Fillable Form
DATE (YYMMDD):
SSN
(LAST 4 DIGITS)
:
ENLISTED PERSONNEL ACTION REQUEST
FROM:
RATE:
NEC (PRI/SEC):
DUTY PHONE:
HOME PHONE:
TO:
VIA:
MEMBERS E-MAIL:
CCC E-MAIL:
REF:
COMMAND TEAMING INFO UPDATED
YES
NO
REASON FOR SUBMISSION (Remarks are limited to 250 characters):
DATE AVAILABLE (YYMM):
PRD:
EAOS/SEAOS:
Earliest:
Latest:
SPOUSE SSN:
BRANCH OF SERVICE:
USN
USMC
USA
USAF
USCG
:
STATUS:
CURRENT DUTY STATION:
ROTATION DATE (YYMM):
SPOUSE RATE/RANK
ENLISTED
OFFICER
NAME
PHONE NO.
SPOUSE DETAILER/MONITOR
NO. OF IMMEDIATE
LOCATION OF IMMEDIATE FAMILY MEMBERS (City, State/Country):
FAMILY MBRS
ENROLLED EFM:
LOCATION OF HOUSE HOLD GOODS (City, State/Country):
YES
NO
OTHER REQUEST
PRIVACY ACT STATEMENT: The authority to request this information is contained in 5 USC 301 Departmental Regulations and
from E.O. 9397. The principal purpose of the information is to enable you to make known your desires for the various types of
PENDING/DATE (YYMM):
duty listed, or some other special assignment consideration. The information will be used to assist officials and employees of the
Department of the Navy in determining your future duty assignment. Completion of the form is mandatory except for duty and
home phone numbers; failure to provide information may result in delay in response to or disapproval of your request.
MEMBER SIGNATURE:
EVAL/FITREP PERIOD
PROMOTION
RETENTION
33
34
35
36
37
38
39
20
(YYMMDD-YYMMDD)
REC
REC
YES
NO
HAS CLEAR RECORD (No NJP) FOR PAST
YEARS AS REQUIRED
YES
NO
N/A
MEETS SECURITY CLEARANCE REQUIREMENTS
RECOMMENDED
COMMAND UIC:
YES
NO
COMMENTS (Address acceptable gap, relief requirement, waivers, etc.):
COMMANDING OFFICER:
DATE:
NAVPERS 1306/7 (Rev. 01-03)
FOR OFFICIAL USE ONLY
S/N: 0106-LF-983-3400
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