Wait until Da 5016 is shown. da form 5016 pdf dd form 2892 dd form 2495 lower extremity functional scale military form beachbody military coach application form military fingerprint waiver new revision pdf form resume template military form dd form 117 1 2 3 Purpose of a military form A military form is kind of a document used for different military purposes. The DA Form 1506 is used for initial tours and is used for soldiers in the IMA and IRR programs. The name and address to be listed on the record must have been written by the individual (see paragraph 2 (n) below). A .mil website belongs to an official government organization in the United States. months qualifying for retirement (DA Form 5016 (Army Reserve), NGB Form 23B (Army National Guard)) and no more than 168 months qualifying for retirement at the time of the board (only more than 168 months may be waiverable). You can also download it, export it or print it out. Fort Belvoir, VA 22060 Army Reserve DA FORM 5016 Naval Reserve NRPC 1070-124 Air Force Reserve AF 526 Marine Corps Reserve NA VMC 798 Coast Guard Reserve CG 4174 or 4175 If you are still serving in the Selected Reserves or the National Guard, you must include an original statement of service signed by, or by the direction of, the adjutant, personnel officer, or . 01. G. For periods of omitted prior reserve service, provide copies of the DA Form 1383, AGUZ Form 115, DARP Form 249, DARP Form 249-2-E, ARPC Form 249-E, AHRC Form 249-2-E,NGB Form 23, AF Form 526, NAVPERS Form 1070-611, NAVMC Form 798, or CG HQ Form 4973. I'm looking for my retirement points. Click Done in the top right corne to save the template. Sign it in a few clicks Draw your signature, type it, upload its image, or use your mobile device as a signature pad. 3. Army Publishing Directorate ILLUSTRATED COMPONENTS LIST/HAND RECEIPT (LRA), MALPRACTICE HISTORY AND CLINICAL PRIVILEGES QUESTIONNAIRE, CONSIGNMENT AGREEMENT (NONAPPROPRIATED FUNDS), CONCESSIONAIRE CONTRACT-SHORT TERM (NONAPPROPRIATED FUNDS), CHILD DEVELOPMENT (CDS) MANAGEMENT PERSONNEL CUMULATIVE INDIVIDUAL EDUCATION PLAN (IEP) TRAINING RECORD (LRA), FAMILY CHILD CARE RISK ASSESSMENT TOOL OBSERVATION SUMMARY (LRA), FAMILY CHILD CARE (FCC) RISK ASSESSMENT TOOL INTERVIEW SUMMARY (LRA), FAMILY CHILD CARE (FCC) RISK ASSESSMENT TOOL REPORT (LRA), FAMILY CHILD CARE (FCC) RISK ASSESSMENT TOOL OBSERVATION INSTRUMENT (LRA), FAMILY CHILD CARE CERTIFICATION REQUIREMENTS (LRA), CHILD DEVELOPMENT SERVICES (CDS) INDIVIDUAL EDUCATION PLAN (IEP) FAMILY CHILD CARE (FCC) PROVISIONAL CERTIFICATION TRAINING RECORD (LRA), INDIVIDUAL EDUCATION PLAN CAREGIVER INITIAL TRAINING RECORD (LRA), CDS DIRECT SERVICE PERSONNEL ANNUAL INDIVIDUAL EDUCATION PLAN TRAINING RECORD (LRA), ARMY ACCIDENT PREVENTION AWARD OF ACCOMPLISHMENT IN SAFETY, U.S. ARMY SAFETY GUARDIAN AWARD (S&I, US ARMY COMBAT READINESS/SAFETY CENTER, ATTN: CHRISTOPHER BOKENFOHR, BLDG. da form 5016: active: 10/1/2015: chronological statement of retirement points (copy availability at https://www.hrcapps.army.mil) g-1: da form 5017: active: 11/1/2001: civilian employee consent statement: g-1: da form 5018-r: active: 11/1/1981: adapcp client`s consent statement for release of treatment information (lra) g-1: RPSC requests Presidential Letter of Appreciation (PLA)* by sending request packet to the Whitehouse Liaison (WHL) at usarmy.pentagon.hqda-csa.mbx.csa-white-house-liaison-of@mail.mil 8. 