier will be given 30 days to overcome deficiencies (DA Guidance).

Documents Required for Chapter:

( ) Request for separation

( ) Mental Examination (if basis is for mental condition) signed by Psychiatrist or Licensed Clinical Psychologist

( ) Medical Examination (if basis is for physical conditions)

( ) All counseling statements including 1-18 “magic” counseling statement (See example - Appendix B) describing inability to perform because of mental or physical condition

( ) Education benefits counseling (Appendix C)

( ) Debt avoidance counseling (Appendix D)

( ) DA Form 2A

( ) DA Form 2-l or ERB

( ) FLAG for elimination

CHAPTER 6: SEPARATION BECAUSE OF DEPENDENCY OR HARDSHIP

This chapter is requested by the soldier to be discharged for Dependency or Hardship. Pursuant to AR 635-200, paragraph 6-3, a “Dependency exists when death or disability of a member of a soldier's (or spouse's) immediate family causes that member to rely upon the soldier for principal care or support.” Paragraph 6-3, AR 635-200 states that a “Hardship exists when in circumstances not involving death or disability of a member of the soldier's (or spouse's) immediate family, separation from the Service will materially affect the care or support of the family by alleviating undue or genuine hardship.”

A married soldier who becomes a parent by birth, adoption or marriage (stepparent), and whose child (or children) under 18 years of age reside within the household, may apply for separation under hardship. The soldier must submit evidence that the roles of parent and soldier are incompatible and that they cannot fulfill their military obligation without neglecting the child or children.

1-18 counseling Required: No (1-18a)

Medical Required: No (l-34a)

Mental Required: No (1-34b)

Approval Authority: Garrison Commander or USDB Commandant (l-21c(l))

Type of discharge authorized: Honorable or General, Under Honorable Conditions (6-11)

Documents Required for Chapter:

( ) DA Form 4187 or Affidavit from soldier explaining conditions (See example at Appendix K if request is for Hardship or Appendix L if request is for Dependency). DA Form 4187 will be approved/disapproved by the Company Commander and forwarded through the chain of command by endorsement to the Garrison Commander or USDB Commandant. The intermediate commander(s) will either disapprove the request or recommend approval and if recommending approval, will specify which characterization of discharge is appropriate, either Honorable, or General, Under Honorable Conditions.

( ) Affidavit or statement from family member on behalf of the soldier substantiating the dependency or hardship claim.

( ) Affidavits by at least 2 agencies or individuals other than family members substantiating the dependency or hardship claim (i.e. Red Cross, Chaplain, Family Physician).

( ) Detailed statement to establish monthly income and expenses (if the basis is financial difficulty).

( ) Death certificate or valid proof of death in the family (if the basis is because of a death).

( ) Physicians statement with diagnosis and date of disability (if the basis is because of a disability).

( ) If sole parenthood results from divorce or legal separation, a judicial decree or court order awarding child custody to the soldier will also be included.

( ) Education benefits counseling (Appendix C)

( ) Debt avoidance counseling (Appendix D)

( ) DA Form 2A

( ) DA Form 2-l or ERB

CHAPTER 7: FRAUDULENT ENLISTMENT

Fraudulent enlistment is the procurement of an enlistment, reenlistment, or period of active service through any deliberate material misrepresentation, omission, or concealment of information which, if known and considered by the Army at the time of enlistment or reenlistment, might have resulted in rejection. Some examples of fraudulent enlistment are:

1. Concealment of Prior Service

2. Concealment of True Citizenship Status

3. Concealment of Conviction by Civil Court

4. Concealment of Record as a Juvenile Offender

5. Concealment of Medical Defects/Personality Disorder

6. Concealment of Absence Without Leave or Desertion from Prior Service

7. Concealment of Pre-service Homosexuality

8. Misrepresentation of Intent with Regard to Legal Custody of Children1

9. Concealment of other disqualifications2

1Paragraph 7-17(8) reads “Soldiers who were applicants without a spouse at the time of enlistment and who executed the certificate required by AR 601-210 will be processed for separation for fraudulent entry if custody of the children is regained by court decree, as provided by State law, or as a result of the children resuming residency with the soldier instead of the legal custodian. Because the soldier certified at enlistment that the custody arrangement was intended to remain in full force and effect during the term of enlistment, the burden is on the soldier to demonstrate that the regaining of custody is not contrary to statements made at the time of enlistment."

2One possible disqualification concerns the failure to disclose a civilian conviction or illegal drug use before entry on active duty. A typical scenario is a soldier tests positive for using an illegal drug. During the subsequent interview with CID, the soldier admits to using illegal drugs before entry on active duty. A check of the soldier's enlistment contract fails to admit illegal drug use or fails to admit a civilian conviction before entry on active duty. Soldier qualifies for separation under this chapter for fraudulent entry.

1-18 counseling Required: No (1-18a)

Medical Required: No (1-34a)

Mental Required: No (l-34b)

Approval Authority: Garrison Commander or USDB Commandant (l-21c(l))

Type of discharge authorized: Honorable, General, Under Honorable Conditions, or Under Other Than Honorable Conditions (7-23)

Note: IAW AR 635-200, para. 7-20b(4), once the separation authority approves the discharge, the separation authority CANNOT SUSPEND the execution of the approved discharge.

