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KCN:K________________

SECTION IV - OBLIGATION

1. I agree to remain in the ARNG as a satisfactory participant for six years ; __________ (initials).

2. I understand that failure to complete my six year obligation entitling me to the MGIB Kicker may result in either suspension, termination or recoupment of any MGIB

Kicker payments I have received ; __________ (initials).

3. I understand that I must remain qualified in a MGIB Kicker eligible MOS and/or unit and that failure to do so may result in either suspension, termination or

recoupment of any MGIB Kicker payments I have received ; __________ (initials).

4. I understand that I must have at least a 6 year obligation with the Selected Reserve from the date this contract is signed: _________(Initials)

SECTION V - ENTITLEMENT

1. I am entitled to the MGIB Kicker incentive for each month of basic MGIB benefits I have remaining for a maximum of 36 months of full time enrollment. The

Department of Veterans Affairs will adjust the amount and the number of months for less than full-time pursuit of qualifying educational programs ; _________ (initials).

2. I understand that I cannot receive any portion of my MGIB Kicker until I have received my secondary school diploma or authorized equivalent and have completed

initial active duty for training or its equivalent ; __________ (initials).

3. I understand that if I voluntarily or involuntarily transfer within or between units of the ARNG or USAR, including the IRR, due to unit transition as described in

AR 135-7, paragraph 1-14.1, or complete my six year Kicker obligation, and have not used the maximum 36 months of my basic MGIB benefits, I will continue to receive

the Kicker incentive until my basic MGIB benefits are exhausted up to 36 months of full time enrollment ; __________ (initials).

SECTION VI – SUSPENSION, TERMINATION and RECOUPMENT

I understand that my MGIB Kicker incentive can be suspended, terminated and/or recouped if I fail to meet the eligibility criteria for my MGIB Kicker category and/or

complete the required MGIB Kicker obligation as outlined in this Annex and my enlistment contract, extension or OSA. The specific conditions regarding MGIB Kicker

incentive suspension, termination and recoupment are outlined in the current fiscal year MGIB Kicker policy distributed by National Guard Bureau (NGB-EDU) and is

available to me upon request to the unit ; __________ (initials).

SECTION VII - STATEMENT OF UNDERSTANDING

I have read and understand each of the statements above. I understand the statements above are intended to constitute all promises and agreements concerning

my ARNG MGIB Kicker incentive.

APPLICANT'S SIGNATURE

DATE SIGNED

TYPED OR PRINTED NAME AND RANK

SSN

SECTION VIII - CERTIFICATION BY AUTHORIZED ARNG REPRESENTATIVE

As an authorized ARNG representative, I certify that I have witnessed the reading and signing of this document and the signature appearing above is that of the

applicant. Per the current fiscal year MGIB Kicker policy distributed by NGB-EDU, I have verified that the applicant above meets the MGIB Kicker eligibility requirements

and that the applicant's unit of assignment and MOS are currently eligible for the MGIB-SR Kicker incentive. No other promises were made to the applicant as a

condition of entitlement to the MGIB Kicker. I have obtained an MGIB Kicker control number from the State MGIB Manager or Education Service Officer (ESO) and will

provide the applicant and the MGIB Manager/ESO with a copy of this form.

SERVICE REPRESENTATIVE SIGNATURE

DATE SIGNED

TYPED OR PRINTED NAME AND RANK

TITLE

UNIT / LOCATION

PHONE

NGB 5435, 20080808 (REVERSE) (EF) (Adobe v8.0)