Get NAVPERS 1336/3 2005

9397 DEPARTMENTAL REGULATIONS. THE PRINCIPLE PURPOSE OF THE INFORMATION IS TO ENABLE YOU TO MAKE KNOW 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. COMPLETION OF THE FORM IS MANDATORY FAILURE TO PROVIDE REQUIRED INFORMATION MAY RESULT IN DELAY IN RESPONSE TO OR DISAPPROVAL OF YOUR REQUEST. NAME SSN LAST 4 DIGITS RATE SHIP OR STATION DATE OF REQUEST DEPARTMENT/DIVISION DUTY SECTION/GROUP LEAVE SPECIAL LIBERTY NO. SPECIAL REQUEST/AUTHORIZATION SUPPORTING DIRECTIVE MILPERSMAN ARTICLES 1810-010 AND 1810-040 PRIVACY ACT STATEMENT THE AUTHORITY TO REQUEST THIS INFORMATION IS CONTAINED IN 5 USC 301 AND FRIM E.O. 9397 DEPARTMENTAL REGULATIONS. THE PRINCIPLE PURPOSE OF THE INFORMATION IS TO ENABLE YOU TO MAKE KNOW 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. COMPLETION OF THE FORM IS MANDATORY FAILURE TO PROVIDE REQUIRED INFORMATION MAY RESULT IN DELAY IN RESPONSE TO OR DISAPPROVAL OF YOUR REQUEST. 9397 DEPARTMENTAL REGULATIONS* THE PRINCIPLE PURPOSE OF THE INFORMATION IS TO ENABLE YOU TO MAKE KNOW 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. COMPLETION OF THE FORM IS MANDATORY FAILURE TO PROVIDE REQUIRED INFORMATION MAY RESULT IN DELAY IN RESPONSE TO OR DISAPPROVAL OF YOUR REQUEST. NAME SSN LAST 4 DIGITS RATE SHIP OR STATION DATE OF REQUEST DEPARTMENT/DIVISION DUTY SECTION/GROUP LEAVE SPECIAL LIBERTY NO. OF DAYS REQUESTED FROM DATE AND TIME DISTANCE MILES MODE OF TRAVEL COMMUTED RATIONS CAR AIR LEAVE ADDRESS SIGNATURE OF APPLICANT I AM ELIGIBLE AND OBLIGATE MYSELF TO PERFORM ALL DUTIES OF PERSON MAKING APPLIZATION* SIGNATURE OF STANDBY DUTY STATION RECOMMENDED APPROVAL SIGNATURE AND RANK/RATE/TITLE/DATE NO YES SIGNATURE APPROVED REASON FOR DISAPPROVAL NAVPERS 1336/3 REV. 08-05 TRAIN BUS TELEPHONE NUMBER REASON FOR REQUEST OTHER BELOW S/N 0106-LF-130-0400 FOR OFFICIAL USE ONLY PRIVACY SENSITIVE. COMPLETION OF THE FORM IS MANDATORY FAILURE TO PROVIDE REQUIRED INFORMATION MAY RESULT IN DELAY IN RESPONSE TO OR DISAPPROVAL OF YOUR REQUEST. NAME SSN LAST 4 DIGITS RATE SHIP OR STATION DATE OF REQUEST DEPARTMENT/DIVISION DUTY SECTION/GROUP LEAVE SPECIAL LIBERTY NO. NAME SSN LAST 4 DIGITS RATE SHIP OR STATION DATE OF REQUEST DEPARTMENT/DIVISION DUTY SECTION/GROUP LEAVE SPECIAL LIBERTY NO. OF DAYS REQUESTED FROM DATE AND TIME DISTANCE MILES MODE OF TRAVEL COMMUTED RATIONS CAR AIR LEAVE ADDRESS SIGNATURE OF APPLICANT I AM ELIGIBLE AND OBLIGATE MYSELF TO PERFORM ALL DUTIES OF PERSON MAKING APPLIZATION* SIGNATURE OF STANDBY DUTY STATION RECOMMENDED APPROVAL SIGNATURE AND RANK/RATE/TITLE/DATE NO YES SIGNATURE APPROVED REASON FOR DISAPPROVAL NAVPERS 1336/3 REV. .