Documents Required for Chapter:

( ) Request for separation

( ) Enlistment contract

( ) Evidence of enlistment fraud

( ) Education benefits counseling (Appendix C)

( ) Debt avoidance counseling (Appendix D)

( ) DA Form 2A

( ) DA Form 2-l or ERB

( ) FLAG for elimination

CHAPTER 8: SEPARATION OF ENLISTED WOMEN - PREGNANCY

If an enlisted woman is pregnant, she will be counseled by the unit commander using the Pregnancy Counseling Checklist (Reproduced at Appendix G). As per the guidance found in AR 635-200, the company commander will explain that the purpose of the counseling is to provide information concerning options, entitlements, and responsibilities and that she may elect to remain on active duty or, upon request, be separated per this provision. The soldier may request a specific separation date, but the Commander, 705th MP Bn. or Garrison Commander and her military physician will determine the separation date. The date must not be later than 30 days before the expected date of delivery or the latest date the soldier’s military physician will authorize her to travel to the home of record. Commanders processing a soldier under this chapter must also understand and be aware of the following guidelines:

1. If a soldier carries a pregnancy for 16 weeks or more, but then has an abortion, miscarriage, or an immature or premature delivery before separation is accomplished, the soldier will have the option to be retained or be separated per this chapter (para. 8-8f).

2. An enlisted woman who elects to remain on active duty when counseled may, if she is still pregnant, subsequently request separation. The Commander, 705th MP Bn. or Garrison Commander must separate the soldier, but may set the separation date (para. 8-8g).

3. An enlisted woman who requested separation in writing may subsequently request withdrawal of the separation request. The Commander, 705th MP Bn. or Garrison Commander based on the circumstances of the case and the best interest of the Army, will determine in writing if the soldier is to be separated or retained (para. 8-8h).

1-18 counseling required: No (1-18a) but Immediate Commander will counsel soldier using Pregnancy Counseling Checklist, figure 8-1, AR 635-200 (See example at Appendix G)

Medical Required: Yes (1-34a)

Mental Required: No (l-34b)

Approval Authority: Commander, 705th MP Bn. or Garrison Commander (l-21d)

Type of discharge authorized: Honorable or General, Under Honorable Conditions (8-3)

Documents Required for Chapter:

( ) Medical Examination establishing Pregnancy. SF Forms 88 and 93 will be used by the physician to establish pregnancy.

( ) Pregnancy Counseling Checklist (see example at Appendix G)

( ) Statement of Pregnancy Counseling (Part II of the Pregnancy Counseling Checklist) signed by pregnant soldier (example at Appendix H).

( ) DA Form 4187 requesting separation UP AR 635-200, Chapter 8. (See example at Appendix M). DA Form 4187 will be approved/disapproved by the Company Commander and forwarded to Commander, 705th MP Bn. or Garrison Commander who must approve the request, but can set the separation date. The Commander, 705th MP Bn. or Garrison Commander must also indicate which characterization of discharge is appropriate, either Honorable, or General, Under Honorable Conditions.

( ) Education benefits counseling (Appendix C)

( ) Debt avoidance counseling (Appendix D)

( ) DA Form 2A

( ) DA Form 2-l or ERB

CHAPTER 9: ALCOHOL OR OTHER DRUG REHABILITATION FAILURE

This chapter provides the authority for discharging soldiers for alcohol or other drug abuse rehabilitation failure. Discharge of a soldier occurs when the commander feels that further rehabilitation efforts are not practical, rendering the soldier a rehabilitation failure. This determination will be made in consultation with the rehabilitation team (ADAPCP Counselor). As per 9-2c, AR 635-200, initiation of separation proceedings is required for soldiers designated as alcohol/drug rehabilitation failures.

1-18 counseling required: No (l-18a)

Medical Required: Yes (l-34a)

Mental Required: No (l-34b)

Approval Authority: Commander, 705th MP Bn. or Garrison Commander (l-21d)

Type of discharge authorized: Honorable or General, Under Honorable Conditions (9-4)

Notes: Read ADAPCP counselor's report. If self-referral is mentioned in the report and the report is used as the basis for declaring the soldier a rehabilitation failure, the soldier will be entitled to receive an Honorable Discharge, as per guidance found in AR 600-85, para. 6-4.

Documents Required for Chapter:

( ) Request for separation

( ) Statement from ADAPCP Counselor indicating rehabilitation failure

( ) Medical examination

( ) Education benefits counseling (Appendix C)

( ) Debt avoidance counseling (Appendix D)

( ) DA Form 2A

( ) DA Form 2-l or ERB

( ) FLAG for elimination

CHAPTER 10: SEPARATION IN LIEU OF COURT-MARTIAL

This chapter is not and cannot be a command initiated chapter. This chapter is requested by the soldier through the U.S. Army Trial Defense Service. In order to qualify to request this type of chapter, the soldier must have committed an offense or offenses, the punishment for which, under the UCMJ and the MCM, 1998, includes a bad-conduct discharge or dishonorable discharge.

