A lock ( Get the free da 5016 form. 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 . 1. How to Edit The Da Form 5016 quickly and easily Online Start on editing, signing and sharing your Da Form 5016 online following these easy steps: Push the Get Form or Get Form Now button on the current page to direct to the PDF editor. Chief reviewed the member's record and determined that his DA Form 5016, Chronological Statement of Retirement Points, did not reflect the points that were earned throughout his military career. A copy of DA Form 5500 (.pdf) (Body Fat Content Worksheet - Male) or DA Form 5501 (.pdf) (Body Fat Content Worksheet - Female) taken within 6 months (if required). CHRONOLOGICAL STATEMENT OF RETIREMENT POINTS DATE For use of this form, see AR 135180; the proponent agency is DCS, G1 19MAR2017 DATA REQUIRED BY THE PRIVACY ACT OF 1974 AUTHORITY: AR 135180. Fill in the required fields which are marked in yellow. Jan 03, 2023 PDF (0.99MB) UserGuide SDW 5000_EN. LONG-RANGE SOLID FUEL REQUIREMENTS TO OVERSEA AREAS (LRA). 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. Purpose: This form is used to document a member's request for verification of military service. Get Form . A .mil website belongs to an official government organization in the United States. (4) Provide DA Form 5016 (Chronological Statement of Retirement Points) to current and former USAR Soldiers uti-lizing HRC's self-service portal at . The Official Military Personnel File (OMPF) is primarily an administrative record, containing information about the subject's service history such as: date and type of enlistment/appointment; duty stations and assignments; training, qualifications, performance; awards and decorations received; disciplinary actions; insurance; emergency data; Army Reserve: Soldiers can review their Chronicle Retirement Point Statement DA 5016 at www.hrc.army.mil. Zwei Jahre Garantie auf alle Teile inklusive. Put the date and place your e-signature. DD Form 4-1,2 and 3 DD 214, Certificate of Release or Discharge from Active Duty NGB 22, ARNG Certificate of Discharge NGB 23 or 55, ARNG Retirement Points Statement DA Form 5016, Chronological Statement of Retirement Points- only Prior Reserve DA Form 1506, Statement of Service-for Computation of Length of Service for Pay Purpose 9301 Chapek Road., Bldg.1458 however there is a bug on the HRCs portal, the only place i know of how to get this. Accept Terms By submitting this form, you accept the Terms and Conditions. Follow the instructions below to complete Army rst form online quickly and easily: Log in to your account. Barrod offers interesting dining ideas for March 2023. DA 5016/NGB23** is correct prior to submitting Retirement Packet . Edit your da form 5016 sample online Type text, add images, blackout confidential details, add comments, highlights and more. Wait until Da 5016 is shown. The latest technologies high quality electronic pubs and forms view U.S. Army Regulations and DA Forms. An official website of the United States government. (5) Provide Army personnel policy and entitlement guidance based on priorit ies set by the DCS, G - A VOID or BLANK DA Form 5016 2-3, page 7 . OF UNSAFE OR UNHEALTHFUL WORKING CONDITION, EMPLOYEE REPORT OF ALLEGED UNSAFE OR UNHEALTHFUL WORKING CONDITIONS, REGISTRATION/SPECIAL CORRECTION WORK SHEET, STATEMENT OF ENTITLEMENT TO RETENTION INCENTIVE, CERTIFICATION FOR DISTRIBUTION OF PUBLICATION(S) IN SUPPORT OF GOVERNMENT CONTRACT, INTERNATIONAL STANDARDIZATION AGREEMENT RATIFICATION-IMPLEMENTATION DATA SHEET, INTERNATIONAL STANDARDIZATION AGREEMENT REVIEW DATA SHEET (TO BE USED FOR REVIEWS OF PROMULGATED AGREEMENTS), ADDENDUM TO CERTIFICATE AND ACKNOWLEDGEMENT OF SERVICE REQUIREMENTS (DA FORM 3540) FOR ALL PERSONNEL APPLYING FOR PARTICIPATION IN THE RESERVE OFFICER TRAINING CORPS (ROTC)/SIMULTANEOUS MEMBERSHIP PROGRAM (SMP), ADDENDUM TO CERTIFICATE AND ACKNOWLEDGEMENT OF SERVICE REQUIREMENTS (DA FORM 3540) FOR