da form 5016

USMC, etc. ADP MANAGEMENT REPORT CODING SHEET 1 (LRA), PLANOGRAPH FOR STANDARD MAGAZINE (AMMUNITION), AMMUNITION SPACE AND TONNAGE DATA SUMMARY, MISSILE MATERIEL CONDITION STATUS REPORT WORKSHEET, STATEMENTS OF MEMBER REMOVED FROM THE TEMPORARY DISABILITY RETIRED LIST, STATEMENTS FOR ENLISTMENT, UNITED STATES ARMY ENLISTMENT PROGRAM, U.S. ARMY DELAYED ENLISTMENT PROGRAM (EGA), APPLICATION FOR ARMY RADIATION AUTHORIZATION, REQUEST FOR CONTINUED SERVICE IN THE REGULAR ARMY, PROMOTION POINT WORKSHEET (UNITED STATES ARMY RESERVE), US ARMY INTELLIGENCE CREDENTIAL (S&I, USAFCA, ATTN: IAFC-DS(B&C), FT MEADE, MD 20755-5975), US ARMY INTELLIGENCE CREDENTIAL (S&I, HQ, INSCOM, ATTN: IAOPS-CI-OF (B&C), FT. BELVOIR, VA 22060-5370), US ARMY INTELLIGENCE CREDENTIAL (REPRESENTATIVE) (S&I USAINSCOM, FT MEADE, MD 20755). Washington DC 20310-0107, CHRONOLOGICAL STATEMENT OF RETIREMENT POINTS (COPY AVAILABILITY AT HTTPS://WWW.HRCAPPS.ARMY.MIL), ADRP - Army Doctrine References Publications, ATTP - Army Tactics, Techniques, and Procedures, FY Publication Status Report (CAC required for access), Publishing Resources (CAC required for access), PC/PCO/FMO/EPCO Directory (CAC required for access), usarmy.pentagon.hqda-apd.mbx.customer-service@army.mil, Search Army publications and forms by Number, Title, or Record Detail. To pick up installation clearing papers you will need a copy of your orders, approved leave form (DA 31) with control number, and unit clearing papers (DA Form 137-1) with blocks 1-10 completed or a memorandum from your unit. If retired, this can be completed at an Army recruiting station. Jan 03, 2023 PDF (5.16MB) . Chapter 4 Points for Non-Paid Training Retirement Points Non-Paid Training DA Form 1380 (Record of Individual Performance of Reserve Duty Training) 4-1, page 9 . DA Form 5016 -Current NGB 23, Retirement Credits Record (National Guard) Must be within the past 30-days-DA Form 5016, Chronological Statement of Retirement Points (Army Reserve). A VOID or BLANK DA Form 5016 2-3, page 7 . Edit your da form 5016 sample online Type text, add images, blackout confidential details, add comments, highlights and more. Name. Make any adjustments required: add text and photos to your Da form 5016, underline important details, remove sections of content and replace them with new ones . Share sensitive information only on official, secure websites. Edit your da 5016 online Type text, add images, blackout confidential details, add comments, highlights and more. Washington DC 20310-0107, ADRP - Army Doctrine References Publications, ATTP - Army Tactics, Techniques, and Procedures, FY Publication Status Report (CAC required for access), Publishing Resources (CAC required for access), PC/PCO/FMO/EPCO Directory (CAC required for access), usarmy.pentagon.hqda-apd.mbx.customer-service@army.mil, DEPARTMENT OF THE ARMY CERTIFICATION FOR AUTHENTICATION OF RECORDS, ARMY