Get USFJ Form 178-R 2013-2024

NONCOMBATANT EVACUATION OPERATIONS NEO CARD USFJ FORM 178-R Mark with an X USA USN SPONSOR S NAME Last First MI USMC DoD Civilian SPONSOR S SEX SPONSOR S DEROS DD Month YY Other SPONSOR S GRADE SPONSOR S DUTY TELEPHONE NUMBER SPONSOR S UNIT SPONSOR S SSN Last 4 SPONSOR S CONTACT TELEPHONE NUMBER Last First MI SEX SSN NONCOMBATANT LOCAL ADDRESS DATE OF BIRTH YYYY MM DD CITIZENSHIP RELATIONSHIP PASSPORT NUMBER EMERGENCY CONTACT AT DESINATION Name address telephone number and/or email address NAME ADDRESS TELEPHONE NUMBER OF PERSON WITH POWER OF ATTORNEY Only sole parent/EEC or dual military/EEC NAME OF SCHOOL ATTENDED BY CHILD NOTE If child is NOT DoD ENROLLED please provide NAME ADDRESS TELEPHONE NUMBER to school. MAKE AUTOMOBILE If applicable PETS TYPE OF PET MODEL WEIGHT OF PET In pounds YEAR LICENSE ADMIN USE ONLY Name MEDICAL NEEDS REMARKS Non-combatant s email address SPONSOR S SIGNATURE DATE YYYY MM DD PRIVACY ACT STATEMENT AUTHORITY Title 5 United States Code Section 301 Title 10 United States Code Section 3012 and Executive Order 9397. PRINCIPAL PURPOSE To assist the command in noncombatant evacuation operations by establishing a database of potential noncombatants during a contingency. ROUTINE USES Information recorded will provide commanders with information to assist in their contingency planning and operations by identifying noncombatants. MANDATORY AND VOLUNTARY DISCLOSURE AND EFFECT ON INDIVIDUAL NOT PROVIDING INFORMATION Disclosure of information is voluntary. There will be no adverse effect for not providing the information other than certain information that will not be available to commanders for contingency planning and operations. PRINCIPAL PURPOSE To assist the command in noncombatant evacuation operations by establishing a database of potential noncombatants during a contingency. ROUTINE USES Information recorded will provide commanders with information to assist in their contingency planning and operations by identifying noncombatants. ROUTINE USES Information recorded will provide commanders with information to assist in their contingency planning and operations by identifying noncombatants. MANDATORY AND VOLUNTARY DISCLOSURE AND EFFECT ON INDIVIDUAL NOT PROVIDING INFORMATION Disclosure of information is voluntary. MANDATORY AND VOLUNTARY DISCLOSURE AND EFFECT ON INDIVIDUAL NOT PROVIDING INFORMATION Disclosure of information is voluntary. There will be no adverse effect for not providing the information other than certain information that will not be available to commanders for contingency planning and operations. PRINCIPAL PURPOSE To assist the command in noncombatant evacuation operations by establishing a database of potential noncombatants during a contingency. ROUTINE USES Information recorded will provide commanders with information to assist in their contingency planning and operations by identifying noncombatants. MANDATORY AND VOLUNTARY DISCLOSURE AND EFFECT ON INDIVIDUAL NOT PROVIDING INFORMATION Disclosure of information is voluntary.