ASSIGNMENT WORKSHEET
1. GRADE
ASSIGNMENT WORKSHEET
(This form is subject to the Privacy Act of 1974)
2. NAME (Last, First, Middle Initial) 3. SSAN
4. UNIT/OFFICE SYMBOL
5. LEAVE ADDRESS (Include Zip Code)
6. DUTY PHONE (Shift)
7. HOME PHONE
CONTACT # (Including Area Code):
8. DEPENDENT INFORMATION (Last name not required unless different)
RELATIONSHIP NAME (First, Middle Initial)
DOB (Children Only)
9. MARITAL STATUS SINGLE MARRIED MILITARY COUPLE DIVORCED
10. CURRENT PHYSICAL ADDRESS OF DEPENDENTS 11. FUTURE ADDRESS OF DEPENDENTS
12. Dependent Relocation Election Statement (ONLY for members with unaccompanied short tour assignments. Indicate
selection by initialing the appropriate box.)
Move dependents to location other than follow-on location. City____________ State: ___ Zip: ______
Relocate dependents to the follow-on location in CONUS.
Relocate dependents to follow-on location in the OCONUS area (includes Alaska and Hawaii).
(HB Assignment) Move dependents to designated place at their own expense.
Not relocate dependents until return from unaccompanied short tour location. Remain at current PDS.
I do not have dependents.
GRADE: DOR: 13. MILITARY SPOUSE INFORMATION:
SSAN:
NAME: (Last, First, Middle Initial)
UNIT/LOCATION:
14. TDY INFORMATION (FOR MEMBERS WHO HAVE TRAINING EN-ROUTE TO THEIR PCS ASSIGNMENT)
TDY LOCATION: _________________________ CLASS START DATE: ____________ CLASS GRAD DATE: _____________
15. CIRCUITOUS TRAVEL INFORMATION
CIRCUITOUS TRAVEL ? Any route other than the one normally prescribed by the LGRD/CTO between the official Places listed in member's travel orders (JTR). **REFERENCE: AFI 24-101, Para 3.10** ? Members and their accompanying dependents that are command sponsored may be authorized circuitous travel in
connection with PCS travel to, from, and between overseas areas. ? Members are required to pay excess costs (if any) compared to the cost the government would have paid over the
prescribed travel route. ? Travel time in excess of normal routing is chargeable as leave. ? Approval authority for circuitous travel resides with our office (MPS) with assistance from the LGRD/CTO. If you wish to apply for circuitous travel, contact your assignment counselor for an application. Route this through the proper channels and submit a signed copy to our office NLT 90 days BEFORE your Projected Departure Date (PDD). Orders will not be amended to add circuitous travel.
INSTRUCTIONS FOR FILLING OUT THE
ASSIGNMENT WORKSHEET
ITEM 1 2 3 4 5 6 7 8 9 10
11
12
13 14
15
DESCRIPTION GRADE NAME SSAN
UNIT/OFFICE SYMBOL
LEAVE ADDRESS DUTY PHONE HOME PHONE DEPENDENT INFORMATION
MARITAL STATUS CURRENT PHYSICAL
ADDRESS OF DEPENDENTS FUTURE ADDRESS OF DEPENDENTS
DEPENDENT RELOCATION
ELECTION STATEMENT MILITARY SPOUSE INFORMATION TDY INFORMATION
CIRCUITOUS TRAVEL INFORMATION
Self-explanatory Self-explanatory Self-explanatory
NARRATIVE
Self-explanatory If taking leave enroute, enter leave address and contact number. Otherwise put N/A. Self-explanatory Self-explanatory Provide dependent information as listed. Also, make sure all dependents have been updated in DEERS. Self-explanatory (Note: If recently change, make sure it is updated in DEERS) Dependent(s) address(es) of where they currently reside. (Note: Make sure the address provided is also reflected in DEERS.)
If relocating dependents to a location other than your 1st assignment or follow-on assignment (CONUS or OS), provide the address here. If they are traveling concurrently with you, write "Concurrent Travel". Initial next to your dependent relocation option. (ONLY for members with unaccompanied short tour assignments.)
Self-explanatory
FOR members going TDY enroute to their PCS. Provide TDY location along with class start and grad dates. Make sure your assignment counselor gets a copy of your signed training/allocation rip. Information on circuitous travel. Self-explanatory.
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- travel worksheet info usaasc
- reassignment processing united states army
- sgt ssg promotion packet composition elections and
- assignment worksheet overseas w dependents v2019
- reassignment status and election statement
- fillable usar semi centralized sgt and ssg promotion
- promotion packet composition elections and preferences
- amc powerpoint presentation template
- your rights as a federal employee osc
- guide for civilian
Related searches
- writing assignment for 2nd grade
- aesop substitute assignment aesop online
- 6th grade writing assignment ideas
- 6th grade writing assignment pdf
- 9th grade writing assignment worksheet
- 9th grade writing assignment classroom
- 10th grade writing assignment idea
- biol 101 individual assignment 1
- aesop substitute assignment pin number
- literacy narrative assignment essay
- online homework assignment help
- new york life assignment form