1-18 counseling required: No (l-18a)

Medical Required: No (l-34a)

Mental Required: No (l-34b)

Approval Authority: CG (1-21a)

Type of discharge authorized: Honorable or General, Under Honorable Conditions or Under Other Than Honorable (UOTH) Conditions Discharge (10-8)

CHAPTER: 11 ENTRY LEVEL PERFORMANCE AND CONDUCT

In order for a soldier to qualify for this chapter, the command must initiate the chapter while the soldier is on the initial 180 days of continuous active military service. Soldier qualifies for separation under this chapter if the soldier displays unsatisfactory performance or minor disciplinary infractions as evidenced by inability, lack of reasonable effort, or failure to adapt to the military environment. Furthermore, pursuant to paragraph 11-3d, if a soldier is in an entry level status and qualifies for separation for unsatisfactory performance (Chapter 13) or for a Pattern of Misconduct (Chapter 14-12b), separation processing will be accomplished under this chapter.

1-18 counseling required: Yes (l-18a(3))

Medical Required: No (l-34a) but check 11-3b for pregnant females.

Mental Required: No (1-34b)

Approval Authority: Commander, 705th MP Bn. or Garrison Commander (l-21d)

Type of discharge authorized: Uncharacterized (11-8)

Note: If Basic Active Service Date and information on DA Form 2A conflict, date on enlistment contract starts the clock.

Documents Required for Chapter:

( ) Request for separation

( ) All counseling statements including 1-18 “magic” counseling statement (See Example - Appendix B) describing soldier's inability to adapt to the military environment.

( ) Debt avoidance counseling (Appendix C)

( ) Education benefits counseling (Appendix D)

( ) DA Form 2A

( ) DA Form 2-1 or ERB

( ) FLAG for elimination

CHAPTER 13: SEPARATION FOR UNSATISFACTORY PERFORMANCE

Commanders will separate a soldier for unsatisfactory duty performance when it is determined that the soldier will not develop sufficiently to participate satisfactorily in further training and/or become a satisfactory soldier; or the seriousness of the circumstances is such that the soldier's retention would have an adverse impact on military discipline, good order, and morale; and it is likely that the soldier will be a disruptive influence in present or future duty assignments. Pursuant to para. 13-2f, AR 635-200, initiation of separation proceedings is required for soldiers without medical limitations who have two consecutive failures of the Army Physical Fitness or who are eliminated for cause from Noncommissioned Officer Education System (NCOES) courses, unless the responsible commander chooses to impose a bar to reenlistment.

1-18 counseling Required: Yes (13-4 or l-18a(4))

Medical Required: Yes (I -34a)

Mental Required: Yes (1-34b)

Approval Authority: Commander 705th MP Bn. or Garrison Commander (if notification procedures are used) (l-21d); otherwise Commanding General (1-21a)

Type of discharge authorized: Honorable or General, Under Honorable Conditions (13-11). A discharge Under Other Than Honorable Conditions (UOTH) is not authorized (3-7c(4))

Notes: AR 350-41, Training in Units, Chapter 9, paragraph 8(b)(4) and FM 21-20 Physical Fitness Training, Chapter 14-11, both state that in the event of a record test failure, commanders may allow soldiers to retake the test as soon as the soldier and the commander feel the soldier is ready. Soldiers without a medical profile will be re-tested no later than 3 months following the initial APFT failure. When a soldier fails the initial record APFT, the soldier will be counseled using the “magic” counseling statement required by paragraph 1-18 and informed of the date of his or her next record APFT which, for the purposes of this chapter, must be scheduled before the 90 days have expired. Soldiers do not have to wait for the next scheduled record APFT date and can request, in writing, that they be able to retake the record APFT as soon as they are ready. The soldier must indicate, in writing, that they understand the ramifications of retaking the record APFT before the allowed time and express their understanding that if they fail the second record APFT, they can be separated.

Documents Required for Chapter 13:

( ) Request for separation

( ) All counseling statements including 1-18 “magic” counseling statement (See example -Appendix B), especially important after initial APFT failure.

( ) For APFT failures: DA Form 705 - APFT Scorecard with “record” and at least 90 days in between record APFT’s. If the time between record APFT’s does not equal 90 days, also include the statement from the soldier indicating their desire to retake the test before the required waiting period has expired. For NCOES disciplinary drops: Any documents reflecting soldier's disenrollment from the school, especially DA Form 1059.

( ) Medical examination

( ) Mental examination

( ) Debt avoidance counseling (Appendix C)

( ) Education benefits counseling (Appendix D)

( ) DA Form 2A

( ) DA Form 2-1 or ERB

( ) Flag for elimination

CHAPTER 14-5: CONVICTION BY CIVIL COURT

A soldier may be considered for discharge when convicted by civil authorities when a punitive discharge (Bad-Conduct Discharge or Dishonorable Discharge) would be authorized for the same or a closely related offense under the MCM, 1984, as amended in 1998, or when the sentence by civil authorities includes confinement for 6 months or more, without regard to suspension or probation.

1-18 counseling required: No (l-18a)

Medical Required: No (l-34a)

Mental Required: No (1-34b)

Approval Authority: Garrison Commander or USDB Commandant (l-21c(2)(a)), unless UOTH, then CG must approve.

Type of discharge: Honorable or General, Under Honorable Conditions – Garrison Commander or USDB Commandant, can approve ONLY if notification procedure used. If board procedures used because of UOTH recommendation, only CG can approve discharge, whether Honorable or General, Under Honorable Conditions or Under Other Than Honorable (UOTH) Conditions.

Note: Initiation of separation action is NOT mandatory (14-5b).

Note: When a soldier waives his or her right to a hearing before an administrative separation board because of an UOTH recommendation, the case will be processed without convening a board. However, the separation authority is still the CG (2-5a).

