[Today’s Date]



Army Review Boards Agency

Army Grade Determination Review Board

251 18th Street South, Suite 385

Arlington, VA 22202-3531



Subject:  Application for Army Grade Determination Review Board



I request to be advanced on the retired list to the highest grade that I held satisfactorily while on active duty, under the provisions of Title 10, United States Code, Section 3964.  Although I retired on ____ (date) in the grade of ____ (examples:  E-4, E-5, W-1, W-2), I previously held the grade of ____ (examples:  E-8, E-9, W-4, W-5, O-2, O-3) while on active duty.  According to my calculation, I have a total of 30 years of time in Active service and on the retired list (periods of inactive Reserve or Guard time cannot be used in your calculation).


In support of this request, I provide the following information:

My full name is:  ____________________________ (example:  John Q. Public, Jr.)

My social security number is:  _________________  (example:  000-00-0000)

My service number (if applicable) was:  _________   (example:  RA 00-000-000)

My mailing address is:  ______________________  (provide complete address and zip code)

[Optional:  If you need to contact me,

            you may call me at __________________  (provide a area code and telephone number)

            or use my email address ___________________________


[Optional:  You may wish to explain your situation.  Some examples are:


(1) While I was in the National Guard, I accepted a voluntary administrative reduction (without prejudice) to fill a full-time position;


(2)  My reduction was caused by a break in service; or


(3) I was subjected to the reduction in force program and reverted to my enlisted or warrant status.]



I understand that Army Regulation 15-80 states, “Generally, service in a grade will not be considered to have been satisfactory when reversion to a lower grade was expressly for prejudice or cause, due to misconduct, caused by nonjudicial punishment pursuant to Article 15, UCMJ, or the result of the sentence of a court-martial.”  However, I believe the Army Grade Determination Review Board should advance me on the retired list to the grade of ____ (examples:  E-6, E-7) because (state your reason(s)].




                                                YOU MUST SIGN YOUR LETTER