AETV - _____ (635-200)
SUBJECT: Revocation of Approved Separation UP AR 635-200, Chapter 14, paragraph 14-2b.
FOR SPC ______________________
1. On DD MM CY, I approved your discharge IAW AR 635-200, Chapter 14, paragraph 14-12b but suspended execution of your discharge for a period of 90 days to evaluate your performance and potential for rehabilitation. Your suspension period ends on DD MM YY.
2. In light of your recent misconduct as evidenced by your willful disobedience to a lawful order issued by your Company Commander which resulted in your punishment under Field Grade Article 15 procedures, I intend to vacate the suspension of your approved discharge.
3. You may submit matters in extenuation and mitigation for me to consider before I make the decision to vacate the suspension of your approved discharge. You will have three working days following receipt of this notification to submit any matters for consideration before I act. I suggest your consult with your Trial Defense Attorney during this period. Any request for additional time to gather matters will be submitted in writing to my office.
4. Execute the attached acknowledgment and return it to my office no later than 1700, DD MM YY.
ACKNOWLEDGMENT OF RECEIPT OF NOTIFICATION _____________________________________________________________________________
I, _________________ hereby acknowledge receipt of notification of intended revocation of suspension at ____ hours, on DD MM YY.