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SEPARATION ACTION CONTROL SHEET For use
of this form, see AR 635-200; the proponent agency is MILPERCEN. |
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NAME (Last, First,
Middle Initial) |
SSN |
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UNIT |
DATE PREPARED |
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ITEM NO. |
ACTION
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DATE |
DAYS REQUIRED
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TOTAL ELAPSED DAYS |
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1. |
Notification
to service member of initiation of separation procedures. |
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2. |
Service
member acknowledged receipt of notification. |
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3. |
Service
member indicated election of rights. |
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4. |
Unit
Commander’s recommendation for separation forwarded to: |
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5. |
Separation
case received at: _________________________________ |
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6. |
Actions
completed (Specify):__________________________________ and/or
case forwarded to:
__________________________________ |
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7. |
Separation
case received at: _________________________________ |
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8. |
Actions
completed (Specify): _________________________________ and/or
case forwarded to:
_________________________________ |
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9. |
Service
member entitled to and elected Hearing
before Administrative Board. Board
convened on: ___________________________________________ |
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10. |
Separation
case received at: _________________________________ |
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11. |
Final
Disposition (Specify): _________________________________ |
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12. |
Service
member separated from the service. |
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13. |
Total
days required to process case. _________________________ |
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REMARKS |
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DA FORM 5138-R, JULY 84 EDITION OF OCT 82 IS OBSOLETE. |
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