03. Authority: 37 USC, Section 1006; Executive Order 9397. An official website of the United States government. Follow the on screen instructions to change your password 5. To pick up installation clearing papers you will need a copy of your orders, approved leave form (DA 31) with control number, and unit clearing papers (DA Form 137-1) with blocks 1-10 completed or a memorandum from your unit. 03. The tips below will allow you to complete Da 5016 Example easily and quickly: Open the form in the full-fledged online editing tool by hitting Get form. 107 Army Pentagon Must be within the past 30-days **These forms are source documents for active federal service served in other services (i.e. Soldier's Medical Evaluation Board/Physical Evaluation Board Counseling Checklist. Either way I still have part of that 6th year as an SMP cadet before I commissioned. Army Publishing Directorate Fort Belvoir, VA 22060 6. Name. To provide members of the Reserve Components a detailed listing of retirement points earned in the previous completed anniversary years. Make any adjustments required: add text and photos to your Da form 5016, underline important details, remove sections of content and replace them with new ones . DA Form 5016 (Chronological Statement of Retirement Points) Go to the e-signature tool to e-sign the form. Common errors with the DA Forms 1380 4-2, pages 10 & 11 . Share sensitive information only on official, secure websites. Its needed for my certificate of eligibility for a VA loan. (DA Form 5016-R). An official website of the United States government. 9301 Chapek Road., Bldg.1458 (4) Provide DA Form 5016 (Chronological Statement of Retirement Points) to current and former USAR Soldiers uti-lizing HRC's self-service portal at . ) or https:// means youve safely connected to the .gov website. Fort Belvoir, VA 22060 Click Done following twice-checking everything. Army DA Form 5016 Marine Reserve Career Retirement Credit Report (CRCR) Navy Reserve DFAS-CL Form 1059 Air Force Reserve ANG/USAFR Point Credit Summary Inquiry (PCFARS) Order your Discharge Document & Official Points Statement For Guardsman & Reservist Only Determine Your Monthly Pension Take Advantage of Benefits Find Your Fastest Option! DA FORM 5016, OCT 2015. DA Form 5016 (Chronological Statement of Retirement Points) Establishing the Anniversary Year Ending Date Recording and Reporting Retirement Points Soldiers can now check their retirement point. Put the date and place your e-signature. How do I get DA Form 5016? A lock ( DA FORM 1577 IS ONLY AUTHORIZED FOR USE WITHIN THE OFFICE OF MILITARY AWARDS BRANCH PERSCOM (ODCSPER) AND NPRC. If you did not receive a full accounting of your retirement points, you will need to contact the Armed Service Branch you served with and ask for a DA Form 5016 (Chronological Statement of Retirement Points). Army DA administrative publications and forms by the Army Publishing Directorate APD. Download Form. DA Form 5016 help. The applicant provides: a. DA Forms 1380 showing the following: * 17 and 31 October 2014 - 8 hours each day administrative actions in support of training and . Download your finished form and share it as you needed. All AR, ARNG and AGR applicants must submit a certified true copy of their DA Form 5016 NGB Form 23B 1. Washington DC 20310-0107, ADRP - Army Doctrine References Publications, ATTP - Army Tactics, Techniques, and Procedures, FY Publication Status Report (CAC required for access), Publishing Resources (CAC required for access), PC/PCO/FMO/EPCO Directory (CAC required for access), usarmy.pentagon.hqda-apd.mbx.customer-service@army.mil, APPLICANT INTERVIEW REPORT - JUDGE ADVOCATE GENERAL`S CORPS (LRA), MEDICAL RECORD - ALLERGY IMMUNOTHERAPY RECORD (SINGLE EXTRACT), MEDICAL RECORD - ALLERGY IMMUNOTHERAPY RECORD (DOUBLE EXTRACT), TELEPHONE MEDICAL ADVICE/CONSULTATION RECORD, MEDICAL RECORD - RELEASE AGAINST MEDICAL ADVICE, CHRONOLOGICAL STATEMENT OF RETIREMENT POINTS (COPY AVAILABILITY AT HTTPS://WWW.HRCAPPS.ARMY.MIL), ADAPCP CLIENT`S CONSENT STATEMENT FOR RELEASE OF TREATMENT INFORMATION (LRA), CONDITION OF EMPLOYMENT FOR CERTAIN CIVILIAN POSITIONS IDENTIFIED CRITICAL UNDER THE DEPARTMENT OF THE ARMY DRUG-FREE FEDERAL WORKPLACE PROGRAM, G. DESIGN DATA CHECKLIST PHYSICAL SECURITY ENHANCEMENT AGAINST TERRORIST THREAT (LRA), G. DESIGN DATA CHECKLIST PHYSICAL SECURITY ENHANCEMENT AGAINST TERRORIST THREAT (CONT`D) (LRA), RECORD OF CERTIFICATION - SMALL ARMS SHIPMENT CONTROL (LRA), MEDCASE SUPPORT AND TRANSMITTAL FORM (LRA), FIELD ARTILLERY DELIVERED MINEFIELD PLANNING SHEET, JUSTIFICATION STATEMENT FOR .0015 CONTINGENCY FUNDS, PAYING AGENT RECEIPT CONTROL AND CASH ACCOUNTABILITY JOURNAL, MAGNETIC COMPASS DEVIATION TABLE INSTALLATIONS, RECORD OF AWARD OF ENTRY GRADE CREDIT (HEALTH SERVICES OFFICER) (LRA), RECORD OF AWARD OF ENTRY GRADE CREDIT (MEDICAL AND DENTAL OFFICERS) (LRA), ANALYSIS OF CUSTODIAL PERSONNEL REQUIREMENTS, FEEDER REPORT TO ANNUAL PRODUCTIVITY REPORT - PECI (LRA), DOCUMENTATION FOR PRODUCTIVITY CAPITAL INVESTMENTS PROGRAM (LRA), REQUEST TO SUPERIOR TO EXERCISE ARTICLE 15, UCMJ, JURISDICTION, SUMMARY COURT-MARTIAL RIGHTS NOTIFICATION/WAIVER STATEMENT, REASSIGNMENT STATUS AND ELECTION STATEMENT, IN- AND OUT- PROCESSING RECORDS CHECKLIST, APPLICATION FOR VOLUNTARY MOBILIZATION PREASSIGNMENT, BRANCH IDENTIFICATION SUMMARY - CONTINUATION SHEET (LRA), BRANCH MAINTENANCE AND REPAIR REQUIREMENTS (LRA), SECTION MAINTENANCE AND REPAIR RECORD (LRA), NONAPPROPRIATED FUND CENTRAL PAYROLL SYSTEM - TIPS, SERVICE CHARGES AND MEALS REPORT, INCENTIVE AWARDS NOMINATION AND APPROVAL - NONAPPROPRIATED FUNDS, SAFETY CLEARANCE ORDER (ELECTRICAL FACILITIES) (LRA), MEDICAL RECORD - PREOPERATIVE/POSTOPERATIVE NURSING DOCUMENT, SOIL SUCTION, WATER CONTENT AND SPECIFIC VOLUME (LRA), APPLICATION FOR RESPITE CARE FOR CHILDREN AND ADULTS WITH DISABILITIES, INFORMATION ON INDIVIDUAL WITH DISABILITY, FAMILY IDENTIFICATION SHEET FOR A CHILD RECEIVING SERVICE, CHILD DEVELOPMENT SERVICES (CDS) FAMILY CHILD CARE (FCC) PROVIDER APPLICATION (LRA), CHILD DEVELOPMENT SERVICES (CDS) FAMILY CHILD CARE (FCC) PROVIDER BACKGROUND CLEARANCE REQUEST (LRA), CHILD DEVELOPMENT SERVICES (CDS) FAMILY CHILD CARE (FCC) CERTIFICATION, DENIAL/REVOCATION (LRA), CHILD DEVELOPMENT SERVICES (CDS) SPONSOR CONSENT FORM (LRA), CHILD DEVELOPMENT SERVICES (CDS) CHILD HEALTH ASSESSMENT (LRA), CHILD DEVELOPMENT SERVICES (CDS) CHILD AND FAMILY PROFILE (LRA), CHILD DEVELOPMENT SERVICES (CDS) MEDICAL DISPENSATION RECORD (LRA), CHILD DEVELOPMENT SERVICES (CDS) SPONSOR/PROGRAM AGREEMENT (LRA), CHILD DEVELOPMENT SERVICES (CDS) REPORT (LRA), REPORT OF UNFAVORABLE INFORMATION FOR SECURITY DETERMINATION (LRA), STATEMENT - EVIDENCE OF CITIZENSHIP STATUS (LRA), SELECTED RESERVE INCENTIVE PROGRAM - OFFICER ACCESSION BONUS, SELECTED RESERVE INCENTIVE PROGRAM - OFFICER AFFLIATION BONUS, HARBOR BOAT DECK AND ENGINE LOG FOR CLASS B VESSELS, ARMY EXCEPTIONAL FAMILY MEMBER CHILD FUNCTIONAL QUESTIONNAIRE (LRA), NONAPPROPRIATED FUND PAYABLE/DISBURSEMENT VOUCHER CONTINUATION SHEET (LRA), NONAPPROPRIATED FUND PAYABLE/DISBURSEMENT VOUCHER (LRA), PERSONAL SERVICES (COMPREHENSIVE) NON-APPROPRIATED FUND (NAF) EMPLOYEES, CPMC (PART A) CAPITAL PURCHASES (OVER $1,000), MAINTENANCE & REPAIR (OVER $2,500, UNDER $1M), AND MINOR CONSTRUCTION (UNDER $200K) (EGA), CHECK COMPUTATION FOR DETERMINING NET INCOME (LRA), PACKAGE BEVERAGE BRANCH COMPUTATION OF INCOME DISTRIBUTION (LRA), BONA FIDE DEPENDENT DECLARATION - MILITARY, BONA FIDE DEPENDENT DECLARATION (CIVILIAN), OCS APPLICANT`S COMMANDERS EVALUATION SHEET, HONORARY SERGEANT MAJOR OF THE REGIMENT APPOINTMENT CERTIFICATE, HONORARY MEMBER OF THE REGIMENT APPOINTMENT CERTIFICATE, NONAPPROPRIATED FUNDS EARNINGS AND LEAVE STATEMENT (CONUS), LONG-RANGE SPECIAL ASSIGNMENT AIRLIFT MISSION (SAAM) FLYING HOURS REQUIREMENTS, ROTATION AGREEMENT - EMPLOYEES RECRUITED FROM THE UNITED STATES, ROTATION AGREEMENT - EMPLOYEES RECRUITED LOCALLY IN FOREIGN AREAS, ROTATION AGREEMENT - EMPLOYEES RECRUITED FROM THE US TERRITORIES AND POSSESSIONS, FIRE AND EMERGENCY SERVICES TRAINING RECORD, WORKLOAD MANAGEMENT SYSTEM FOR NURSING INTERRATER RELIABILITY TESTING (LRA), PATRIOT MULTIPLE LOCATION/STATUS/CONDITION REPORT (LRA), OVERSEAS TOUR EXTENSION INCENTIVE PROGRAM MONTHLY REPORT, BULK PETROLEUM STORAGE FACILITIES