Note: If the soldier has over 6 years on active duty, the administrative board procedure must be used regardless of recommendation.

Note: If the soldier is recommended for an UOTH separation, the administrative board procedure must be used.

Documents Required for Chapter:

( ) Request for separation

( ) Any court documents reflecting the conviction by civil authorities and the sentence imposed.

( ) Education benefits counseling (Appendix C)

( ) Debt avoidance counseling (Appendix D)

( ) DA Form 2A

( ) DA Form 2-1 or ERB

( ) FLAG for elimination

CHAPTER: 14-12b ACTS OR PATTERNS OF MISCONDUCT

Soldiers are subject to separation per this chapter for the discreditable involvement with civil or military authorities and/or conduct prejudicial to good order and discipline. Discreditable conduct and conduct prejudicial to good order and discipline includes conduct that violates accepted standards of personal conduct found in the UCMJ, Army Regulations, the civil law, and time-honored customs and traditions of the Army.

1-18 counseling required: Yes (1-18a(5))

Medical Required: Yes (1-34a)

Mental Required: Yes (1-34b)

Approval Authority: Garrison Commander or USDB Commandant (1-2lc(2)(a)), unless UOTH, then CG must approve.

Type of discharge: Honorable, General, Under Hon6rable Conditions – Garrison Commander or USDB Commandant, can approve ONLY if notification procedure used. If board procedures are used because of UOTH recommendation, only CG can approve discharge, whether Honorable or General, Under Honorable Conditions or Under Other Than Honorable (UOTH) Conditions.

Note: When a soldier waives his or her right to a hearing before an administrative board because of an UOTH recommendation, the case will be processed without convening a board. However, the separation authority is still the CG (2-5a).

Note: If the soldier has over 6 years on active duty, the administrative board procedure must be used regardless of recommendation.

Note: If the soldier is recommended for an UOTH separation, the administrative board procedure must be used.

Documents Required for Chapter

( ) Request for separation

( ) Counseling statements including 1-18 “magic” counseling statement (See example – Appendix B) detailing soldier's pattern of misconduct

( ) Evidence of misconduct to include Summary Courts-Martial Result of Trial (DA Form 2329) to include JAG Review Endorsement, Article 15s, bad check notification, letter of reprimand, bar to reenlistment, DA Form 4187s for AWOL, etc.

( ) Medical examination

( ) Mental examination

( ) Education benefits counseling (Appendix C)

( ) Debt avoidance counseling (Appendix D)

( ) DA Form 2A

( ) DA Form2-l or ERB

( ) FLAG for elimination

CHAPTER: 14-12c COMMISSION OF A SERIOUS OFFENSE

A soldier may be separated for the commission of a serious offense if the specific circumstances of the offense warrant separation and a punitive discharge would be authorized for the same or a closely related offense under the MCM, or for the following reasons:

1. An absentee returned to military control from a status of AWOL or desertion may be separated for commission of a serious offense.

2. Abuse of illegal drugs is serious misconduct.

a. First-time drug offenders below the grade of sergeant (E-5), or with less than 3 years of total military service, Active or Reserve, may be processed for separation upon discovery of a drug offense (14-12c(2)).

b. First-time drug offenders in the grade of sergeant and above, and all soldiers with 3 years or more of total military service, Active and Reserve, will be processed for separation upon discovery of a drug offense (14-12c(2)a).

c. All Second-time drug offenders must be processed for separation after a second offense (14-12c(2)b).

1-18 counseling Required: No (l-18a)

Medical Required: Yes (l-34a)

Mental Required: Yes (1-34b)

Approval Authority: Garrison Commander or USDB Commandant (l-2lc(2(a)), unless UOTH, then CG must approve.

Type of discharge: Only Honorable or General, Under Honorable Conditions – Garrison Commander or USDB Commandant, can be approved if notification procedures are used. If Board Procedures are used because of UOTH recommendation, only CG can approve discharge, whether Honorable or General, Under Honorable Conditions, or Under Other Than Honorable (UOTH) Conditions.

Note: When the sole basis for separation is a serious offense which resulted in a conviction by a court-martial which was authorized to, but did not impose a punitive discharge, (Bad-Conduct Discharge or Dishonorable Discharge), the soldier's service may not be characterized Under Other Than Honorable (UOTH) Conditions unless approved by the Secretary of the Army (3-8e).

Documents Required for Chapter:

( ) Request for separation

( ) Evidence of misconduct to include Summary Courts-Martial Result of Trial (DA Form 2329) to include JAG Review Endorsement, Article l5s, bad check notification, letter of reprimand, bar to reenlistment, DA Form 4187s for AWOL, etc.

( ) Medical examination

( ) Mental examination

( ) Debt avoidance counseling (Appendix C)

( ) Education benefits counseling (Appendix D)

( ) DA Form 2A

( ) DA Form 2-1 or ERB

( ) FLAG for elimination

CHAPTER 15: DISCHARGE FOR HOMOSEXUAL CONDUCT

Before initiating any action regarding homosexuality, CONTACT THE TRIAL COUNSEL!!!!

A soldier may be separated under this chapter if the soldier has engaged in, attempted to engage in, or solicited another person to engage in a homosexual act or acts.

