Early Active Duty Release Request Form
Use this form to request early release from active duty and provide the information needed for review.
Requestor Information
Full Name
*
First Name
Last Name
Rank / Grade
*
Branch / Component
*
Please Select
Army
Navy
Air Force
Marine Corps
Space Force
Coast Guard
National Guard
Reserve Component
Other
Unit / Command
*
Preferred Contact Email or Phone
*
Release Request Details
Requested Early Release Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Current Active Duty Status or Duty Station
Reason for Requesting Early Active Duty Release
*
Supporting Documentation and Acknowledgment
Supporting Documents
*
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of
Acknowledgment
*
I certify that the information provided is accurate and complete, and I understand this request will be reviewed.
Other
Additional Information
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