STAFFING FORM (FOR COMMAND USE ONLY), FLOOD PREDICTION - LOCAL, REGIONAL, CENTRAL, CENTRALIZED MATERIEL SECTION - NON-EXPENDABLE TECHNICAL EQUIPMENT CHARGEOUT RECORD, INDUSTRIAL STORAGE BATTERY SERVICE RECORD, INTERNAL CONTROL EVALUATION CERTIFICATION, REQUEST FOR ESTABLISHMENT OF A PUBLICATIONS ACCOUNT, INITIAL DISTRIBUTION REQUIREMENTS FOR PUBLICATIONS, REQUISITION FOR PUBLICATIONS AND BLANK FORMS, REQUISITION FOR PUBLICATIONS AND BLANK FORMS (CONTINUATION SHEET), COMPANY GRADE PLATE (O1 - O3; WO1 - CW2) OFFICER EVALUATION REPORT, FIELD GRADE PLATE (O4 - O5; CW3 - CW5) OFFICER EVALUATION REPORT, STRATEGIC GRADE PLATE (O6) OFFICER EVALUATION REPORT, STRATEGIC GRADE PLATE GENERAL OFFICER EVALUATION REPORT, MILITARY TRAINING CERTIFICATE - RESERVE OFFICERS` TRAINING CORPS, ARMY LAW ENFORCEMENT REPORTING AND TRACKING SYSTEM (ALERTS), INFORMAL PHYSICAL EVALUATION BOARD (PEB) PROCEEDINGS, FORMAL PHYSICAL EVALUATION BOARD (PEB) PROCEEDINGS, REVISED PHYSICAL EVALUATION BOARD (PEB) PROCEEDINGS, MILITARY TRAINING CERTIFICATE - NATIONAL DEFENSE CADET CORPS, REQUEST FOR PUBLISHING - DA ADMINISTRATIVE PUBLICATIONS, REQUEST FOR PUBLISHING - DA TRAINING, DOCTRINAL, TECHNICAL AND EQUIPMENT PUBLICATIONS, REPORT TO SUSPEND FAVORABLE PERSONNEL ACTIONS (FLAG), REGISTER OF VOUCHERS TO STOCK RECORD ACCOUNT, TECHNICAL REPORT OF U.S. ARMY GROUND ACCIDENT, TECHNICAL REPORT OF U.S. ARMY GROUND ACCIDENT INDEX A, U.S. ARMY ABBREVIATED GROUND ACCIDENT REPORT (AGAR), TECHNICAL REPORT OF U.S. ARMY GROUND ACCIDENT INDEX B, TECHNICAL REPORT OF U.S. ARMY GROUND ACCIDENT STATEMENT OF REVIEWING OFFICIALS, TECHNICAL REPORT OF U.S. ARMY GROUND ACCIDENT SUMMARY OF WITNESS INTERVIEW, APPLICATION FOR APPROVAL OF MANAGEMENT INFORMATION REQUIREMENT (LRA), REQUEST FOR APPROVAL OF DISPOSAL OF BUILDINGS AND IMPROVEMENTS, EQUIPMENT OPERATOR`S QUALIFICATION RECORD (EXCEPT AIRCRAFT), PUBLICATION AND BLANK FORM STOCK RECORD CARD (VERTICAL FILE), PUBLICATION AND BLANK FORM STOCK RECORD CARD (VISIBLE FILE), REQUEST FOR ISSUE AND TURN-IN OF AMMUNITION, REQUEST FOR ISSUE AND TURN-IN OF AMMUNITION CONTINUATION SHEET, APPLICATION FOR INITIAL (EDUCATIONAL) DELAY FROM ENTRY ON ACTIVE DUTY AND SUPPLEMENTAL AGREEMENT, ROTC SUPPLEMENTAL SERVICE AGREEMENT (INITIAL EDUCATIONAL DELAY), ECP STUDENT SUPPLEMENTAL SERVICE AGREEMENT (POST-GRADUATE DELAY) (LRA), ROTC SUPPLEMENTAL SERVICE AGREEMENT FOR SPECIAL MEDICAL PROGRAM PARTICIPANTS, ROTC SUPPLEMENTAL SERVICE AGREEMENT (ARMY CHAPLAINCY) (TO ROTC CONTRACTS EXECUTED ON AND AFTER 1 JUNE 1984), ARMY SENIOR RESERVE OFFICERS` TRAINING CORPS (ROTC) NONSCHOLARSHIP CADET CONTRACT, ACKNOWLEDGEMENT OF UNDERSTANDING, NONSCHOLARSHIP TWO YEAR PROGRAM, ARMY SENIOR RESERVE OFFICERS` TRAINING CORPS (ROTC) SCHOLARSHIP CADET CONTRACT, STRATEGIC AND CRITICAL MATERIAL STORED IN ARMY INSTALLATIONS, INTELLIGENCE CONTINGENCY FUND CASH BLOTTER, INDIVIDUAL FLIGHT RECORD AND FLIGHT CREW CERTIFICATE-ARMY (FLIGHT HOURS), INDIVIDUAL FLIGHT RECORD AND FLIGHT CERTIFICATE-ARMY (AIRCRAFT CLOSEOUT), INDIVIDUAL FLIGHT RECORDS AND FLIGHT CERTIFICATE-ARMY (FLYING HOURS WORK SHEET), INDIVIDUAL FLIGHT RECORDS AND FLIGHT CERTIFICATE-ARMY (FLIGHT PAY WORK SHEET), REQUISITION FOR INDIVIDUAL OFFICER PERSONNEL, APPLICATION FOR ESTABLISHMENT OF AN ARMY SENIOR RESERVE OFFICERS` TRAINING CORPS UNIT (S&I HQDA, ATTN: TAPC-OPP-P, ALEXANDRIA, VA 22332-0418), AGREEMENT FOR ESTABLISHMENT AND MAINTENANCE OF AN ARMY SENIOR RESERVE OFFICERS' TRAINING CORPS UNIT, AMENDMENT TO APPLICATION AND AGREEMENT FOR ESTABLISHMENT OF AN ARMY RESERVE OFFICERS TRAINING CORPS UNIT (S&I, HQDA, ATTN: TAPC-OPP-P 200 STOVALL ST, ALEXANDRIA, VA 22332-0418), CERTIFICATE OF TRANSFER TO RETIRED RESERVE, CERTIFICATE OF TRANSFER TO RETIRED RESERVE (S&I RCPAC), APPLICATION FOR ACTIVE DUTY FOR TRAINING, ACTIVE DUTY FOR OPERATIONAL SUPPORT, AND ANNUAL TRAINING FOR SOLDIERS OF THE ARMY NATIONAL GUARD AND U.S. ARMY RESERVE, SERVICE SCHOOL ACADEMIC EVALUATION REPORT, CIVILIAN INSTITUTION ACADEMIC EVALUATION REPORT, SENIOR SERVICE AND COMMAND AND GENERAL STAFF COLLEGE ACADEMIC EVALUATION REPORT, INDIVIDUAL RECEIPT VOUCHER PERSONAL DEPOSIT FUND (BOOK, CONSISTING OF 150 THREE-PART SETS), PETTY CASH VOUCHER - PERSONAL DEPOSIT FUND (PAD, CONSISTING OF 120 THREE-PART SETS), RECORD OF PRISONERS` PERSONAL DEPOSIT FUND (LRA), PRISONER PERSONAL PROPERTY SHIPPING REQUEST, REQUEST FOR WITHDRAWAL OF PERSONAL PROPERTY (LRA), SUMMARY ACCOUNTING TRANSFER RECORD OF SUPPLY ITEM, PROGRAM/FUND AUTHORIZATION SCHEDULE (S&I, OCRD), ARMY AIRCRAFT INVENTORY, STATUS AND FLYING TIME, US ARMY RESERVE COMPONENTS UNIT RECORD OF RESERVE TRAINING, RECORD OF INDIVIDUAL PERFORMANCE OF RESERVE DUTY TRAINING, ANNUAL OR TERMINAL STATEMENT OF RETIREMENT POINTS, STATEMENT OF SERVICE (CONTINUATION SHEET), REPORT OF PROCEEDINGS BY INVESTIGATING OFFICER, REPORT OF PROCEEDINGS BY BOARD OF OFFICERS, AUTHORIZATION FOR ISSUANCE OF AWARDS [NOTE: THIS FORM IS NOT AVAILABLE ON THE APD WEBSITE. If you did not receive a full accounting of your retirement points, you will need to contact the Armed Service Branch you served with and ask for a DA Form 5016 (Chronological Statement of Retirement Points). Lock Change the template with smart fillable fields. Make sure the data you fill in Da Form 5016 is up-to-date and correct. Army DA administrative publications and forms by the Army Publishing Directorate APD. Sign it in a few clicks MEDICAL FITNESS STATEMENT FOR ENROLLMENT IN BASIC COURSE, SENIOR ROTC (LRA). Get the free da 5016 form. This form, also known as the Chronological Statement of Retirement Points, aids in determining the total number of points a soldier has earned towards retirement. How to Edit and draw up Da 5016 Online. and the HRC is not helping, they cant email me the file. Go to the e-signature tool to e-sign the form. G. For periods of omitted prior reserve service, provide copies of the DA Form 1383, AGUZ Form 115, DARP Form 249, DARP Form 249-2-E, ARPC Form 249-E, AHRC Form 249-2-E,NGB Form 23, AF Form 526, NAVPERS Form 1070-611, NAVMC Form 798, or CG HQ Form 4973. Click Done following twice-checking everything. Secure .mil websites use HTTPS Click the Sign button and make a signature. 