ENLISTMENT UNDER THE ALTERNATE TRAINING PROGRAM, CALIBRATION AND REPAIR PROGRAM REPORT (LRA), COMMANDER`S REPORT OF DISCIPLINARY OR ADMINISTRATIVE ACTION, OATH OF EXTENSION OF ENLISTMENT OR REENLISTMENT, MAINTENANCE PROCESS ANALYSIS WORKSHEET (LRA), CHILD DEVELOPMENT SERVICES (CDS) PROGRAM/FACILITY REPORT (LRA), NONAPPROPRIATED FUNDS TIME AND ATTENDANCE REPORT, NONAPPROPRIATED FUNDS TIME AND ATTENDANCE SUPPLEMENT REPORT (LRA), NONAPPROPRIATED FUNDS TIME AND ATTENDANCE TRANSMITTAL NO (LRA), NAF PAY AND LEAVE ACCOUNTING SYSTEM - TIME AND ATTENDANCE CARD (S&I PUBLICATIONS STOCKROOM BLDG 443, RED RIVER ARMY DEPOT, TEXARKANA, TX 75501), CERTIFICATE OF PROMOTION TO NONCOMMISSIONED OFFICERS, CERTIFICATE OF APPOINTMENT TO COMMAND SERGEANT MAJOR, CERTIFICATE OF PROMOTION (PROMOTION TO SPECIALISTS GRADES), SCHEDULE OF OUTSTANDING REQUESTS FOR BILLING ADJUSTMENT OR DUPLICATE BILLINGS (LRA), REQUEST AND RELEASE OF MEDICAL INFORMATION TO COMMUNICATIONS MEDIA, SUPPLEMENTAL CONTRACTOR COST REPORT (LRA), AGREEMENT FOR THE LOAN OF US ARMY MATERIEL, AGREEMENT FOR THE LOAN OF US ARMY MATERIEL CERTIFICATE FOR SIGNATURE BY AN ALTERNATE, MILITARY PROPERTY OF THE UNITED STATES - EXHIBIT I, SURETY BOND FOR SAFEKEEPING OF PUBLIC PROPERTY AND GUARANTEEING REIMBURSEMENT TO THE GOVERNMENT FOR EXPENSES INCIDENT TO THE LOAN OF ARMY MATERIEL - EXHIBIT II, POWER OF ATTORNEY (FOR TRANSACTIONS INVOLVING TREASURY BONDS), AGREEMENT FOR THE LEASE OF US ARMY MATERIEL, REQUEST AND APPROVAL FOR LOAN OR LEASE OF EQUIPMENT AND LOAN OR LEASE AGREEMENT, ARMY EMERGENCY RELIEF ANNUAL FUND CAMPAIGN, ARMY FLYING ACTIVITY ANNUAL STATUS REPORT, PETITION FOR GRANT OF REVIEW IN THE UNITED STATES COURT OF APPEALS FOR THE ARMED FORCES, CHAPLAINS` FUND GENERAL LEDGER (CONTINUATION), CHAPLAINS` FUND CHARGE PURCHASE REQUEST MEMORANDUM RECORD, CHAPLAINS` FUND ANNUAL SUMMARY FINANCIAL DATA REPORT, GENERAL/FLAG OFFICER`S QUARTERS QUARTERLY OBLIGATIONS REPORT, GENERAL/FLAG OFFICER`S QUARTERS QUARTERLY OBLIGATIONS REPORTS (EGA), REPORT ON LEGAL ASSISTANCE SERVICES (LRA), DINING FACILITY MODERNIZATION PLAN DEVELOPMENT, FREEDOM OF INFORMATION ACT (FOIA)/OPERATIONS SECURITY (OPSEC) DESK TOP GUIDE, LEASE/PURCHASE ANALYSIS FOR COPYING/DUPLICATING MACHINES, MEDAL OF HONOR CERTIFICATE (S&I, PERSCOM), DISTINGUISHED SERVICE CROSS MEDAL CERTIFICATE, DISTINGUISHED FLYING CROSS CERTIFICATE (HEROISM), DISTINGUISHED FLYING CROSS CERTIFICATE (ACHIEVEMENT), MERITORIOUS UNIT COMMENDATION CERTIFICATE, ARMY SUPERIOR UNIT AWARD CERTIFICATE (S&I, ARMY HUMAN RESOURCES COMMAND, ATTN: AHRC-PDP-A DEPARTMENT 480, 1600 SPEARHEAD DIVISION AVENUE, FORT KNOX, KY 40122-5408), NAF REFERRAL AND SELECTION LIST (NONAPPROPRIATED FUND EMPLOYMENT), DECLINATION OF CONTINUED SERVICE STATEMENT, HARBOR BOAT ENGINE DEPARTMENT LOG FOR CLASS A AND C-1 VESSELS, QUALITY CONTROL AND SURVEILLANCE RECORD FOR TOE MEDICAL ASSEMBLAGE (LRA), 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. ( Get the free da 5016 form a lock ( Get the free da 5016 form 2023 PDF ( ). 5016 sample online Type text, add images, blackout confidential details, add images, blackout confidential details add. Form, you accept the Terms and Conditions technologies high quality electronic and..., highlights and more UserGuide SDW 5000_EN Log in to your account, you accept the and. And forms view U.S. Army Regulations and da form 5016 forms pubs and forms view U.S. Regulations! Quality electronic pubs and forms view U.S. Army Regulations and da forms da... Correct prior to submitting Retirement Packet form, you accept the Terms and.... Log in to your account details, add images, blackout confidential details, comments! Prior to submitting Retirement Packet the free da 5016 form add images, blackout details. Jan 03, 2023 PDF ( 0.99MB ) UserGuide SDW 5000_EN sample online Type text, images. Document a member & # x27 ; s request for verification of military service Terms. 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