1-18 counseling required: No (1-18a)

Medical Required: Yes (1-34a)

Mental Required: Yes (1-34b)

Approval Authority: Garrison Commander, MEDDAC Commander, or USDB Commandant (l-21(3)(a))

Type of discharge authorized: Honorable or General, Under Honorable Conditions. A discharge Under Other Than Honorable (UOTH) Conditions is authorized only if one of the findings noted below exist.

Note: If a soldier waives the board and a general discharge is requested, Garrison Commander, MEDDAC Commander, or USDB Commandant can approve. (l-21c(3)(4))

Note: UP AR 635-200, paragraph 15-4a, when the sole basis for separation is homosexual conduct, a discharge Under Other Than Honorable (UOTH) Conditions may be issued only if there is a finding that, during the current term of service, the soldier attempted, solicited, or committed a homosexual act:

1. By using force, coercion or intimidation.

2. With a person under 16 years of age.

3. With a subordinate in circumstances that violate customary military superior-subordinate relationships.

4. Openly in public view.

5. For compensation.

6. Aboard a military vessel or aircraft.

Documents required for Chapter:

( ) A statement by the soldier that demonstrates a propensity or intent to engage in homosexual acts. Soldiers are entitled to visit the Legal Assistance Office of the OSJA for guidance and assistance before writing their statement.

OR

( ) Documentation showing that the soldier has engaged in homosexual acts. If a discharge under UOTH Conditions is contemplated, include any evidence that will support 1 through 6 above.

( ) Medical examination

( ) Mental examination

( ) Debt avoidance counseling (Appendix C)

( ) Education benefits counseling (Appendix D)

( ) DA Form 2A

( ) DA Form 2-l or ERB

( ) FLAG for elimination

CHAPTER 16: VOLUNTARY SEPARATION OF SOLDIERS DENIED REENLISTMENT

As per message UNCLAS ALARACT 035/97 dated 14 Apr 97, Chapter 16-5b (Locally imposed bars to reenlistment) has been indefinitely suspended.

This chapter is requested by those soldiers who want to be discharged based on one of the following three categories:

1. HQDA imposed bars to reenlistment (para. 16-5a): Soldiers who perceive that they will be unable to overcome an HQDA bar to reenlistment will be discharged upon their request. Soldiers may request discharge at any time after receipt of the HQDA bar to reenlistment from unit commanders or upon notification that an appeal of the bar to reenlistment was disapproved. Soldier's request will be submitted on DA Form 4941-R (reproduced at Appendix N).

2. Locally imposed bars to reenlistment (para. 16-5b): This provision of Chapter 16 has been suspended indefinitely. The information is provided in case the suspension is lifted. Soldiers who perceive that they will be unable to overcome a locally imposed bar to reenlistment may request immediate separation. Soldier's request will be submitted on DA Form 4187. Company Commander either disapproves request or recommends approval and forwards to Garrison Commander, MEDDAC Commander, or Battalion Commander. If Garrison Command, MEDDAC Commander, or Battalion Commander approves request, must award Honorable Discharge (para. 16-5i).

3. Declination of Continued Service Statement (DCSS): Soldiers who decline to meet service remaining requirements and who have signed a DCSS may request immediate separation. Soldiers who have signed a DCSS and are subsequently alerted for schooling or an assignment for which they have sufficient service remaining, must request early separation within 30 days of alert, or else comply with the reassignment instruction (para. 16-5c(l)). Soldiers request will be submitted on DA Form 4187 (example at Appendix O).

1-18 counseling required: No (l-18a)

Medical Required: No (1-34a)

Mental Required: No (l-34b)

Approval Authority: Commander 705th MP Bn. or Garrison Commander (l-21d)

Characterization of service: Honorable (16-5i)

Documents Required for Chapter:

( ) For HQDA imposed bars to reenlistment - Statement of Option, DA Form 4941-R (example at Appendix N).

( ) For Locally imposed bars to reenlistment - DA Form 4187 (Remember, this provision has been indefinitely suspended).

( ) For DCSS - DA Form 4187 (example at Appendix O).

( ) Education benefits counseling (Appendix C)

( ) Debt avoidance counseling (Appendix D)

( ) DA Form 2A

( ) DA Form 2-l or ERB

CHAPTER 18: FAILURE TO MEET BODY FAT STANDARDS

Soldiers who fail to meet the body fat standards set forth in AR 600-9 are subject to separation UP of this chapter when such condition is the sole basis for the separation. Soldiers who have been diagnosed by health care personnel as having a medical condition preventing them from participating in the Army body fat reduction program will not be separated under this chapter. IAW AR 600-9 and IAW AR 635-200, a commander may separate a soldier who is in the weight control program under the following circumstances:

1. Failure to make satisfactory progress after any two consecutive monthly weigh-ins while enrolled in the Army Weight Control Program (AR 600-9, para. 21e(2)).

2. If no medical condition exists, initiation of separation proceedings is required for soldiers who do not make satisfactory progress in the program after a period of 6 months, unless the responsible commander chooses to impose a bar to reenlistment per AR 635-200, para. 18-2a.

3. Initiation of separation proceedings is required for soldiers who fail to meet screening table weight and body fat standards during the 12-month period following removal from the weight control program, provided no medical condition exists (para. 18-2a).

4. Soldiers without medical limitations who exceed the screening table weight and body fat standards after the 12 month period but prior to 36 months following removal from the program, and who do not meet the standards during the 90-day grace period prescribed by AR 600-9, will be processed for separation.