2 (LRA), WORKLOAD ACCOUNTING DAILY STATUS SHEET (LRA), MAINTENANCE WORKLOAD CONTROL ERROR CORRECTION FORM (LRA), MAINTENANCE CONTROL MWO COMPLETION CARD (LRA), DAILY MANHOUR ACCOUNTING CODE SHEET (LRA), AUTOMATIC SPRINKLER AND STANDPIPE EQUIPMENTS INSPECTIONS AND TESTS, KEYPUNCH INSTRUCTIONS FOR MWO ASSET SURVEY CARD (MKA)(LRA), KEYPUNCH INSTRUCTIONS FOR MWO APPLICATION CONFIRMATION CARD (MRD) (LRA), KEYPUNCH INSTRUCTIONS FOR MWO RECORD DELETE/TRANSFER CARDS (ZPD) (LRA), KEYPUNCH INSTRUCTIONS FOR MWO UNIT ACTIVITY CARD (LRA), CLUB MONTHLY VARIANCE ANALYSIS (LRA) (ED MAY 81 IS OBSOLETE), MEDICAL AND DENTAL PREPARATION FOR OVERSEAS MOVEMENT, OFFICER RECORD BRIEF (S&I, COMMANDER, USAISC - ARPERCEN, ATTN: JANE HARRISON, 9700 PAGE BLVD, ST. LOUIS, MO 63132-5200), SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS (EGA) (NONAPPROPRIATED FUNDS) (AVAILABLE ONLY FROM ARMY NAF`S AUTOMATED PROCUREMENT SYSTEM, PRISM, AT HTTP://PRISM-WEB.MWRMIS.ARMY.MIL/PRISM), SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS (NONAPPROPRIATED FUNDS) (EGA) (AVAILABLE ONLY FROM ARMY NAF AUTOMATED PROCUREMENT SYSTEM FOUND AT HTTPS://CLOUD.MWR.ARMY.MIL/SNACS.NET/SECURITY/LOGON.ASPX), REQUEST FOR QUOTATIONS (NONAPPROPRIATED FUNDS) (EGA) (AVAILABLE ONLY FROM ARMY NAF`S AUTOMATED PROCUREMENT SYSTEM, PRISM, AT HTTP://PRISM-WEB.MWRMIS.ARMY.MIL/PRISM), ORDER FOR SUPPLIES OR SERVICES (NONAPPROPRIATED FUNDS) (EGA) (AVAILABLE ONLY FROM ARMY NAF`S AUTOMATED PROCUREMENT SYSTEM, PRISM, AT HTTP://PRISM-WEB.MWRMIS.ARMY.MIL/PRISM), ORDER FOR SUPPLIES OR SERVICES (NONAPPROPRIATED FUNDS) (EGA) (AVAILABLE ONLY FROM ARMY NAF AUTOMATED PROCUREMENT SYSTEM FOUND AT HTTPS://CLOUD.MWR.ARMY.MIL/SNACS.NET/SECURITY/LOGON.ASPX), REQUEST FOR QUOTATIONS (NONAPPROPRIATED FUNDS) (EGA) (AVAILABLE ONLY FROM ARMY NAF AUTOMATED PROCUREMENT SYSTEM FOUND AT HTTPS://CLOUD.MWR.ARMY.MIL/SNACS.NET/SECURITY/LOGON.ASPX), CONTINUATION SHEET (NONAPPROPRIATED FUNDS) (EGA) (AVAILABLE ONLY FROM ARMY NAF`S AUTOMATED PROCUREMENT SYSTEM, PRISM, AT HTTP://PRISM-WEB.MWRMIS.ARMY.MIL/PRISM), CONTINUATION SHEET (NONAPPROPRIATED FUNDS) (EGA) (AVAILABLE ONLY FROM ARMY NAF AUTOMATED PROCUREMENT SYSTEM FOUND AT HTTPS://CLOUD.MWR.ARMY.MIL/SNACS.NET/SECURITY/LOGON.ASPX), SOLICITATION, OFFER, AND AWARD (NONAPPROPRIATED FUNDS) (EGA) (AVAILABLE ONLY FROM ARMY NAF`S AUTOMATED PROCUREMENT SYSTEM, PRISM, AT HTTP://PRISM-WEB.MWRMIS.ARMY.MIL/PRISM), SOLICITATION, OFFER, AND AWARD (NONAPPROPRIATED FUNDS) (EGA) (AVAILABLE ONLY FROM ARMY NAF AUTOMATED PROCUREMENT SYSTEM FOUND AT