Da Form 4836, Aug 2010 - Oath Of Extension Of Enlistment Or Reenlistment
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1OATH OF EXTENSION OF ENLISTMENT OR REENLISTMENT
For use of this form, see AR 140-111 (USAR) , and NGR 600-200 (ARNG)
the proponent agencies are DCS, G-1 and Chief, National Guard Bureau.
DATA REQUIRED BY THE PRIVACY ACT 1974 (5 USC 552a)
Title 10, USC, Sec 509, Title 32, USC Sec 302(c), and Executive Order 9397
AUTHORITY:
To be used when a member of the ARNG or USAR extends a current enlistment/reenlistment
PRINCIPLE PURPOSE(s):
agreement (Chapter 7 NGR 600-200/Chapter 3, AR 140-111)
Confirmation of obligation and participation requirements, and as a basis for non-participation
ROUTINE USES:
action if the individual fails to meet participation requirements.
If member refuses to provide the requested information and sign the form, the member will be
DISCLOSURE:
released upon normal ETS date. A copy of this form will be retained by the individual.
EXTENSION PROCESSING DATA
1. THIS IS AN EXTENSION OF ENLISTMENT/REENLISTMENT OF A CURRENT MEMBER OF
ARMY NATIONAL GUARD AND A
A TROOP PROGRAM UNIT OF THE
USAR-ACTIVE GUARD/RESERVE
RESERVE OF THE ARMY
US ARMY RESERVE
INDIVIDUAL READY RESERVE
INDIVIDUAL MOBILIZATION AUGMENTEE
2. NAME (Last, First, MI)
(YYYYMMDD)
3. GRADE
4. DATE
5. UNIT OF ASSIGNMENT (Include unit designation, address, UIC and ZIP Code)
6. CURRENT (Latest) DD FORM 4-SERIES
a. DATE (YYYYMMDD)
b. TERM OF SERVICE (Years)
c. NUMBER OF EXTENSIONS PREVIOUSLY GRANTED TO CURRENT DD FORM 4
d. ETS
e. BASIC PAY ENTRY DATE (YYYYMMDD)
7. PROVISIONS AND COMPUTATION OF THIS EXTENSION
(Day)
(Month)
(Year(s))
a. CURRENT ETS (Extracted from item 6d above)
b. PERIOD OF THIS EXTENSION
c. NEW ETS (Sum of a and b above)
8. AUTHORITY AND REASON FOR THIS EXTENSION
TABLE
RULE
(AR 140-111)
(NGR 600-200)
OATH OF EXTENSION
I do hereby acknowledge this
day of
,
, that I have voluntarily extended my current
enlistment/reenlistment agreement of
day of
,
, for the period indicated
in item 7b above. I agree to remain a member of the (Army National Guard of
and as a Reserve of the Army) (United States Army Reserve ) during the entire period of this extension. I understand this extension will
establish my Expiration Term of Service (ETS) date as shown in item 7c.
SIGNATURE
DATE (YYYYMMDD)
OFFICER CERTIFICATION
day of
I certify that the above Oath of Extension was subscribed and duly sworn before me on this
,
TYPED NAME, GRADE, AND BRANCH OF COMMISSIONED OFFICER*
SIGNATURE OF COMMISSIONED OFFICER*
* Or warrant officer, or any other person so designated to administer oaths under State law, for member of the Army National Guard
NOTE
ARNG: Original to soldier , 1 copy to State AG (Title 10 AGR Soldiers are responsible for sending a copy to State AG for PERMS).
USAR: (Unit member) Original to appropriate Regional Readiness Command (RRC) to HRC-St. Louis, AHRC-CIS-PP, 1 Reserve Way, St.
Louis, MO 63132-5200, 1 copy attached to current DD Form 4-series and filed in MPRJ, 1 copy to Defense Joint Military Systems
(DJMS) , 1
copy for unit member.
(IRR or IMA member) Original to HRC-St. Louis, AHRC-EPS-F, 1 Reserve Way, St. Louis, MO 63132-5200, 1 copy for IRR or IMA member.
(AGR member) Original to HRC-St.Louis, AHRC-ARE-ME, 1 Reserve Way, St. Louis, Mo 63132-5200, 1 copy for AGR member.
DA FORM 4836, AUG 2010
APD PE v1.01ES
PREVIOUS EDITIONS ARE OBSOLETE.
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