1-18 counseling required: No (1-18a)

Medical required: Yes (1-34a)

Mental required: No (1-34b)

Approval Authority: Garrison Commander or USDB Commandant (when notification procedures are used) (1-21d); otherwise Commanding General (1-21a)

Characterization of service: Honorable (18-2e).

Note: Below is a proposed course of action for those commanders who identify a soldier who is overweight:

1. Soldier is weighed and exceeds the screening table weight (AR 600-9) and taped and exceeds the body fat standard (AR 600-9).

2. Commander initiates flag. The commander enrolls the soldier into the overweight program and informs the soldier using a memorandum format. When the soldier acknowledges receipt of the memorandum, the clock starts for the purposed chapter action.

3. Commander refers the soldier to the nutritionist for nutritional counseling and proper weight-loss counseling. This is done by memorandum and must take place as soon as the soldier is enrolled in the program.

4. Commander refers the soldier to the TMC for medical screening to determine if there is a medical condition which will preclude the soldier from losing weight. This is also done by memorandum and also must take place as soon as possible after the soldier has been enrolled in the program.

5. Conduct monthly weight-ins. If the soldier shows no improvement in any two consecutive monthly weigh-ins, initiate chapter. If after six months, the commander determines that the soldier has not shown adequate improvement, the commander can either impose a bar to reenlistment or can initiate chapter.

6. If the soldier meets the body fat standard and the screening table weight table as prescribed in AR 600-9, remove the soldier from the overweight program. This removal is accomplished through a memorandum and should be kept on file in the unit for the next 36 months.

Documents Required for Chapter:

( ) Request for Separation

( ) Notification from immediate Commander and receipt of notification from Soldier acknowledging entry into Weight Control Program (AR 600-9). The clock starts ticking upon receipt from the soldier. (Appendix P)

( ) Memorandum from health care personnel indicating no medical condition exists which precludes the soldier from losing weight (AR 600-9). Completed and DATED. (Appendix Q)

( ) Memorandum from nutritionist indicating the soldier was provided nutrition education and weight reduction counseling (AR 600-9). Completed and DATED. (Appendix R)

( ) If the chapter is for a soldier who re-enters the overweight program, evidence of prior disenrollment from the weight control program (AR 600-9).

( ) Monthly weigh-in sheets (DA Form 5500-R for male and DA Form 5501-R for female)

( ) Medical examination

( ) Debt avoidance counseling (Appendix C)

( ) Education benefits counseling (Appendix D)

( ) DA Form 2A

( ) DA Form 2-l or ERB

( ) FLAG for elimination

REVOKING AN APPROVED CHAPTER THAT HAS BEEN SUSPENDED

A highly deserving soldier may be given a probation period to show successful rehabilitation before the soldier's enlistment or obligated service expires. The separation authority may suspend (except for action involving fraudulent enlistment or homosexuality) execution of an approved separation for a period of full-time military duty not to exceed 6 months (para. 1-20). Upon satisfactory completion of the probation period or earlier, if rehabilitation has been achieved, the authority who suspended the separation will cancel execution of the approved separation. If the soldier engages in conduct similar to that for which separation was approved but suspended, or otherwise fails to meet the appropriate standards of conduct and duty performance, the separation authority will take the following actions:

1. Advise the soldier in writing that vacation action is being considered and the reasons/evidence of misconduct that warrant such considerations.

2. Advise and give the soldier 3 duty days to consult with counsel and submit a written statement in his or her own behalf or decline to make any statement.

3. The commander taking the action will consider any information the soldier submits. If the soldier identifies specific legal issues for consideration, the separation authority will have the matter reviewed by the unit trial counsel.

4. The separation authority may either:

(a) vacate suspension of the approved separation and execute the separation, or

(b) continue to suspend execution of the approved separation for the remainder of the probation period.

5. See Examples at Appendix S.


 

MEMORANDUM FOR Office of the Staff Judge Advocate, ATTN: Criminal Law Section

SUBJECT: Request for Elimination Packet


1. SOLDIER'S PERSONAL DATA:

_____ _____ __ ___________

NAME RANK SSN SEX RACE

___________________________

UNIT

2. RECOMMEND SEPARATION UNDER:

[ ] Chapter 5-8 – Involuntary Separation Due to Parenthood

[ ] Chapter 5-13 – Personality Disorder

[ ] Chapter 5-18 – Other Designated Physical or Mental Conditions

[ ] Chapter 7 – Fraudulent Enlistment

[ ] Chapter 9 – Alcohol/Drug Rehabilitation Failure

[ ] Chapter 11 – Entry Level Status Performance and Conduct

[ ] Chapter 13 – Unsatisfactory Performance

[ ] Chapter 14-5 – Conviction by Civil Court

[ ] Chapter 14-12b – Pattern of Misconduct

[ ] Chapter 14-12c – Commission of a Serious Offense

[ ] Chapter 15 – Discharge for Homosexual Conduct

[ ] Chapter 18 – Failure to Meet Body Fat Standards

3. RECOMMEND THAT THE SOLDIER RECEIVE:

[ ] an Honorable [ ] a general [ ] an Under other than Honorable Conditions Discharge

4. POINT OF CONTACT FOR THIS ACTION: Name _________ Phone _________

5. IS THE SOLDIER PENDING A MEDICAL EVALUATION BOARD (MEB)?

[ ] Yes [ ] No

DATE REC’D MJ: ___________ __________________

 

DATE READY PU:___________

DATE TO UNIT:_____________ _______________________________

 

_______________________

SIGNATURE BLOCK

 


ATZL-
SUBJECT: Debt Avoidance Notice


1. Individual listed below is being considered for early separation/elimination from the U.S. Army. Request you review individual's finance account to determine any outstanding indebtedness to the U.S. Government.

