COMMAND ORIENTED ARMS, AMMUNITION, AND EXPLOSIVES (AA&E)
SECURITY SCREENING AND EVALUATION RECORD
For use of this form, see AR 190-11; the proponent agency is PMG.
When completed, this form is considered personal in nature and should be protected by a For Official Use Only Cover Sheet.
NAME OF INDIVIDUAL BEING SCREENED
GRADE
SECTION I - IMMEDIATE COMMANDER'S INTERVIEW
The interview required by AR 190-11 has been conducted.
NAME OF COMMANDER
GRADE
SIGNATURE
DATE
SECTION II - PERSONNEL RECORDS SCREENING
Personnel records have been reviewed in accordance with the AR 190-11.
Information
is
is not attached which may preclude assignment.
NAME OF REVIEWING OFFICIAL
GRADE
SIGNATURE
DATE
SECTION III - MEDICAL RECORDS SCREENING
Medical records have been reviewed in accordance with the AR 190-11.
Information
is
is not attached which may preclude assignment.
NAME OF REVIEWING OFFICIAL
GRADE
SIGNATURE
DATE
SECTION IV - PROVOST MARSHAL/SECURITY OFFICE RECORDS CHECK
A law enforcement/security records check has been conducted in accordance with AR 190-11.
Information
is
is not attached which may preclude assignment.
NAME OF REVIEWING OFFICIAL
GRADE
SIGNATURE
DATE
SECTION V - LOCAL CIVILIAN LAW ENFORCEMENT AGENCY RECORDS CHECK
(If permitted by state, city, or local laws)
Local civilian law enforcement agencies in the area of the individual's residence have been checked in accordance with AR 190-11.
Information
is
is not attached which may preclude assignment.
NAME OF REVIEWING OFFICIAL
GRADE
SIGNATURE
DATE
SECTION VI - IMMEDIATE COMMANDER EVALUATION
Individual has been screened in accordance with AR 190-11.
After thorough review of all information provided, I find this individual
suitable
unsuitable to perform duties which
involve responsibility for the control, accountability, and shipment of AA&E.
GRADE
SIGNATURE
DATE
NAME OF REVIEWING OFFICIAL
APD LC v1.00ES
PREVIOUS EDITIONS ARE OBSOLETE.
DA FORM 7281, SEP 2009
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