Early Release Request Form

Page 1

DEPARTMENT OF THE ARMY 807TH MEDICAL COMMAND (DEPLOYMENT SUPPORT) 106 SOLDIERS CIRCLE FT DOUGLAS, UTAH 84113-5007

DATE:___________

AFRC-MUT-HC MEMORANDUM FOR Commander, HHC, 807 MCDS

SUBJECT: Approval/Disapproval for Early Release Soldier to Sign-Out

1. The following Soldier requests departure at __________ hours, on ________

and to be excused from final formation:

Name: _______________________ Rank: _________ Section: _____________ Reason (Justification):______________________________________________ 2. I recommend that the Soldier:

______ be allowed to submit an RST form and a DA 1380 and receive pay. ______ not be allowed to sign out and receive an UNSAT (U) or EXCUSED (A) absence for the BA concerned (inlude excused absence request if recommending approval of an A for the BA). _________________________ Supervisor's signature block

3. Disposition:

_____ Early release is approved. Supervisor will ensure Soldier submits an RST form and a DA 1380 within 30 days. _____ Excused absence is approved. _____ Unexcused absence is approved. ______________________________ Commander's or 1SG signature block

HHC, 807 MCDS Early Release Permission Slip - 3 APR 2017


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