NAME: ___________________________________________

RANK: ________ SSN#: _________________________

Contemplated Chapter Action: ___________________

Estimated Date of Separation: ___________________

2. If the individual is indebted to the U.S. Government, request appropriate action be taken to satisfy the outstanding indebtedness.

3. Request you reply in writing with the results of the finance review.

 

_____________

Commander's Signature and Date

For Soldiers Chaptering Out of the U.S. Army:

I am aware that:

1. If I am indebted to the U.S. Government, my pay and allowances will be put in accrual and my pay options will stop (i.e. direct deposit). I am also aware that my allotments will stop with the exception of involuntary support (garnishment), child support, and insurance allotments.

2. When my pay is suspended and I wish payment, a DA Form 2142 requesting my end of month pay must be signed by my commander and submitted to finance on a monthly basis by my PAC along with a memorandum stating that I have at least 30 days prior to my separation. I also realize that I will receive NO payment within 30 days of estimated discharge.

3. If this chapter action is disapproved, and my pay is in suspense, I realize that I must notify the Debt Management Section by memorandum from my commander.

 

__________________________

Soldier's Signature and Date


ATZL-


SUBJECT: Briefing on GI Bill Benefits

TO: Whom It May Concern

IAW Title 10 USC 1142 (Pre-Separation Counseling) and Public Law 101-510, Section 561, or Public Law 102484, Section 4404, I have received counseling on Veterans' Educational Benefits. I understand that I must receive a Fully Honorable Discharge and Meet minimum Time in Service requirements to be eligible to receive benefits. Also, I understand the Veterans Administration determines both eligibility for benefits and dollar amounts. The VA toll free telephone number is 1-800-827-1000.

________________________

(Signature of Soldier and Date)

________________________

Education Counselor


ATZL-


MEMORANDUM FOR

SUBJECT: Statement of Pregnancy Counseling, PART II of Pregnancy Counseling Checklist, DA Form 5304-R and DA Form 5305-R


Request your election of appropriate option indicated below and return within 72 hours.

_______________

_______________

_______________


ATZL-              1st End

1. I affirm that I have been counseled by this date on all items on the DA Form 5304-R and DA Form 5305-R and I understand my entitlements and responsibilities. I understand that if I elect separation I may receive maternity care at Department of Defense expense, on a space available basis for up to 6 weeks postpartum for the birth of my child only in a military medical treatment facility which has maternity care capability and that I may elect a separation date no later than 30 days prior to expected date of delivery, or latest date my physician will authorize me travel, whichever is earlier. Further, I understand that many military medical treatment facilities cannot provide maternity care and that unforeseen circumstances or medical emergency could force me to use civilian medical treatment facilities following separation from active duty. Should this happen, I fully understand that UNDER NO CIRCUMSTANCES can CHAMPUS, any military department, or the Veterans Administration reimburse my civilian maternity care expenses. Such costs will be a matter of my personal responsibility. Further, I understand that the separation authority, in conjunction with my military physician and the needs of the Army, will determine my separation date. I also understand that if I should remain on active duty, I will be expected to fulfill the terms of my enlistment contract If I elect to remain on active duty, I understand that I must remain available for unrestricted service on a worldwide basis when directed and I will be afforded no special consideration in duty assignments or duty stations based on my status as a parent.

2. ( ) During the counseling session, there was no coercion on the part of the counselor influencing my decision.

3. ( ) I elect separation for reason of pregnancy per AR 635-200, Chapter 8. I will provide a DA Form 4187 reflecting this desire within 5 working days.

4. ( ) I elect to remain on active duty to fulfill the terms of my enlistment contract.

 

___________________________

(Signature of Soldier and Date)


ATZL-


MEMORANDUM FOR: ___________________________________________________

(Enter Soldier's Name, Rank, SSN#, and Unit)

SUBJECT: Entry into the Weight Reduction/Exercise Program


1. You have been determined to exceed U.S. Army body fat standards. IAW AR 600-9, you are hereby entered into the Weight Control Program, and flagged UP AR 600-31.

2. You will be weighed and taped on a monthly basis. You must make satisfactory progress in order to remain in the Army. Satisfactory progress is defined as losing 3 to 8 pounds each month.

3. If you fail to make satisfactory progress after any two consecutive months, you may be administratively separated from the Army IAW AR 635-200, Chapter 18. If you are still overweight and on the Weight Control Program six months from this date, depending upon your progress, I will make either initiate separation proceedings or I will initiate a bar to reenlistment as required UP AR 635-200, chapter 18.

____________

____________

Commanding


ATZL-           1st End

FROM: _______________________________________________________________

(Soldier's name, rank, SSN#, and Unit)

To Commander: _________________________________________________________

IAW AR 600-9, I understand my responsibilities to achieve body fat standards and to have my weight recorded on a monthly basis.

