Summarized Record Of Proceedings Under Article 15 (Page 2 of 2) in pdf

NOTES

See AR 27-10 for further guidance. Ordinarily entries on this form will be handwritten in ink.

Insert a concise statement of each offense in terms stating a specific violation and the Article of the UCMJ. If additional space is needed,

use item 7 and/or continuation sheets as described in note 9 below.

Inform the member that if he or she demands trial, trial could be by SCM, SPCM, or GCM. Additionally, inform the member that he or she

may object to trial by SCM and that at SPCM or GCM he or she would be entitled to be represented by qualified military counsel, or by

civilian counsel at no expense to the government. If the member is attached to or embarked in a vessel, he or she is not permitted to refuse

Article 15 punishment. In such cases, all reference to a demand for trial will be lined out and an appropriate remark will be made in item

7 indicating the official name of the vessel and that the member was attached to or embarked in the vessel at the time punishment was

imposed.

Offenses determined not to have been committed will not be listed. If the imposing commander decides not to impose punishment, the member

will be notified and no copies of this record will be prepared. If a punishment is suspended, the following statement should be added after

it: "To be automatically remitted if not vacated before (date)."

If the member immediately elects not to appeal, item 5 will not be completed.

The imposing commander will initial the appropriate block.

If the individual appeals, this form and all matters set forth in item 7 will be forwarded to the superior authority.

The superior authority will initial the appropriate block. Refer to note 10, below.

In this space indicate the number of pages as follows: Allied documents on appeal consist of _________ pages. Allied documents include

all written matters considered by the imposing commander, submitted by the member on appeal, commander's rebuttal, and copies of

supplementary actions taken on the punishment. Supplementary actions will be recorded in accordance with note 10. If additional space

is needed for completion of any item(s), use plain bond headed "Continuation Sheet 1," etc.

Applicable portions of the following suggested formats may be used to record action taken on an appeal and supplementary actions for

summarized Article 15 proceedings. Appropriate language should be entered in item 7 or, if necessary, on continuation sheets.

a. Suspension, Mitigation, Remission, or Setting Aside.

On (date) the punishment(s) of ______________________________________________________________________________________,

imposed on (date of punishment) (was) (were) (suspended and will be automatically remitted if not vacated before (date)) (mitigated to)

(set aside, and all rights, privileges, and property affected restored) (by my order) (by order of) (the officer who imposed the

punishment) (the successor in command to the imposing commander) (as superior authority).

(Typed name, grade, and organization of commander)

/s/_________________________________________________

b. Vacation of Suspension

The suspension of the punishment(s) of _______________________________________________________________________________

imposed on (date of punishment) (is) (are) hereby vacated. The unexecuted portion(s) of the punishment(s) will be duly executed.

(Typed name, grade, and organization of commander)

/s/_________________________________________________

Racial/ethnic identifiers will be placed in item 7 (Chap 15, AR 27-10).

Reverse of DA Form 2627-1, Aug 84

USAPPC V1.00

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