Da Form 137-1 - Unit Clearance Record Page 2

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SECTION D - PROPERTY ACCOUNTABILITY AND PAY ITEMS
11. PROPERTY ACCOUNTABILITY
11a.
11d. DISPOSITION
11b. DATE OF SOURCE DOCUMENT
STATEMENT OF CHARGES/ CASH
(YYYYMMDD)
COLLECTION VOUCHER
REPORT OF SURVEY
11c. AMOUNT
12. PAY ITEMS (Check all that apply)
12b.
12a. INCENTIVE PAY (Specify Type)
BAS
BAH
COLA
OHA
FSA
IDP
CPP
SDAP
ENLISTMENT BONUS
REENLISTMENT BONUS
OTHER (Specify)
SECTION E - BATTALION/UNIT CLEARANCE ITEMS. A check by an item confirms that the item has been verified and that necessary action has been taken.
13. BN S1/UNIT COMMANDER VERIFYING OFFICIAL
a. TYPE OR PRINT NAME
b. SIGNATURE
c. DATE (YYYYMMDD)
DA Form 31
Family Care Plan
PROFIS Duty Position
TRICARE Dental Program
Meal Card
DD Form 2648
Duty Roster
Exceptional Family Member Program
Line of Duty Investigation
DOD Travel Charge Card
Physical Profile
Unit Items
Flagged
Personnel Register
Evaluation Reports
Weight Control Program
Change of Address Form
14. BN S2/3/UNIT COMMANDER VERIFYING OFFICIAL
a. TYPE OR PRINT NAME
b. SIGNATURE
c. DATE (YYYYMMDD)
Security Briefing/Debriefing
APFT
Security Clearance
Weapons Qualification
Training Records
Antiterrorism Briefing
PERSTEMPO Verification Sheet
Training Room
15. BN S4/UNIT COMMANDER VERIFYING OFFICIAL
a.
TYPE OR PRINT NAME
b. SIGNATURE
c. DATE (YYYYMMDD)
Supply Room
NBC Room
Motor Pool
Arms Room
Protective Mask Inserts
16. OTHER
a. OTHER CLEARANCES
b. TYPE OR PRINT NAME
c. SIGNATURE
d. DATE (YYYYMMDD)
Career Counselor
17. REMARKS
18. SOLDIER'S AUTHENTICATION
a. TYPE OR PRINT NAME
b. SIGNATURE
c. DATE (YYYYMMDD)
19. COMMANDER/BN S1 AUTHENTICATING OFFICIAL
a. TYPE OR PRINT NAME
b. SIGNATURE
c. DATE (YYYYMMDD)
Page 2 of 2
DA FORM 137-1, JUN 2010
APD LC v1.00

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