Da Form 4856 - Developmental Counseling Form - 2014

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DEVELOPMENTAL COUNSELING FORM
For use of this form, see ATP 6-22.1; the proponent agency is TRADOC.
DATA REQUIRED BY THE PRIVACY ACT OF 1974
AUTHORITY:
5 USC 301, Departmental Regulations; 10 USC 3013, Secretary of the Army.
PRINCIPAL PURPOSE:
To assist leaders in conducting and recording counseling data pertaining to subordinates.
ROUTINE USES:
The DoD Blanket Routine Uses set forth at the beginning of the Army's compilation of systems or records notices also
apply to this system.
DISCLOSURE:
Disclosure is voluntary.
PART I - ADMINISTRATIVE DATA
Name (Last, First, MI)
Rank/Grade
Date of Counseling
Organization
Name and Title of Counselor
PART II - BACKGROUND INFORMATION
Purpose of Counseling: (Leader states the reason for the counseling, e.g. Performance/Professional or Event-Oriented counseling, and includes
the leader's facts and observations prior to the counseling.)
PART III - SUMMARY OF COUNSELING
Complete this section during or immediately subsequent to counseling.
Key Points of Discussion:
OTHER INSTRUCTIONS
This form will be destroyed upon: reassignment (other than rehabilitative transfers) , separation at ETS, or upon retirement. For separation
requirements and notification of loss of benefits/consequences see local directives and AR 635-200.
DA FORM 4856, JUL 2014
PREVIOUS EDITIONS ARE OBSOLETE.
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APD LC v1.02ES

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