SECRETARIAL PLENARY AUTHORITY CHAPTER 3 SECRETARIAL PLENARY AUTHORITY DA Form 4187 (Soldier requesting separation) Promotion /Reduction Order (if ever been reduced) Assignment Orders to Fort Hood Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES DA Form 31 Physical Required Other___________________________________________ Approving Authority: DA Voluntary/Involuntary

SURVIVING SON OR DAUGHTER CHAPTER 5-4 SURVIVING SON OR DAUGHTER CDR Recommendation- Approval DA Form 4187 (Soldier requesting separation) Statement from Department of Veteran’s Affairs Promotion /Reduction Order (if ever been reduced) Assignment Orders to Fort Hood Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES DA Form 31(If taken leave) Physical Not Required unless requested Other __________________________________________ Approval Authority: Special Court Martial convening Authority Voluntary Will not be transferred to IRR

INVOLUNTARY SEPARATION DUE TO PARENTHOOD CHAPTER 5-8 INVOLUNTARY SEPARATION DUE TO PARENTHOOD CDR Recommendation- Approval (06 or higher) Counseling/Supporting Documents (Can not be wavered) Family Care Plan Promotion /Reduction Order (if ever been reduced) Assignment Orders to Fort Hood Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Physical Not Required unless requested Other___________________________________________ Approval Authority: Special Court Martial convening Authority Involuntary Will not be transferred to IRR

CHAPTER 5-9 LACK OF JURISDICTION CDR Recommendation- Approval (06 or higher) Counseling/Supporting Documents (Can not be wavered) Family Care Plan Promotion /Reduction Order (if ever been reduced) Assignment Orders to Fort Hood Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Physical Not Required unless requested Other_________________________________________ Approval Authority: Special Court Martial convening Authority Involuntary Will not be transferred to IRR

NOT LAWFULL ADMITTED TO THE US CHAPTER 5-10 ALIENS NOT LAWFULL ADMITTED TO THE US CDR Recommendation- Approval (06 or higher) Supporting documentation Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Physical Not Required unless requested Other__________________________________________ Approval Authority: Special Court Martial convening Authority Involuntary Will not be transferred to IRR

SEPARATION OF SM WHO DID NOT MEET PROCUREMENT MEDICAL CHAPTER 5-11 SEPARATION OF SM WHO DID NOT MEET PROCUREMENT MEDICAL FITNESS STANDARDS CDR Recommendation- Approval (06 or higher) Supporting Documents Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Physical Required Other _______________________________________________ Approval Authority: Special Court Martial convening Authority Involuntary

CHAPTER 5-13 PERSONALTY DISORDER CDR Recommendation- Approval (06 or higher) Counseling/Supporting Documents (Can not be wavered) Promotion /Reduction Order (if ever been reduced) Assignment Orders to Fort Hood Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Mental Health Evaluation (mandatory) Physical Not Required unless requested Other_________________________________________ Approval Authority: Special Court Martial convening Authority Involuntary Will not be transferred to IRR

CONCEALMENT OF ARREST RECORD CHAPTER 5-14 CONCEALMENT OF ARREST RECORD CDR Recommendation- Approval (06 or higher) Supporting Documents Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Physical Required Other___________________________________________ Approval Authority: Special Court Martial convening Authority Involuntary Will not be transferred to IRR

CHAPTER 5-16 FURTHER EDUCATION CDR Recommendation- Approval (05 or higher) DA Form 4187 (Soldier requesting release) Promotion /Reduction Order (if ever been reduced) Letter of Acceptance (School-starting date for 1st day of class) Scholarship (if Applicable) Ability to Pay Statement Enlistment Contract Assignment Orders to Fort Hood Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES DA Form 31 (If taking leave) Physical Not Required Other_________________________________________________ Approval Authority: Battalion Commander Voluntary: If soldier is on initial Enlistment 3yrs or less they are not eligible

PHYSICAL OR MENTAL CONDITIONS NOT AMOUNTING TO A DISABILITY CHAPTER 5-17 PHYSICAL OR MENTAL CONDITIONS NOT AMOUNTING TO A DISABILITY CDR Recommendation (06 or higher) Counseling/Supporting Documents (Can not be wavered) Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES DA 31 (If taking leave) Physical Not Required unless requested Mental Health Evaluation (Mandatory) Other_________________________________________ Approval Authority: Special Court Martial convening Authority Involuntary Will not be transferred to IRR

DEPENDENCY OR HARDSHIP CHAPTER 6 DEPENDENCY OR HARDSHIP CDR Recommendation- Approval (06 or higher) Counseling/Supporting Documents (Can not be wavered) DA Form 4187 (Soldier requesting separation) Promotion /Reduction Order (if ever been reduced) Assignment Orders to Fort Hood Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Physical Not Required unless requested Other___________________________________________ Approval Authority: Special Court Martial convening Authority Voluntary For those chapters that have more than on reason, you have to state on the memorandum from the approval authority which on it is. ( I.e Chapter 9 Drug and Alcohol…you have to state either drugs or Alcohol is the reason for the chapter).