REPORT, ARMY (RCS: DRC-830) (LRA), FIELD CATEGORY TRAINING EVALUATION CHECKLIST, TERRAIN MORTAR POSITION/SPECIAL CORRECTIONS WORKSHEET (LRA), APPLICANT/NOMINEE PERSONAL FINANCIAL STATEMENT, BATTALION COMMAND TEAM RECRUITER CANDIDATE INTERVIEW AND EVALUATION, COMPANY COMMANDER RECRUITER CANDIDATE INTERVIEW AND ASSESSMENT, SPONSORSHIP PROGRAM COUNCELING AND INFORMATION SHEET, STATEMENT OF UNDERSTANDING - THE SELECTED RESERVE MONTGOMERY GI BILL (10 USC CHAPTER 1606), STATEMENT OF UNDERSTANDING - THE SELECTED RESERVE MONTGOMERY GI BILL KICKER PROGRAM (10 USC 16131), EXPLOSIVE ORDNANCE DISPOSAL (EOD) VOLUNTEER STATEMENT, VOLUNTARY WITHDRAWAL FROM EXPLOSIVE ORDNANCE DISPOSAL (EOD) STATEMENT, INVOLUNTARY TERMINATION FROM EXPLOSIVE ORDNANCE DISPOSAL (EOD) DUTIES, DELINEATION OF CLINICAL PRIVILEGES-ANESTHESIA, DELINEATION OF CLINICAL PRIVILEGES-DENTISTRY, DELINEATION OF CLINICAL PRIVILEGES-FAMILY PRACTICE, DELINEATION OF CLINICAL PRIVILEGES-INTERNAL MEDICINE, DELINEATION OF CLINICAL PRIVILEGES-NEUROLOGY, DELINEATION OF CLINICAL PRIVILEGES-OBSTETRICS AND GYNECOLOGY, DELINEATION OF CLINICAL PRIVILEGES-OPTOMETRY SERVICE, DELINEATION OF CLINICAL PRIVILEGES-PATHOLOGY, DELINEATION OF CLINICAL PRIVILEGES-PEDIATRICS, DELINEATION OF CLINICAL PRIVILEGES-PODIATRY, DELINEATION OF CLINICAL PRIVILEGES-PSYCHIATRY, DELINEATION OF CLINICAL PRIVILEGES-PSYCHOLOGY, DELINEATION OF CLINICAL PRIVILEGES-DIAGNOSTIC RADIOLOGY, DELINEATION OF CLINICAL PRIVILEGES-GENERAL SURGERY, DELINEATION OF CLINICAL PRIVILEGES-NURSE ANESTHETISTS, DELINEATION OF CLINICAL PRIVILEGES-CERTIFIED NURSE MIDWIVES, DELINEATION OF CLINICAL PRIVILEGES-NURSE PRACTITIONER, DELINEATION OF CLINICAL PRIVILEGES - PHYSICIAN ASSISTANT, DELINEATION OF CLINICAL PRIVILEGES-DIETETICS, DELINEATION OF CLINICAL PRIVILEGES-OCCUPATIONAL THERAPY, DELINEATION OF CLINICAL PRIVILEGES-PHYSICAL THERAPY, DELINEATION OF CLINICAL PRIVILEGES-EMERGENCY MEDICINE, DELINEATION OF CLINICAL PRIVILEGES-AEROSPACE MEDICINE, DELINEATION OF CLINICAL PRIVILEGES-GENERAL MEDICAL OFFICER, DELINEATION OF CLINICAL PRIVILEGES - SOCIAL WORK, DELINEATION OF CLINICAL PRIVILEGES - ALLERGY/IMMUNOLOGY, DELINEATION OF CLINICAL PRIVILEGES - NEPHROLOGY, DELINEATION OF CLINICAL PRIVILEGES - CHIROPRACTIC, DELINEATION OF CLINICAL PRIVILEGES - DERMATOLOGY, DELINEATION OF CLINICAL PRIVILEGES - UROLOGY, DELINEATION OF CLINICAL PRIVILEGES - BEHAVIORAL HEALTH PRACTITIONER, DELINEATION OF CLINICAL PRIVILEGES - PSYCHOLOGICAL ASSOCIATE, DELINEATION OF CLINICAL PRIVILEGES - AUDIOLOGY, DELINEATION OF CLINICAL PRIVILEGES - SPEECH PATHOLOGY, DELINEATION OF CLINICAL PRIVILEGES - CLINICAL PHARMACY, DELINEATION OF CLINICAL PRIVILEGES - NUCLEAR MEDICINE, DELINEATION OF CLINICAL PRIVILEGES - THERAPEUTIC RADIOLOGY, DELINEATION OF CLINICAL PRIVILEGES - PHYSICAL MEDICINE AND REHABILITATION, DELINEATION OF CLINICAL PRIVILEGES - CARDIOLOGY, DELINEATION OF CLINICAL PRIVILEGES - OPHTHALMOLOGY, DELINEATION OF CLINICAL PRIVILEGES - OTOLARYNGOLOGY, DELINEATION OF CLINICAL PRIVILEGES - CARDIOVASCULAR SURGERY, DELINEATION OF CLINICAL PRIVILEGES - PULMONARY DISEASE, DELINEATION OF CLINICAL PRIVILEGES - PREVENTIVE MEDICINE, DELINEATION OF CLINICAL PRIVILEGES - ORAL & MAXILLOFACIAL SURGERY, DELINEATION OF CLINICAL PRIVILEGES - PLASTIC SURGERY, DELINEATION OF CLINICAL PRIVILEGES - VASCULAR SURGERY, DELINEATION OF CLINICAL PRIVILEGES - NEUROSURGERY, DELINEATION OF CLINICAL PRIVILEGES - CRITICAL CARE MEDICINE, DELINEATION OF CLINICAL PRIVILEGES - OCCUPATIONAL MEDICINE, DELINEATION OF CLINICAL PRIVILEGES - THORACIC SURGERY, DELINEATION OF CLINICAL PRIVILEGES - ORTHOPAEDICS, DELINEATION OF CLINICAL PRIVILEGES - BLOOD SERVICES, DELINEATION OF CLINICAL PRIVILEGES - PSYCHIATRIC ADVANCED PRACTICE NURSE, DELINEATION OF CLINICAL PRIVILEGES - SUBSTANCE ABUSE REHABILITATION, APPROVAL OF CLINICAL PRIVILEGES/STAFF APPOINTMENT, EVALUATION OF CLINICAL PRIVILEGES - ANESTHESIA, EVALUATION OF CLINICAL PRIVILEGES-DENTISTRY, EVALUATION