_______________

(Signature of Soldier and Date)


ATZL-           2dEnd

TO: Medical Officer

FROM: Commander, ________________________________________

SUBJECT: Medical Screening For Weight Reduction/Exercise Program


1. __________________exceeds the body fat standard IAW AR 600-9.

2. I request that you conduct a medical evaluation to determine if the cause of the soldier's overweight status is due to a medical condition.

______________

______________

Commanding


ATZL-      3d End


FROM: Medical Officer

TO: Commander, ______________________________________________________

SUBJECT: Medical Screening For Weight Reduction/Exercise Program


1. IAW AR 600-9, ________________________has been examined and found to be (FIT) (UNFIT) for participation in a weight reduction/exercise program.

2. The cause of the overweight condition (IS) (IS NOT) due to a medical condition.

3. The following action is recommended:

_______ Initiation or continuation in a weight reduction/exercise program.

_______Medical treatment for a pathological medical disorder.

 

______________

(Signature of Medical Officer and Date)


ATZL-      4th End


TO: Medical Officer/Nutritionist

FROM: Commander, ________________________________________________

SUBJECT: Nutrition Counseling for Weight Reduction/Exercise Program


1. _________________________________ exceeds the body fat standards UP AR 600-9. Soldier currently weights _________ with _________% body fat. Soldier's allowed weight is ___________with _______% body fat.

2. Request nutrition counseling and weight reduction counseling IAW AR 600-9.

____________

____________

Commanding


ATZL-      5th End


TO: Commander, ____________________________________________________________

FROM: Medical Officer/Nutritionist

SUBJECT: Nutrition Counseling for Weight Reduction/Exercise Program




1. __________________________ has been provided with nutrition and weight reduction counseling JAW AR 600-9.

2. Follow up counseling should be provided at the unit level using information in Appendix C of AR 600-9 with the assistance of your master fitness trainer.


________________________________

(Signature of Medical Officer/Nutritionist)


ATZL-               (ATZL-         ) (635-200) 3rd End


SUBJECT: Revocation of Approved Separation UP AR 635-200, Chapter 14, paragraph 14-12b.

Commander, _________________________________________________________________

FOR _______________________________________________________________________

 

1. On 16 December 1995, I approved your discharge IAW AR 635-200, Chapter 14, paragraph 14-12b but suspended execution of your discharge for a period of 90 days to evaluate your performance and potential for rehabilitation. Your suspension period ends on 16 March 1996.

2. In light of your recent misconduct as evidenced by your willful disobedience to a lawful order issued by your Company Commander which resulted in your punishment under Field Grade Article 15 procedures, I intend to vacate the suspension of your approved discharge.

3. You may submit matters in extenuation and mitigation for me to consider before I make the decision to vacate the suspension of your approved discharge. You will have three working days following receipt of this notification to submit any matters for consideration before I act. I suggest you consult with your Trial Defense Attorney during this period. Any request for additional time to gather matters will be submitted in writing to my office.

4. Execute the attached acknowledgment and return it to my office no later than 1700 hours, 10 March 1996.

_______________

_______________

Commanding

ACKNOWLEDGMENT OF RECEIPT OF NOTIFICATION

I, _____________________________ hereby acknowledgment receipt of notification of intended revocation of suspension at hours, on ___________________________.

________________________

(Signature of Soldier and Date)


ATZL-      (ATZL-      ) (635-200) 4th End

SUBJECT: Revocation of Approved Separation UP AR 635-200, Chapter 14, paragraph 14-l2b.

Commander, _________________________________________________________________

For Commander, Combined Arms Center and Fort Leavenworth, ATTN: Adjutant General, Fort Leavenworth, Kansas 66027


1. The suspension of the approved separation UP AR 635-200, Chapter 14, paragraph l4-l2b, pertaining to ____________________________________ is hereby vacated and ordered executed.

2. On_________________________ I approved the separation but suspended execution of the discharge until ___________________. During this suspension period, the soldier committed an offense under the UCMJ which resulted in punishment under Field Grade Article 15 procedures.

3. IAW AR 635-200, Chapter 14, paragraph l4-12b, _______________________ will be separated from the United States Army for a pattern of misconduct and will receive:

( ) An Honorable Discharge

( ) A General, Under Honorable Conditions Discharge.

______________

______________

Commanding


APPENDIX

 

Appendix A Request for Elimination Packet

Appendix B DA Form 4856 – 1-18 Language

Appendix C Educational Benefits Counseling

Appendix D Debt Avoidance Counseling

Appendix E DA Form 5304-R, Family Care Counseling Checklist

Appendix F DA Form 5305-R, Family Care Plan

Appendix G Pregnancy Counseling Checklist

Appendix H Statement of Pregnancy Counseling

Appendix I DA Form 4187, Example of Chapter 5-3 Action, Secretarial Plenary

Appendix J DA Form 4187, Example of Chapter 5-17 Action, To Further Education

Appendix K DA Form 4187, Example of Chapter 6 Action, Hardship

Appendix L DA Form 4187, Example of Chapter 6 Action, Dependency

Appendix M DA Form 4187, Example of Chapter 8 Action, Pregnancy

Appendix N DA Form 4941-R

Appendix O DA Form 4187, Example of Chapter 16, DCSS

Appendix P Notification to Enter Weight Control Program

Appendix Q Memorandum from Health Care Professional

Appendix R Memorandum from Nutritionist

Appendix S Revoking Approved Suspended Chapter


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