CHAPTER 3 SECRETARIAL PLENARY AUTHORITY DA Form 4187

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

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

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

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

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

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 1 st 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 3 yrs or less they are not eligible

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

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).

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

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 15 s 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 6 yrs of service the soldier is entitled To a separation board

CHAPTER 14 -5 a CONVICTED BY CIVILIAN COURT CDR Recommendation- Approval (07 or higher) Counseling/Supporting Documents Article 15 s (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 -12 a MINOR DISCIPLINARY INFRACTIONS CDR Recommendation- Approval (06 or higher) Counseling/Supporting Documents Article 15 s (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 -12 b PATTERN OF MISCONDUCT CDR Recommendation- Approval (06 or higher) Counseling/Supporting Documents Article 15 s (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 -12 c COMMISSION OF SERIOUS OFFENSE CDR Recommendation- Approval (06 or higher) Counseling/Supporting Documents Article 15 s (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 15 s (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 1 st 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 1 st day of school or training

CHAPTER 16 -4 b 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

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