OF CLINICAL PRIVILEGES-FAMILY PRACTICE, EVALUATION OF CLINICAL PRIVILEGES-INTERNAL MEDICINE, EVALUATION OF CLINICAL PRIVILEGES-NEUROLOGY, EVALUATION OF CLINICAL PRIVILEGES-OBSTETRICS AND GYNECOLOGY, EVALUATION OF CLINICAL PRIVILEGES-OPTOMETRY, EVALUATION OF CLINICAL PRIVILEGES-PATHOLOGY, EVALUATION OF CLINICAL PRIVILEGES-PEDIATRICS, EVALUATION OF CLINICAL PRIVILEGES-PODIATRY, EVALUATION OF CLINICAL PRIVILEGES-PSYCHIATRY, EVALUATION OF CLINICAL PRIVILEGES - CLINICAL PSYCHOLOGY, EVALUATION OF CLINICAL PRIVILEGES - DIAGNOSTIC RADIOLOGY, EVALUATION OF CLINICAL PRIVILEGES - GENERAL SURGERY, EVALUATION OF CLINICAL PRIVILEGES-NURSE ANESTHETIST, EVALUATION OF CLINICAL PRIVILEGES - CERTIFIED NURSE MIDWIFE, EVALUATION OF CLINICAL PRIVILEGES - NURSE PRACTITIONER, EVALUATION OF CLINICAL PRIVILEGES - PHYSICIAN ASSISTANT, EVALUATION OF CLINICAL PRIVILEGES - DIETETICS, EVALUATION OF CLINICAL PRIVILEGES - OCCUPATIONAL THERAPY, EVALUATION OF CLINICAL PRIVILEGES - PHYSICAL THERAPY, EVALUATION OF CLINICAL PRIVILEGES - EMERGENCY MEDICINE, EVALUATION OF CLINICAL PRIVILEGES - AEROSPACE MEDICINE, EVALUATION OF CLINICAL PRIVILEGES - GENERAL MEDICAL OFFICER, EVALUATION OF CLINICAL PRIVILEGES - SOCIAL WORK, EVALUATION OF CLINICAL PRIVILEGES - ALLERGY/IMMUNOLOGY, EVALUATION OF CLINICAL PRIVILEGES - NEPHROLOGY, EVALUATION OF CLINICAL PRIVILEGES - CHIROPRACTIC, EVALUATION OF CLINICAL PRIVILEGES - DERMATOLOGY, EVALUATION OF CLINICAL PRIVILEGES - UROLOGY, EVALUATION OF CLINICAL PRIVILEGES - BEHAVIORAL HEALTH PRACTITIONER, EVALUATION OF CLINICAL PRIVILEGES - PSYCHOLOGICAL ASSOCIATE, EVALUATION OF CLINICAL PRIVILEGES - AUDIOLOGY, EVALUATION OF CLINICAL PRIVILEGES - SPEECH PATHOLOGY, EVALUATION OF CLINICAL PRIVILEGES - CLINICAL PHARMACY, EVALUATION OF CLINICAL PRIVILEGES - NUCLEAR MEDICINE, EVALUATION OF CLINICAL PRIVILEGES - THERAPEUTIC RADIOLOGY, EVALUATION OF CLINICAL PRIVILEGES - PHYSICAL MEDICINE AND REHABILITATION, EVALUATION OF CLINICAL PRIVILEGES - CARDIOLOGY, EVALUATION OF CLINICAL PRIVILEGES - OPHTHALMOLOGY, EVALUATION OF CLINICAL PRIVILEGES - OTOLARYNGOLOGY, EVALUATION OF CLINICAL PRIVILEGES - CARDIOVASCULAR SURGERY, EVALUATION OF CLINICAL PRIVILEGES - PULMONARY DISEASE, EVALUATION OF CLINICAL PRIVILEGES - PREVENTIVE MEDICINE, EVALUATION OF CLINICAL PRIVILEGES - ORAL & MAXILLOFACIAL SURGERY, EVALUATION OF CLINICAL PRIVILEGES - PLASTIC SURGERY, EVALUATION OF CLINICAL PRIVILEGES - VASCULAR SURGERY, EVALUATION OF CLINICAL PRIVILEGES - NEUROSURGERY, EVALUATION OF CLINICAL PRIVILEGES - CRITICAL CARE MEDICINE, EVALUATION OF CLINICAL PRIVILEGES - OCCUPATIONAL MEDICINE, EVALUATION OF CLINICAL PRIVILEGES - THORACIC SURGERY, EVALUATION OF CLINICAL PRIVILEGES - ORTHOPAEDICS, EVALUATION OF CLINICAL PRIVILEGES - BLOOD SERVICES, EVALUATION OF CLINICAL PRIVILEGES - PSYCHIATRIC ADVANCED PRACTICE NURSE, EVALUATION OF CLINICAL PRIVILEGES - SUBSTANCE ABUSE REHABILITATION, OFFICER SERVICE AGREEMENT SELECTED RESERVE EDUCATIONAL ASSISTANCE PROGRAM (SHORT TITLE: MONTGOMERY GI BILL), MOISTURE AND DENSITY TESTER FIELD DATA WORKSHEET (LRA), MOISTURE AND DENSITY TESTER (NUCLEAR METHOD) UTILIZATION LOG (LRA), MOISTURE AND DENSITY FIELD TEST SHEET (LRA), AUTHORIZATION TO RELEASE INFORMATION FROM ARMY RECORDS ON NONSUPPORT/CHILD CUSTODY/PATERNITY INQUIRIES, MAINTENANCE REQUEST AND ASSIGNMENT REGISTER, US ARMY RECRUITING COMMAND AWARD FOR JROTC CERTIFICATE (S&I, CDR, USA, RECRUITING COMMAND, ATTN: USARCASP-SP, BLDG 698, FT SHERIDAN, IL 60037-6100), CHAPLAIN/CHAPLIN ASSISTANT TRAINING RECORD, TAMIS TRAINING AMMUNITION FORECAST REPORT (LRA), TRAINING AMMUNITION CONTROL DOCUMENT CONTINUATION SHEET, RECORD OF EMERGENCY DATA AND DESIGNATION OF BENEFICIARY FOR UNPAID COMPENSATION OF DECEASED NAF EMPLOYEE, AGREEMENT HEALTH PROFESSIONALS LOAN REPAYMENT (HPLR), INDIVIDUAL RELIABILITY SCREENING AND EVALUATION RECORD, NO SMOKING EXCEPT IN DESIGNATED SMOKING AREAS, CHILD DEVELOPMENT SERVICES NEEDS ASSESSMENT (LRA), ABSTRACT OF OFFERS (NONAPPROPRIATED FUNDS) (EGA) (AVAILABLE ONLY FROM ARMY NAF`S AUTOMATED PROCUREMENT SYSTEM, PRISM, AT HTTP://PRISM-WEB.MWRMIS.ARMY.MIL/PRISM), ABSTRACT OF OFFERS, CONTINUATION SHEET FOR DA FORM 5567 (EGA) (AVAILABLE ONLY FROM ARMY NAF`S AUTOMATED PROCUREMENT SYSTEM, PRISM, AT HTTP://PRISM-WEB.MWRMIS.ARMY.MIL/PRISM), ABSTRACT OF OFFERS - CONTINUATION SHEET FOR DA FORM 5567(EGA) (AVAILABLE ONLY FROM ARMY NAF AUTOMATED PROCUREMENT SYSTEM FOUND AT HTTPS://CLOUD.MWR.ARMY.MIL/SNACS.NET/SECURITY/LOGON.ASPX), ABSTRACT OF OFFERS (NONAPPROPRIATED FUNDS) (EGA) (AVAILABLE ONLY FROM ARMY NAF AUTOMATED PROCUREMENT SYSTEM FOUND AT HTTPS://CLOUD.MWR.ARMY.MIL/SNACS.NET/SECURITY/LOGON.ASPX), HEALTH QUESTIONNAIRE FOR DENTAL TREATMENT, VEHICLE FORECAST AND MOVEMENT SCHEDULES (LRA), ADDENDUM TO CERTIFICATE OF ACKNOWLEDGEMENT OF SERVICE REQUIREMENTS (DA FORM 3540) FOR ENLISTMENT INTO THE US ARMY RESERVE TROOP PROGRAM UNIT WARRANT OFFICER FLIGHT PROGRAM, ADDENDUM TO CERTIFICATE OF ACKNOWLEDGE OF SERVICE REQUIREMENT FOR ENLISTMENT INTO THE UNITED STATES ARMY RESERVE OFFICER CANDIDATE SCHOOL ENLISTMENT OPTION, REPORT OF DRYDOCKING, PAINTING AND CONDITION OF VESSEL BOTTOM, COMPUTATION-CONVERGENCE OF TRUE AZIMUTH TO GRID AZIMUTH (BUCS)(LRA), LIFE CYCLE COST ANALYSIS SAVINGS-TO-INVESTMENT RATIO (SIR) & DISCOUNTED PAYBACK CALCULATION (LRA), LIFE CYCLE COST ANALYSIS - BASIC INPUT DATA SUMMARY (LRA), LIFE CYCLE COST ANALYSIS - PRESENT WORTH: CONVENTIONAL APPROACH (LRA), LIFE CYCLE COST ANALYSIS - PRESENT WORTH: ONE-STEP APPROACH (LRA), CERTIFICATE OF APPRECIATION FOR ARMY SPOUSE (OF REENLISTEES), DISPATCHER`S RECORD OF TRAIN MOVEMENTS (S&I COMMANDANT, USATALS, ATTN: ATSP-TDP, FT EUSTIS, VA 23604-5403), SUPERINTENDENT`S TELEGRAPHIC REPORT OF ACCIDENT (LRA), DAILY INSTALLATION SITUATION REPORT (LRA), CASH PROPERTY AND RECONCILIATION RECORD (LRA), VOUCHER FOR SPECIAL MISSION FUNDS (SMF) EXPENDITURES (LRA), MANEUVER/PROCEDURE GRADE SLIP FOR OH-58D AVIATORS (LRA), STATEMENT OF CONDITIONS OF SERVICE - ACTIVE GUARD RESERVE (AGR), DATA INTERCHANGE OF SUPPORT EQUIPMENT DATA, UNITED STATES ARMY MARINE CERTIFICATE (S&I USA TRANSPORTATION SCHOOL, ATTN: ATSP-OCT, FT EUSTIS, VA 23604), POLICY STATEMENT AND MEMORANDUM OF UNDERSTANDING FOR REVIEW AND RECEIPT OF R&D DOCUMENTS (LRA), POLICY STATEMENT AND MEMORANDUM OF UNDERSTANDING FOR PARTICIPATION IN THE U.S. ARMY POTENTIAL CONTRACTOR PROGRAM (LRA), POLICY STATEMENT AND STUDY AGREEMENT FOR PARTICIPATION IN THE U.S. ARMY R&D UNFUNDED STUDY PROGRAM (LRA), NEW SPECIALIZED TRAINING ASSISTANCE PROGRAM (NEW STRAP) SERVICE AGREEMENT, INITIAL INSPECTION CHECKLIST FOR INDOOR RANGES, DETAILED INSPECTION CHECKLIST FOR INDOOR RANGES, RESERVE COMPONENTS CAREER COUNSELOR INTERVIEW RECORD, REQUEST FOR RESERVE COMPONENT ASSIGNMENT ORDERS, INFORMATION MANAGEMENT REQUIREMENT PROJECT DOCUMENT, OH-58A/C AND TH-67 PERFORMANCE PLANNING CARD, PROTECTIVE SERVICE(S&I, HQDA, ATTN: DAMO-0DL, PENTAGON, WASH, DC 20310-0440), SECTION II. Open it using the online editor and begin altering. Alter your file. Get the free da 5016 form. By using this site you agree to our use of cookies as described in our UPDATED . Edit your army pubs 1380 online. The DA Form 5016 is an important form for any United States Army soldiers who are planning to retire. 2. Where do I find da 5016? ], DAILY STAFF JOURNAL OR DUTY OFFICER'S LOG, INITIAL LISTING OF NONAPPROPRIATED FUND INSTRUMENTALITIES, CHANGED LISTING OF NONAPPROPRIATED FUND INSTRUMENTALITIES, APPLICATION FOR DETAIL AS STUDENT OFFICER AT A CIVILIAN EDUCATIONAL INSTITUTION OR AT TRAINING WITH INDUSTRY, BOND FOR SAFEKEEPING OF GOVERNMENT PROPERTY ISSUED TO EDUCATIONAL INSTITUTIONS (LRA), FINANCIAL LIABILITY INVESTIGATION OF PROPERTY LOSS REGISTER, REQUEST FOR NATIONAL STOCK NUMBER AND DEPARTMENT OF DEFENSE IDENTIFICATION CODE FOR AMMUNITION AND EXPLOSIVE SUPPLIES, NOTICE OF DELEGATION OF AUTHORITY - RECEIPT FOR