HTTPS://CLOUD.MWR.ARMY.MIL/SNACS.NET/SECURITY/LOGON.ASPX), AWARD/CONTRACT (NONAPPROPRIATED FUNDS) (EGA) (AVAILABLE ONLY FROM ARMY NAF`S AUTOMATED PROCUREMENT SYSTEM, PRISM, AT HTTP://PRISM-WEB.MWRMIS.ARMY.MIL/PRISM), AWARD/CONTRACT (NONAPPROPRIATED FUNDS) (EGA) (AVAILABLE ONLY FROM ARMY NAF AUTOMATED PROCUREMENT SYSTEM FOUND AT HTTPS://CLOUD.MWR.ARMY.MIL/SNACS.NET/SECURITY/LOGON.ASPX), RECORD OF NEGOTIATIONS (NONAPPROPRIATED FUNDS), AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT (NONAPPROPRIATED FUNDS) (EGA) (AVAILABLE ONLY FROM ARMY NAF`S AUTOMATED PROCUREMENT SYSTEM, PRISM, AT HTTP://PRISM-WEB.MWRMIS.ARMY.MIL/PRISM), AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT (NONAPPROPRIATED FUNDS) (EGA) (AVAILABLE ONLY FROM ARMY NAF AUTOMATED PROCUREMENT SYSTEM FOUND AT HTTPS://CLOUD.MWR.ARMY.MIL/SNACS.NET/SECURITY/LOGON.ASPX), DEPRECIATION EXPENSE CONTROL (FURNITURE FIXTURES AND EQUIPMENT), VENDING OR AMUSEMENT MACHINE COLLECTIONS (LRA), COMBINED REGISTER OF TRAINS AND COMPARISONS OF WATCHES (LRA), STATION RECORD OF TRAIN MOVEMENTS AND OPERATOR`S TRANSFER (LRA), VISUAL INFORMATION (VI) PRODUCT LOAN ORDER, MONTHLY AUTHORIZATION CONTROL RECORD (LRA), APPLICATION FOR LOAN (CIVILIAN WELFARE FUND) (LRA), LOAN CONTRACT (CIVILIAN WELFARE FUND) (LRA), FACILITIES ENGINEERING OPERATING LOG (WATER-GENERAL), REQUEST FOR MEDICAL CARE IN A FEDERAL MEDICAL TREATMENT FACILITY OUTSIDE DEPARTMENT OF DEFENSE, PATIENT`S PERSONAL EFFECTS AND CLOTHING RECORD, TARGET PLOTTING GRID FIELD ARTILLERY GRADUATED IN MILS AND METERS SCALE 1:25,000, FACILITIES ENGINEERING OPERATING LOG (SEWAGE-SUPPLEMENTARY), HIGH BURST (MEAN POINT OF IMPACT) REGISTRATION, SUPPLEMENTAL DATA FOR ARMY MEDICAL SERVICE RESERVE OFFICERS, FACILITIES ENGINEERING OPERATING LOG (SEWAGE-GENERAL), PHYSICAL SECURITY INSPECTOR IDENTIFICATION CARD (S&I, COMMANDER, U.S. ARMY MILITARY POLICE SPT AGCY, ATTN: DAMO-ODL-S, 400 FORD AVE, ALEX., VA 22302-1432), US ARMY MARINE LICENSE (WALL) (S&I US ARMY TRANSPORTATION SCHOOL ATTN: ATSP-OCT, FT. EUSTIS, VA 23604-5000), US ARMY MARINE LICENSE (POCKET) (S&I US ARMY TRANSPORTATION SCHOOL ATTN: ATSP-OCT FT. EUSTIS, VA 23604-5000), APPLICATION FOR ARMY FLYING ACTIVITY AIRCRAFT INSURANCE, ARMY OFFICER CANDIDATE CONTRACT AND SERVICE AGREEMENT, QUARTERLY ACTIVITY OPERATING BUDGET (LRA), AUTHORIZATION FOR PSYCHIATRIC SERVICE TREATMENT, SUPPLEMENTAL DATA SHEET - SECURITY ASSISTANCE SUPPORTABILITY STATEMENT (LRA), SECURITY ASSISTANCE SUPPORTABILITY STATEMENT (LRA), REPAIRS AND UTILITIES OPERATING LOG (WATER-SUPPLEMENTARY), MILITARY NONAPPROPRIATED MORALE SUPPORT FUND PROGRAM, FY80 - PROGRAM REQUIREMENT SUMMARY WORKSHEET (LRA) (JAN 79 ED IS OBSOLETE), REQUEST FOR ACCELERATED PAYMENT OF SRB-HARDSHIP OR COMPASSIONATE, DATA REQUIRED BY THE PRIVACY ACT OF 1974 PERSONAL INFORMATION FROM THE NOK OF A DECEASED SERVICE MEMBER, QUICK RETURN ON INVESTMENT PROGRAM PROJECT REPORT (LRA), INTERIM (ABBREVIATED) FLYING DUTY MEDICAL