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ENLISTED PROMOTION SYSTEM
VOLUNTARY REDUCTION
NGMO-PER-E UNIT
SM’S REQUEST FOR REDUCTION (DA FORM 4187)
COMMANDER’S RECOMMENDATION ENDORSED BY BN AND BDE COMMANDERS
SM’S STATEMENT OF UNDERSTANDING (SEE DA 4856 FOR EXAMPLE)
ALL OTHER REQUIRED DOCUMENTATION IN ACCORDANCE WITH APPLICABLE REGULATIONS
Packet verified by:________________________________________________________ (Unit)
Packet verified by:________________________________________________________ (Enlisted Personnel)
PERSONNEL ACTION
To request or record personnel actions for or by Soldiers in accordance with DA PAM 600-8.
Identification Card
Identification Tags
Separate Rations
Leave - Excess/Advance/Outside CONUS
Change of Name/SSN/DOB
DATA REQUIRED BY THE PRIVACY ACT OF 1974
SECTION I - PERSONAL IDENTIFICATION
SECTION V - CERTIFICATION/APPROVAL/DISAPPROVAL
7. The above Soldier's duty status is changed from to
effective hours,
SECTION III - REQUEST FOR PERSONNEL ACTION
IS APPROVEDRECOMMEND APPROVAL IS DISAPPROVEDRECOMMEND DISAPPROVAL
SUPERSEDES DA FORM 4187, JAN 2000 AND REPLACES DA FORM 4187-1-R, APR 1995
DA FORM 4187, MAY 2014
HAS BEEN VERIFIED
AUTHORITY:PRINCIPAL PURPOSE:
DISCLOSURE:
Title 10, USC, Section 3013, E.O. 9397 (SSN), as amended
ROUTINE USES: The DoD Blanket Routine Uses that appear at the beginning of the Army's compilation of systems of records may apply to this system.
5. RANK/PMOS/AOC 6. SOCIAL SECURITY NUMBER
Special Forces Training/Assignment
Retesting in Army Personnel Tests
Reassignment Married Army Couples
Reclassification
Officer Candidate School
Asgmt of Pers with Exceptional Family Members
ROTC or Reserve Component Duty
Volunteering For Oversea Service
Ranger Training
Reassignment Extreme Family Problems
Airborne Training
12. COMMANDER/AUTHORIZED REPRESENTATIVE 13. SIGNATURE
For use of this form, see PAM 600-8; the proponent agency is DCS, G-1.
11. I certify that the duty status change (Section II) or that the request for personnel action (Section III) contained herein -
SECTION II - DUTY STATUS CHANGE (AR 600-8-6)
SECTION IV - REMARKS (Applies to Sections II, III, and V) (Continue on separate sheet)
8. I request the following action: (Check as appropriate)
4. NAME (Last, First, MI)
2. TO (Include ZIP Code) 3. FROM (Include ZIP Code)1. THRU (Include ZIP Code)
On-the-Job Training (Enl only)Service School (Enl only)
Exchange Reassignment (Enl only) Other (Specify)
9. SIGNATURE OF SOLDIER (When required) 10. DATE (YYYYMMDD)
14. DATE (YYYYMMDD)
Voluntary; however failure to provide Social Security Number may result in a delay or error in processing the request for personnel action.
APD LC v1.03ESPage 1 of 2
f. DATE (YYYYMMDD)e. RANK
i. COMMENTS
h. SIGNATUREg. TITLE/POSITION
d. NAME (Last, First, Middle)
b. FROMa. TO
AUTHORITY
APPROVED APPROVALRECOMMEND:DISAPPROVED DISAPPROVALc. ACTION:
c. ACTION: DISAPPROVALDISAPPROVED RECOMMEND: APPROVALAPPROVED
AUTHORITY
a. TO b. FROM
d. NAME (Last, First, Middle)
g. TITLE/POSITION h. SIGNATURE
i. COMMENTS
e. RANK f. DATE (YYYYMMDD)
f. DATE (YYYYMMDD)e. RANK
i. COMMENTS
h. SIGNATUREg. TITLE/POSITION
d. NAME (Last, First, Middle)
b. FROMa. TO
AUTHORITY
APPROVED APPROVALRECOMMEND:DISAPPROVED DISAPPROVALc. ACTION:
c. ACTION: DISAPPROVALDISAPPROVED RECOMMEND: APPROVALAPPROVED
16. SSN15. NAME OF INDIVIDUAL
AUTHORITY
a. TO b. FROM
d. NAME (Last, First, Middle)
g. TITLE/POSITION h. SIGNATURE
ADDENDUM - RECOMMENDATIONS FOR APPROVAL/DISAPPROVAL
APD LC v1.03ESPage 2 of 2DA FORM 4187, MAY 2014
i. COMMENTS
e. RANK f. DATE (YYYYMMDD)
Name (Last, First, MI) Rank Date of Counseling
Organization Name and Title of Counselor
Purpose of Counseling: (Leader states the reason for the counseling, e.g. Performance/Professional or Event-Oriented counseling, and includesthe leader's facts and observations prior to the counseling.)
Key Points of Discussion:
DEVELOPMENTAL COUNSELING FORMFor use of this form, see ATP 6-22.1; the proponent agency is TRADOC.
DATA REQUIRED BY THE PRIVACY ACT OF 1974AUTHORITY:PRINCIPAL PURPOSE:ROUTINE USES:
DISCLOSURE:
5 USC 301, Departmental Regulations; 10 USC 3013, Secretary of the Army.To assist leaders in conducting and recording counseling data pertaining to subordinates.The DoD Blanket Routine Uses set forth at the beginning of the Army's compilation of systems or records notices also apply to this system.Disclosure is voluntary.
PART I - ADMINISTRATIVE DATA
PART II - BACKGROUND INFORMATION
PART III - SUMMARY OF COUNSELINGComplete this section during or immediately subsequent to counseling.
OTHER INSTRUCTIONSThis form will be destroyed upon: reassignment (other than rehabilitative transfers) , separation at ETS, or upon retirement. For separation
requirements and notification of loss of benefits/consequences see local directives and AR 635-200.
PREVIOUS EDITIONS ARE OBSOLETE.DA FORM 4856, JUL 2014APD LC v1.03ES
Page 1 of 2
Plan of Action (Outlines actions that the subordinate will do after the counseling session to reach the agreed upon goal(s). The actions must bespecific enough to modify or maintain the subordinate's behavior and include a specified time line for implementation and assessment (Part IV below)
Individual counseled remarks:
Leader Responsibilities: (Leader's responsibilities in implementing the plan of action.)
Assessment: (Did the plan of action achieve the desired results? This section is completed by both the leader and the individual counseledand provides useful information for follow-up counseling.)
REVERSE, DA FORM 4856, JUL 2014
Session Closing: (The leader summarizes the key points of the session and checks if the subordinate understands the plan of action. Thesubordinate agrees/disagrees and provides remarks if appropriate.)
Individual counseled: I agree disagree with the information above.
Signature of Individual Counseled: Date:
Signature of Counselor: Date:
PART IV - ASSESSMENT OF THE PLAN OF ACTION
Individual Counseled: Date of Assessment:Counselor:
Note: Both the counselor and the individual counseled should retain a record of the counseling.
APD LC v1.03ESPage 2 of 2