SUPPLIES, ENLISTMENT/REENLISTMENT QUALIFYING APPLICATION (SPECIALLY RECRUITED PERSONNEL), DAILY WATER PRODUCTION LOG - 3,000 GPH ROWPU, DAILY WATER PRODUCTION LOG - 1,500 GPH TWPS, CHAPLAINS` FUND PURCHASE ORDER AND RECEIVING RECORD, CITATION FOR THE SUPERIOR CADET DECORATION AWARD, CITATION FOR THE SUPERIOR JUNIOR CADET DECORATION AWARD, CITATION FOR THE SUPERIOR NATIONAL DEFENSE CADET DECORATION AWARD, HOSPITAL FOOD SERVICE - FOOD RECEIPT AND CONSUMPTION RECORD, DELIVERY AND PICK-UP SERVICE (PAD, CONSISTING OF 20 THREE-PART SETS), CHEMICAL DATA SHEET - MONITORING OR SURVEY, LAUNDRY LIST (MEDICAL TREATMENT FACILITY AND ORGANIZATION), NONAPPROPRIATED FUND PETTY CASH SUMMARY VOUCHER, COMSEC EQUIPMENT ITEMS REGISTER (USING UNIT), RECOMMENDED CHANGES TO PUBLICATIONS AND BLANK FORMS, DOCUMENT REGISTER FOR SUPPLY ACTIONS (EGA), ABSTRACT OF LAUNDRY OR DRY CLEANING ORGANIZATIONAL WORK, REPORT OF TIRE RETREADING-COMMAND SUMMARY (LRA), INSTALLATION REPORT OF TIRE RETREADING (LRA), CONTRACT FOR SALE OF UTILITIES AND RELATED SERVICES, MEMORANDUM OF UNDERSTANDING FOR SALE OF UTILITIES AND RELATED SERVICES, SPECIAL PROVISIONS F(S) REFUSE COLLECTION AND DISPOSAL SERVICE, NONAPPROPRIATED FUND - RECEIPT AND DISBURSEMENT VOUCHER, STATEMENT OF COMPLIANCE, TRANSFER OF CUSTODY, AND INTERMENT CHECKLIST, DISTINGUISHED MILITARY STUDENT CERTIFICATE, DISTINGUISHED MILITARY GRADUATE CERTIFICATE, STATEMENT OF MEDICAL EXAMINATION AND DUTY STATUS, ARMY RESERVE PAY VOUCHER SUMMARY AND CERTIFICATION SHEET, CHAPLAINS` FUND STATEMENT OF OPERATIONS AND NET WORTH, CHAPLAINS` FUND STATEMENT OF OPERATIONS AND NET WORTH (EGA), DEPRESERVATION GUIDE FOR VEHICLES AND EQUIPMENT, INDEX TRACING RECORD OF ALIASES AND CO-SUBJECTS, TECHNICAL REPORT OF US ARMY AIRCRAFT ACCIDENT PART I - STATEMENT OF REVIEWING OFFICIALS, TECHNICAL REPORT OF US ARMY AIRCRAFT ACCIDENT PART II - SUMMARY, TECHNICAL REPORT OF US ARMY AIRCRAFT ACCIDENT PART III - FINDINGS AND RECOMMENDATIONS, TECHNICAL REPORT OF U.S. ARMY AIRCRAFT ACCIDENT PART IV - NARRATIVE, TECHNICAL REPORT OF U.S. ARMY AIRCRAFT ACCIDENT PART V - SUMMARY OF WITNESS INTERVIEW, TECHNICAL REPORT OF U.S. ARMY AIRCRAFT ACCIDENT PART VI - WRECKAGE DISTRIBUTION, TECHNICAL REPORT OF U.S. ARMY AIRCRAFT ACCIDENT PART VII - IN-FLIGHT OR TERRAIN IMPACT AND CRASH DAMAGE DATA, TECHNICAL REPORT OF U.S. ARMY AIRCRAFT ACCIDENT PART VIII - MAINTENANCE AND MATERIAL DATA, TECHNICAL REPORT OF U.S. ARMY AIRCRAFT ACCIDENT, PART IX - PERSONAL DATA, TECHNICAL REPORT OF U.S. ARMY AIRCRAFT ACCIDENT PART X - INJURY/OCCUPATIONAL ILLNESS DATA, TECHNICAL REPORT OF U.S. ARMY AIRCRAFT ACCIDENT, PART XI - PERSONNAL PROTECTIVE/ESCAPE/SURVIVAL/RESCUE DATA, TECHNICAL REPORT OF U.S. ARMY AIRCRAFT ACCIDENT PART XII - WEATHER/ENVIRONMENTAL, TECHNICAL REPORT OF U.S. ARMY AIRCRAFT ACCIDENT PART XIII - FIRE, TECHNICAL REPORT OF U.S. ARMY AIRCRAFT ACCIDENT INDEX A, TECHNICAL REPORT OF U.S. ARMY AIRCRAFT ACCIDENT INDEX B, ABBREVIATED AVIATION ACCIDENT REPORT (AAAR) FOR ALL CLASS C, D, E, F, COMBAT A AND B, AND ALL AIRCRAFT GROUND, UNMANNED AIRCRAFT SYSTEM ACCIDENT REPORT (UASAR), ORGANIZATION CONTROL RECORD FOR EQUIPMENT, EQUIPMENT INSPECTION AND MAINTENANCE WORKSHEET, EQUIPMENT MODIFICATION RECORD (COMPONENT), AIRCRAFT NSPECTION AND MAINTENANCE RECORD, HISTORY RECORDER, COMPONENT, MODULE RECORD, AUXILIARY POWER UNIT AND COMPONENT RECORD, AIRCRAFT ENGINE TURBINE WHEEL HISTORICAL RECORD, T53/T55 TURBINE ENGINE ANALYSIS CHECK RECORD, T700 SERIES TURBINE ENGINE ANALYSIS CHECK RECORD, MULTIPLACE LIFE RAFT INSPECTION AND MAINTENANCE RECORD, HELMET AND ATTACHED EQUIPMENT INSPECTION/MAINTENANCE RECORD, SURVIVAL RADIO/EMERGENCY LOCATION TRANSMITTER INSPECTION RECORD, SURVIVAL KIT/VEST INSPECTION AND MAINTENANCE RECORD, ANTI-EXPOSURE COVERALLS INSPECTION RECORD, COMPONENT REMOVAL/REPAIR/INSTALL/GAIN/LOSS RECORD, US ARMY CALIBRATION SYSTEM REJECTED INSTRUMENT, STATEMENT OF HEALTH AND MEDICAL EXAMINATION (LRA), ATTORNEY