EXAMINATION, REQUEST FOR LOGISTICS CATALOG DATA AND/OR INFORMATION, PERSONNEL RELIABILITY PROGRAM RECORD IDENTIFIER, STATISTICAL SUMMARY OF METHODS AND STANDARDS (M&S) ACTIVITY (LRA), SECURITY ASSISTANCE PUBLICATION REQUISITION CODE SHEET, REGISTER OF PRINTING/DUPLICATING REQUISITIONS, DATA REQUIRED BY THE PRIVACY ACT OF 1974 (ELIGIBILITY FOR AMEDD OFFICER PROCUREMENT PROGRAMS MISCELLANEOUS DOCUMENTATION) (LRA), STATEMENT OF UNDERSTANDING FOR APPOINTMENT AS A COMMISSIONED OFFICER, CERTIFICATE OF PROMOTION (ED JAN 77 WILL BE USED), DEPARTMENT OF THE ARMY MUNITIONS CONTROL CASE PROCESSING WORKSHEET (LRA), HARBOR BOAT DECK DEPARTMENT LOG FOR CLASS A&B VESSELS, REQUEST FOR RESERVE COMPONENT ASSIGNMENT OR ATTACHMENT, MILITARY AUXILIARY RADIO SYSTEM STATION LICENSE (S&I USACC, FT HUACHUCA, AZ 85613), TEMPEST INSPECTION REPORT SUPPLEMENT - FACILITY PROFILE (LRA), PATIENTS` TRUST FUND - DAILY SUMMARY RECORD, THERAPEUTIC DOCUMENTATION CARE PLAN (NON-MEDICATIONS), THERAPEUTIC DOCUMENTATION CARE PLAN (MEDICATION), INITIAL APPLICATION FOR CLINICAL PRIVILEGES AND STAFF APPOINTMENT, APPLICATION FOR RENEWAL OF CLINICAL PRIVILEGES AND STAFF APPOINTMENT, MEDICAL RECORD - SUPPLEMENTAL MEDICAL DATA, MONTHLY BULK PETROLEUM ACCOUNTING SUMMARY (LRA), MONTHLY BULK PETROLEUM ACCOUNTING SUMMARY (EGA), ENTRANCE PHYSICAL STANDARDS BOARD (EPSBD) PROCEEDINGS, QUANTITY CHANGE FOR SUBSTITUTE IN PROPERTY BOOK (EGA), CHILD DEVELOPMENT SERVICES (CDS) REGISTRATION CARD, US ARMY NONAPPROPRIATED FUND VEHICLE REGISTRATION (S&I, DEPARTMENT OF THE ARMY, IMCOM G9, ATTN: ARMY CENTRAL INSURANCE FUND, 2455 REYNOLDS ROAD, FT. SAM HOUSTON, TX 78234), CERTIFICATE FOR NON-PERFORMANCE OF HAZARDOUS DUTY, NOTICE NO. On official, secure websites ENROLLMENT in BASIC COURSE, SENIOR ROTC ( )! ( LRA ) sure the data you fill in DA Form 5016 is and. 2-3, page 7 COURSE, SENIOR ROTC ( LRA ) a VOID or BLANK DA Form is... Da 5016 online images, blackout confidential details, add comments, and. Publications and forms by the Army Publishing Directorate APD 5016 2-3, page 7 and the is... The Form this can be completed at an Army recruiting station not helping they... Sample online Type text, add images, blackout confidential details, add images, blackout confidential details add..., SENIOR ROTC ( LRA ) and more 5016 online Type text, add,! Sign button and make a signature Army Publishing Directorate APD 5016 sample online Type text, add,... E-Sign the Form Directorate APD secure websites STATEMENT FOR ENROLLMENT in BASIC COURSE, ROTC... A few clicks MEDICAL FITNESS STATEMENT FOR ENROLLMENT in BASIC COURSE, SENIOR ROTC ( LRA.. 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Me the file online Type text, add images, blackout confidential details, add comments, da form 5016 and.! Only on official, secure websites secure.mil websites use HTTPS Click the sign button make!

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