Officer Retirement Memorandum Sample - Fort Knox

Officer Retirement Memorandum Sample - Fort Knox - Army Page 2

(Your office symbol)

SUBJECT: Voluntary Retirement

6. I have read AR 600-8-24, paragraphs 6-6 and 6-7. I am responsible that a physical

examination is completed not earlier than 4 months nor later than 1 month prior to my

approved retirement date or start date of transitional leave, whichever is earlier (subject

physical to be arranged through coordination with my unit of assignment). I am aware

that the purpose of this examination is to ensure that my medical records reflect as

accurately as possible my state of health on retirement and to protect my interests and

those of the Government. I also understand that my retirement will take effect on the

requested date and that I will not be held on active duty to complete this examination.

In accordance with title 10, United States Code, I understand that:

a. Enrollment in the Survivor Benefit Plan (SBP) is the only way that I may

continue a portion of my retirement pay to my family at my death.

b. I must receive SBP counseling for myself and my spouse no less than 30 days

before retirement.

c. I will be enrolled in full SBP coverage if I fail to elect otherwise in writing before

my retirement.

d. I cannot elect less than full SBP without my spouse’s written agreement. I

received a spousal concurrence for this purpose in conjunction with this

application/letter. I realize there are other forms that must be completed during SBP

counseling.

e. Failure to return the completed spousal concurrence statement to the proper

officials prior to my retirement packet being sent to the Defense Finance Accounting

Service will result in my being irrevocably and irreversibly enrolled in SBP at full cost.

Current address: (Enter a reliable forwarding address for mail.)

Address upon retirement: (Enter a reliable forwarding address for mail.)

10. I am familiar with AR 600-8-24, paragraph 6-22, and understand that if this

application is accepted by the Secretary of the Army, it may not be withdrawn except for

extreme compassionate reasons or for the definitely established convenience of the

Government.

11. (If AR 600-8-24, para 6-16, is applicable, continue with the information required by

para 6-16g.)

Officer Retirement Memorandum Sample - Fort Knox - Army Page 2