DEFECTIVE ENLISTMENTS/RE-ENLISTMENTS AND EXTENSIONS – MINORITY CHAPTER 7-3 DEFECTIVE ENLISTMENTS/RE-ENLISTMENTS AND EXTENSIONS – MINORITY CDR Recommendation- Approval (06 or higher) Counseling/Supporting Documents (See AR 635-200, Para 7-5) DA Form 4187 (Soldier requesting separation) Promotion /Reduction Order (if ever been reduced) Assignment Orders to Fort Hood Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Physical Not Required unless requested Other__________________________________________ Approval Authority: Special Court Martial convening Authority Involuntary

ERRONEOUS ENLISTMENTS, RE-ENLISTMENTS, OR EXTENSIONS CHAPTER 7-15 ERRONEOUS ENLISTMENTS, RE-ENLISTMENTS, OR EXTENSIONS CDR Recommendation- Approval (06 or higher) Counseling/Supporting Documents (See AR 635-200, Para 7-15) DA Form 4187 (Soldier requesting separation) Promotion /Reduction Order (if ever been reduced) Assignment Orders to Fort Hood Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Physical Not Required unless requested Other _______________________________________ Approval Authority: Special Court Martial convening Authority Voluntary

CHAPTER 7-16 DEFECTIVE OR UNFULFILLED ENLISTMENT OR REENNLISTMENT AGREEMENT CDR Recommendation- Approval (06 or higher) Counseling/Supporting Documents (See AR 635-200, Para 7-16) DA Form 4187 (Soldier requesting separation) Promotion /Reduction Order (if ever been reduced) Assignment Orders to Fort Hood Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Physical Not Required unless requested Other________________________________________ Approval Authority: Special Court Martial convening Authority Voluntary

CHAPTER 7-17 FRAUDULENT ENTRY CDR Recommendation- Approval (06 or higher) Counseling/Supporting Documents (See AR 635-200, Para 7-17) DA Form 4187 (Soldier requesting separation) Promotion /Reduction Order (if ever been reduced) Assignment Orders to Fort Hood Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Physical Not Required unless requested Other _______________________________________ Approval Authority: Special Court Martial convening Authority Involuntary Will not be transferred to IRR

CHAPTER 8 PREGNANCY CDR Recommendation- Approval (06 or higher) Counseling/Supporting Documents (Mandatory) DA Form 4187 (Soldier requesting separation) FH Form 441 (Pregnancy Exam Counseling) Promotion /Reduction Order (if ever been reduced) Assignment Orders to Fort Hood Education Records Medical Records Dental Record Most Recent LES DA 31 (If taking leave) SF 88 SF 93 Initial /Final Flag (DA form 268) If Applicable Other_________________________________________________ Approval Authority: Special Court Martial convening Authority Voluntary Not eligible if within 30 days of delivery

CHAPTER 9 ALCOHOL OR OTHER DRUG ABUSE REHABILITATION CDR Recommendation- Approval (06 or higher) Counseling/Supporting Documents Letter from ADAPCP Promotion /Reduction Order (if ever been reduced) Assignment Orders to Fort Hood Bar Certification Education Records Medical Records Dental Record Most Recent LES Initial /Final Flag (DA form 268) If Applicable Mental Health Evaluation Physical Required Other_________________________________________________ Approval Authority: Special Court Martial convening Authority Involuntary Will not be transferred to IRR

CHAPTER 10 IN LIEU OF COURT MARTIAL CDR Recommendation- Approval (07 or higher) Statement from soldier’s counsel (if applicable) Charge Sheet (DD Form 458) Counseling/Supporting Document Promotion /Reduction Order (if ever been reduced) Bar Certification Article 15s DA Form 4187 (AWOL/CONF) Assignment Orders to Fort Hood Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Physical Not Required Other___________________________________________ Approval Authority: General Court Martial convening Authority

CHAPTER 13 UNSATIFACTORY PERFORMANCE CDR Recommendation- Approval (06 or higher) Counseling/Supporting Documents Promotion /Reduction Order (if ever been reduced) Bar Certification Assignment Orders to Fort Hood Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Physical Required Mental/Health Eval Other___________________________________________ Approval Authority: Special Court Martial convening Authority Involuntary Will not be transferred to IRR If SM has more than 6yrs of service the soldier is entitled To a separation board