OF RECORD DESIGNATION FOR CIVILIAN COUNSEL, RECORD OF PROCEEDINGS UNDER ARTICLE 15, UCMJ, SUMMARIZED RECORD OF PROCEEDINGS UNDER ARTICLE 15, UCMJ, RECORD OF SUPPLEMENTARY ACTION UNDER ARTICLE 15, UCMJ, MEDICAL CARE-THIRD PARTY LIABILITY NOTIFICATION, PRODUCTION EQUIPMENT VISUAL INSPECTION RECORD (LRA), COMSEC ACCOUNT - DAILY SHIFT INVENTORY (LRA), UNITED STATES ARMY EPW IDENTITY CARD (LRA), PRISONER OF WAR NOTIFICATION OF ADDRESS (LRA), PRISONER OF WAR MAIL (LETTER) (LRA) (ED JUL 63 WILL BE USED), MIXED MEDICAL COMMISSION CERTIFICATE FOR EPW (LRA), CERTIFICATE OF DIRECT REPATRIATION FOR EPW (LRA), CLASSIFICATION QUESTIONNAIRE FOR OFFICER RETAINED PERSONNEL (LRA), CLASSIFICATION QUESTIONNAIRE FOR ENLISTED RETAINED PERSONNEL (LRA), ENEMY PRISONER OF WAR/CIVILIAN INTERNEE STRENGTH REPORT (LRA), CERTIFICATION OF WORK INCURRED INJURY OR DISABILITY (LRA), UNITED STATES ARMY CIVILIAN INTERNEE IDENTITY CARD (LRA), CIVILIAN INTERNEE NATL-INTERNMENT CARD (LRA), DRY CLEANING LIST (FOR PIECE RATE PATRONS), INTERNATIONAL BALANCE OF PAYMENTS TRANSACTIONS, NONAPPROPRIATED FUND TRANSACTIONS (LRA), INSTALLATION NATURAL RESOURCES REPORT: PART II - FOREST MANAGEMENT (LRA), INSTALLATION NATURAL RESOURCES REPORT: PART II - FISH AND WILDLIFE MANAGEMENT (LRA), INSTALLATION NATURAL RESOURCES REPORT: PART I - LAND USE AND CONSTRUCTION (LRA), POLYGRAPH EXAMINATION STATEMENT OF CONSENT, MILITARY WORKING DOG TRAINING AND UTILIZATION RECORD, REQUEST FOR DETERMINATION OF INVENTION RIGHTS (LRA), HOSPITAL FOOD SERVICE - DIETARY HISTORY RECORD, HOSPITAL FOOD SERVICE - TELEPHONE DIET ORDER, HOSPITAL FOOD SERVICE - KITCHEN REQUISITION, FOOD COST AND FEEDING STRENGTH SUMMARY, US ARMY RESERVES (LRA), CONTAINER AND DUNNAGE FABRICATION WORK ORDER, CONTAINER AND DUNNAGE FABRICATION WORK ORDER AND PRODUCTION CONTROL REGISTER, VERY SERIOUSLY ILL/SERIOUSLY ILL/SPECIAL CATEGORY PATIENT REPORT, ARTS AND CRAFTS CENTER SAFETY AND EQUIPMENT QUALIFICATION CARD, AUTOMOTIVE SKILLS SHOP SAFETY AND EQUIPMENT QUALIFICATION CARD, REPORT OF MISSING/RECOVERED FIREARMS, AMMUNITION AND EXPLOSIVES, ARMY COMMUNITY SERVICE (ACS) MANAGEMENT REPORT (SYSTEM GENERATED LOCATED AT WWW.ACSSTAFF.ORG), MARINE SERVICE BOOK (S&I, DEPARTMENT OF THE ARMY, MARINE QUALIFICATION DIVISION, CAREER SEA PAY OFFICE, BLDG 705, RM 12, FORT EUSTIS, VA 23604-5407), WAIVER OF DISQUALIFICATION FOR CONTINUED SERVICE IN THE REGULAR ARMY, MEDICAL EXAMINATION FOR CERTAIN GEOGRAPHICAL AREAS, APPLICATION AND CONTRACT FOR ESTABLISHMENT OF A JUNIOR RESERVE OFFICERS` TRAINING CORPS UNIT (S&I, HQDA, ATTN: TAPC-OPP-P, 200 STOVALL ST., ALEXANDRIA, VA 22332-0418), APPLICATION AND AGREEMENT FOR ESTABLISHMENT OF A NATIONAL DEFENSE CADET CORPS UNIT (S&I MILPERCEN), ABSTRACT OF ENLISTED AND ORGANIZATIONAL LAUNDRY AND DRY CLEANING, REQUEST FOR ISSUE AND TURN-IN (CONTINUATION SHEET), POSTHUMOUS PROMOTION CERTIFICATE (ENLISTED) S&I,CDR, HRC, ATTN: AHRC-PDC-C (MR. JOHNSON), 1600 SPEARHEAD DIVISION AVENUE, DEPARTMENT 450 FORT KNOX, KY 40122-5405), REPORT OF JUDICIAL DISCIPLINARY ACTIVITY IN THE ARMY, PERSONNEL SCREENING AND EVALUATION RECORD, CHEMICAL AND BIOLOGICAL PERSONNEL RELIABILITY PROGRAM STATEMENT OF UNDERSTANDING, CHEMICAL AND BIOLOGICAL PERSONNEL SCREENING AND EVALUATION RECORD, CHEMICAL AND BIOLOGICAL PERSONNEL RELIABILITY PROGRAM (PRP) STATUS REPORT, MONTHLY INVENTORY RECAP SHEET FOR DA FORM 3234, REQUEST FOR COPYRIGHT CLEARANCE ON MUSICAL OR DRAMATIC WORKS, PUNCHCARD TRANSMISSION WORKSHEET - RADIOISOTOPE INVENTORY AND LEAK TEST REPORT (LRA), OIL ANALYSIS RECOMMENDATION AND FEEDBACK (LRA). Previous completed anniversary years Statement of retirement points earned in the top right corne to save the.. Youve safely connected to the e-signature tool to e-sign the Form export it print... Directorate APD sensitive information only on official, secure websites who are planning to retire, pages &! 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