Personnel Actions Request Form
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1Texas State Guard
Texas State Guard
Personnel Actions Request
________________
Officer/Warrant Officer/Enlisted
Order Number 20___ _______ - ____
14
Texas
___________
__________________________________,
-Unit Action Number
ACTION REQUESTED: ____________________ Other: _______________________
Select Action
Date: _____________________
___________________________________________________________________________________________________
Present Grade If Applicable
Last Name
First Name
Middle Name/Initial
Social Security Number
Present rank if applicable
DOIE __________ DOR __________ DOB __________ Weight ___ lbs Height___ ins
TIS yrs___ mos___
(TXSG)
REQUIREMENTS:
Professional Military Education Completed:
Officer/Warrant Officer:
ROTC
War College
WOC
OCS
OBC
OAC
C&GSC
Enlisted/NCO:
BOT
PLDC/ALS
BNCOC/NCOA
ANCOC/SrNCOA
546
775
547
Officer:
100
200
700
800
FEMA Courses Completed:
Warrant Officer:
100
200
700
800
775
546
547
Enlisted/NCO:
800
775
546
547
100
200
700
_______________________ Date __________
For Notes:
Certifying Signature of Unit Personnel Officer
ACTION:
You are ______________as indicated: Recommended grade/rank
_____
_____
Position Title _______________
Select Action
Select Rank
Select Grade
(IAW 10-
1, 10-2, 10-3, 10-4)
Request for Waiver of ___________________is required for indicated action. A letter of recommendation is attached.
Explain what is being waived
TRANSFER/DISCHARGE DETAILS:
Transferred from: _________________, _______________ Reassigned from: _________________, ________________
Select Unit Designation
Select Unit Designation
Unit Designation
City
Unit Designation
City
Transferred to:
_________________, ________________ Reassigned to:
_________________, ________________
Select Unit Designation
Select Unit Designation
Unit Designation
City
Unit Designation
City
Losing Unit Commander's Signature: __________________ Gaining Unit Commander's Signature: __________________
______________________________
_______________________________
Commander's Printed Name:
Commander's Printed Name:
Honorable Discharge for reason: _________________________________
effective the date of this document.
Select Reason
This member
is
is not recommended for future re-appointment in the TXSG.
COMPONENT COMMAND APPROVAL SIGNATURES:
______________________________
__________
______________________________
Date
Signature of Sub-MSC Commander at
Signature of enio
at
sub-MSC Level
sub-MSC Level
___________________________
______________________________________
_____________
Signature of MSC Commander at
Signature of enior
MSC Level
Date
MSC Level
______________________________
_____________________________________
_____________
Signature of Component Commander at
Signature of Senior Enlisted Advisor at
Date
COMPONENT COMMAND
COMPONENT COMMAND
HEADQUARTERS COMMAND APPROVAL SIGNATURES:
______________________________
_________________________________
Date__________
J1 Personnel Officer
Chief of Staff, TXSG
TXSG Form 35 Order for Officer/ Warrant Officer/ Enlisted Personnel Actions dtd 23
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