CHAPTER 14-5a CONVICTED BY CIVILIAN COURT CDR Recommendation- Approval (07 or higher) Counseling/Supporting Documents Article 15s (if applicable) Promotion /Reduction Order (if ever been reduced) Assignment Orders to Fort Hood DA Form 4187 (AWOL/CONF) (If applicable) Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Physical Required Mental/Health Evaluation Other___________________________________________ Approval Authority: General Court Martial convening Authority Involuntary. Will not be transferred to IRR

CHAPTER 14-12a MINOR DISCIPLINARY INFRACTIONS CDR Recommendation- Approval (06 or higher) Counseling/Supporting Documents Article 15s (if applicable) Assignment Orders to Fort Hood DA Form 4187 (AWOL/CONF) (If applicable) Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Physical Required Mental/Health Evaluation Other___________________________________________ Approval Authority: Special Court Martial convening Authority Involuntary. Will not be transferred to IRR

CHAPTER 14-12b PATTERN OF MISCONDUCT CDR Recommendation- Approval (06 or higher) Counseling/Supporting Documents Article 15s (if applicable) Assignment Orders to Fort Hood DA Form 4187 (AWOL/CONF) (If applicable) Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Physical Required Mental/Health Evaluation Other___________________________________________ Approval Authority: Special Court Martial convening Authority Involuntary. Will not be transferred to IRR

CHAPTER 14-12c COMMISSION OF SERIOUS OFFENSE CDR Recommendation- Approval (06 or higher) Counseling/Supporting Documents Article 15s (if applicable) Assignment Orders to Fort Hood DA Form 4187 (AWOL/CONF) (If applicable) Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Physical Required (DD 2807-1) Mental/Health Evaluation Other___________________________________________ Approval Authority: Special Court Martial convening Authority Involuntary. Will not be transferred to IRR

CHAPTER 15 DISCHARGE FOR HOMOSEXUAL CONDUCT CDR Recommendation- Approval (06 or higher) Promotion/Reduction Order (if ever been reduce) Article 15s (if applicable) Assignment Orders to Fort Hood DA Form 4187 (AWOL/CONF) (If applicable) Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Physical Required Mental/Health Evaluation (Mandatory) Other_________________________________________ Approval Authority: Special Court Martial convening Authority Voluntary/Involuntary. Will not be transferred to IRR

CHAPTER 16-2 TO ENTER COMMISSIONING PROGRAM CDR Recommendation- Approval (05 or higher) DA Form 4187 (Soldier requesting immediate separation Promotion/Reduction Order (if ever been reduce) Letter of Acceptance (School-Starting date for 1st day of class) Letter of Acceptance (Professor of Military Science) Scholarship Enlistment Contract (Mandatory) Assignment Orders to Fort Hood DA Form 4187 (AWOL/CONF) (If applicable) Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Other_________________________________________________ Approval Authority: Special Court Martial convening Authority Voluntary. Will not be transferred to IRR ETS date will be 30 days prior to 1st day of school or training

CHAPTER 16-4b DECLINATION OF CONTINUED SERVICE (DCSS) CDR Recommendation- Approval (05 or higher) Statement from soldier counseled (if applicable) DA Form 4187 (Soldier requesting immediate separation) DA Form 4126-R (Bar to Reenlistment Certificate OR DA Form 4991-R (Declination of Continued Service Statement) Promotion /Reduction Order (if ever been reduced) Assignment Orders to Fort Hood Education Records Medical Records Dental Record Initial /Final Flag (DA form 268) If Applicable Most Recent LES Physical Not Required unless requested Other________________________________________________ Approval Authority: Special Court Martial convening Authority Involuntary/Voluntary.

CHAPTER 18 FAILURE TO MEET BODY FAT STANDARDS CDR Recommendation- Approval (06 or higher) DA Form 5500 (Body Fat Content Worksheet) Promotion /Reduction Order (if ever been reduced) Bar Certification Assignment Orders to Fort Hood DA Form 4187 (AWOL/CONF) (If applicable) Education Records Medical Records Dental Record Most Recent LES Initial /Final Flag (DA form 268) If Applicable Physical Required Other_________________________________________________ Approval Authority: Battalion Commander Involuntary

QUALITATIVE MANAGEMENT PROGRAM CHAPTER 19 QUALITATIVE MANAGEMENT PROGRAM Notification Letter From HQDA Individual Appeal DA Form 4941-R Assignment Orders to Fort Hood Education Records Medical Records Dental Record Most Recent LES Initial /Final Flag (DA form 268) If Applicable Physical Required (?) Other_________________________________________________ Approval Authority: Special Court Martial convening Authority Involuntary Will not be transferred to IRR