Fillable Navpers 1336/3 Special Request /authorization printable pdf download

Navpers 1336/3 Special Request /authorization

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SPECIAL REQUEST/AUTHORIZATION

SUPPORTING DIRECTIVE MILPERSMAN ARTICLES

1810-010 AND 1810-040

PRIVACY ACT STATEMENT

THE AUTHORITY TO REQUEST THIS INFORMATION IS CONTAINED IN 5 USC 301, AND FRIM E.O. 9397 DEPARTMENTAL REGULATIONS.

THE PRINCIPLE PURPOSE OF THE INFORMATION IS TO ENABLE YOU TO MAKE KNOW YOUR DESIRE FOR ITEMS LISTED OR FOR SOME

OTHER SPECIAL CONSIDERATION OR AUTHORIZATION. THE INFORMATION WILL BE USED TO ASSIST OFFICIALS AND EMPLOYEES OF

THE DEPARTMENT OF THE NAVY IN DETERMINING YOUR ELIGIBILITY FOR AND APPROVING OR DISAPPROVING THE SPECIAL

CONSIDERATION OR AUTHORIZATION BEING REQUESTED. COMPLETION OF THE FORM IS MANDATORY, FAILURE TO PROVIDE

REQUIRED INFORMATION MAY RESULT IN DELAY IN RESPONSE TO OR DISAPPROVAL OF YOUR REQUEST.

NAME:

SSN

RATE:

(LAST 4 DIGITS)

SHIP OR STATION:

DATE OF REQUEST:

DEPARTMENT/DIVISION:

DUTY SECTION/GROUP:

NATURE OF REQUEST:

SPECIAL

COMMUTED

OTHER

LEAVE

SPECIAL PAY

LIBERTY

RATIONS

(BELOW)

FROM (DATE AND TIME):

TO (DATE AND TIME):

NO. OF DAYS REQUESTED:

DISTANCE (MILES):

MODE OF TRAVEL:

CAR

AIR

TRAIN

BUS

LEAVE ADDRESS:

TELEPHONE NUMBER:

REASON FOR REQUEST:

SIGNATURE OF APPLICANT:

I AM ELIGIBLE AND OBLIGATE MYSELF TO PERFORM ALL DUTIES OF PERSON MAKING APPLIZATION.

SIGNATURE OF STANDBY:

DUTY STATION:

RECOMMENDED APPROVAL