SIGNATURE OF APPLICANT Use CAC for digital signature SIGNATURE OF STANDBY 14. REASON FOR DISAPPROVAL NAVPERS 1336/3 Rev* 10-2011 FOR OFFICIAL USE ONLY - PRIVACY SENSITIVE. RECOMMENDED APPROVAL YES DATE RANK/RATE/TITLE SIGNATURE NO APPROVED 22. ![]() I am eligible and obligate myself to DUTY STATION perform all duties of person making application* 15. COMPLETION OF THE FORM IS MANDATORY FAILURE TO PROVIDE REQUIRED INFORMATION MAY RESULT IN DELAY IN RESPONSE TO OR DISAPPROVAL OF YOUR REQUEST. THE PRINCIPLE PURPOSE OF THE INFORMATION IS TO ENABLE YOU TO MAKE KNOWN YOUR DESIRE FOR ITEMS LISTED OR FOR SOME OTHER SPECIAL CONSIDERATION OR AUTHORIZATION* THE INFORMATION WILL BE USED TO ASSIST OFFICIALS AND EMPLOYEES OF THE DEPARTMENT OF THE NAVY IN DETERMINING YOUR ELIGIBILITY FOR AND APPROVING OR DISAPPROVING THE SPECIAL CONSIDERATION OR AUTHORIZATION BEING REQUESTED. THE INFORMATION WILL BE USED TO ASSIST OFFICIALS AND EMPLOYEES OF THE DEPARTMENT OF THE NAVY IN DETERMINING YOUR ELIGIBILITY FOR AND APPROVING OR DISAPPROVING THE SPECIAL CONSIDERATION OR AUTHORIZATION BEING REQUESTED. THE PRINCIPLE PURPOSE OF THE INFORMATION IS TO ENABLE YOU TO MAKE KNOWN YOUR DESIRE FOR ITEMS LISTED OR FOR SOME OTHER SPECIAL CONSIDERATION OR AUTHORIZATION. DISTANCE MILES COMMUTED RATIONS OTHER BELOW MODE OF TRAVEL CAR AIR 10. NATURE OF REQUEST SPECIAL LIBERTY LEAVE 8. NAVPERS 1200/6 U.S.SPECIAL REQUEST/AUTHORIZATION PRIVACY ACT STATEMENT THE AUTHORITY TO REQUEST THIS INFORMATION IS CONTAINED IN 5 USC 301. NAVPERS 1200/2 Navy Reserve Qualification Questionnaire for Inactive Duty Personnel NAVPERS 1200/1 Ready Reserve Transfer Request Service Agreement NAVPERS 1132/1 Reserve Officer Recall Staffing Application and Routing Control NAVPERS 1131/1 Training and Administration of the Reserve (TAR) Officer Candidate Service Agreement NAVPERS 1130/11 Application for Navy Music Program NAVPERS 1080/3 Individual Ready Reserve (IRR) Annual Screening NAVPERS 1070/887 Sex Offense Accountability Record (SOAR) NAVPERS 1070/856 Request for Authority to Draw Personnel Records NAVPERS 1070/622 Agreement to Recall or Extend Active Duty NAVPERS 1070/621 Agreement to Extend Enlistment NAVPERS 1070/615 Honorable Discharge from the United States Navy Reserve ![]() NAVPERS 1070/605 History of Assignments (form in revision 6/30/23) NAVPERS 1070/601 Immediate Reenlistment Agreement NAVPERS 1070/120 Request for Change to Permanent Personnel Record NAVPERS 1070/74 Officer’s Report of Home of Record and Place from Which Ordered to Active Duty NAVPERS 1050/3 Appellate Leave Statement of Understanding NAVPERS 1040/3 Career Counselor Initial Tour Feedback NAVPERS 1040/2 Command Information Program Review ![]() NAVPERS 1001/3 Ready Reserve Screening Questionnaire NAVPERS 1000/32 Consent to Release Personal Contact Information NAVPERS 1000/1 Pseudofolliculitis Barbae (PFB) Temporary Shaving Waiver and Treatment Regimen NAVPERS 1070/613 Administrative Remarks (COVID-19 Vaccine Refusal) NAVPERS 1070/613 Administrative Remarks (COVID-19 Vaccine Refusal Administrative Warning) NAVPERS 1070/613 Administrative Remarks (Physical Fitness Assessment) MS Edge: When the file opens in the browser window with the error message, click save icon (right, upper corner) to save to your computer and open from the saved location.Īnd Pre-Drafted Forms: PERS-83 Reporting Letter Templates Google Chrome: Open any PDF file saved on your computer > Click Edit > Select Preferences > Select Internet > Uncheck Allow Fast Web View Here is the guidance to default your browser of choice. Important Adobe Notice:Browsers other than Internet Explorer are not initially configured to open PDF forms with Adobe as the default and causes an error.
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