Dd Form 4/1 - Enlistment/reenlistment Document Armed Forces Of The United States - 2001

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ENLISTMENT/REENLISTMENT DOCUMENT
ARMED FORCES OF THE UNITED STATES
PRIVACY ACT STATEMENT
AUTHORITY: 5 USC 3331; 32 USC 708; 44 USC 708 and 3101; 10 USC 133, 265, 275, 504, 508, 510, 591, 672(d), 678, 837, 1007,
1071 through 1087; 1168, 1169, 1475 through 1480, 1553, 2107, 2122, 3012, 5031, 8012, 8033, 8496, and 9411; 14 USC 351 and
632; and Executive Order 9397, November 1943 (SSN).
PRINCIPAL PURPOSE(S): To record enlistment or reenlistment into the U.S. Armed Forces. This information becomes a part of the subject's
military personnel records which are used to document promotion, reassignment, training, medical support, and other personnel management
actions. The purpose of soliciting the SSN is for positive identification.
ROUTINE USE(S): This form becomes a part of the Service's Enlisted Master File and Field Personnel File. All uses of the form are internal to
the relevant Service.
DISCLOSURE: Voluntary; however, failure to furnish personal identification information may negate the enlistment/reenlistment application.
A. ENLISTEE/REENLISTEE IDENTIFICATION DATA
1. NAME
2. SOCIAL SECURITY NUMBER
(Last, First, Middle)
3. HOME OF RECORD
4. PLACE OF ENLISTMENT/REENLISTMENT
(Street, City, State, ZIP Code)
(Mil. Installation, City, State)
5. DATE OF ENLISTMENT/
6. DATE OF BIRTH
(YYYYMMDD)
7. PREV MIL SVC UPON ENL/REENLIST
YEARS
MONTHS
DAYS
REENLISTMENT
(YYYYMMDD)
a. TOTAL ACTIVE MILITARY SERVICE
b. TOTAL INACTIVE MILITARY SERVICE
B. AGREEMENTS
8. I am enlisting/reenlisting in the United States
(list branch of service)
this date for
years and
weeks beginning in pay grade
The additional details of my enlistment/reenlistment are in Section C and Annex(es)
a. FOR ENLISTMENT IN A DELAYED ENTRY/ENLISTMENT PROGRAM (DEP):
I understand that I will be ordered to active duty as a Reservist unless I report to the place shown in item 4
for enlistment in the Regular component of the United
above by
(list date (YYYYMMDD))
States
for not less than
years and
(list branch of service)
weeks. My enlistment in the DEP is in a nonpay status. I understand that my period in the DEP is
NOT creditable for pay purposes upon entry into a pay status. However, I also understand that this time is
counted toward fulfillment of my military service obligation or commitment.
I must maintain my current
qualifications and keep my recruiter informed of any changes in my physical or dependency status, moral
qualifications, and mailing address.
b. REMARKS:
(lf none, so state.)
c. The agreements in this section and attached annex(es) are all the promises made to me by the Government.
ANYTHING ELSE ANYONE HAS PROMISED ME IS NOT VALID AND WILL NOT BE HONORED.
(Initials of Enlistee/Reenlistee)
(Continued on reverse side.)
DD FORM 4/1, JAN 2001
PREVIOUS EDITION MAY BE USED.

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