PerFORM Communicator File Packet v 1.00 cc:\formflow\forms\A48:OAp: 2":C::a4187.fro\temp\df000000\a4187.fro8(Ta4187.fdb\temp\df000001\a4187.fdb3 example.dbfemp\df000001\example.dbf3  Wexample.dbtemp\df000001\example.dbt3mVexample.fdsemp\df000001\example.fds3}! DA Form 4187, JAN 2000Ruth Ann Coyner217C:\DRUCE\DRUCE\CAB4187.FPKLS~1\TEMPOR~1\OLK67\EXAMPLE.FPKC:\FORMFLOW\FORMS\C:\WINDOWS\TEMP\F000000\KDA Form 4187, JAN 200000r0?0xx 5,5"5 5^195*Q5|9;ࡱ> ERoot EntryRoot Entry` )H@fFContentsGbOccDataInTempoWorkflow   !"#$%&'()*+,-./0123456789:;<=>?@ABCDHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxSummaryInformation(YFBMacrosafafGeneralMacroStream(_uPNK}'Oh+'0)  ( 4 @ LX`hDA Form 4187, JAN 2000Ruth Ann CoynerPersonnel Action 217@t/e@@@ fG}48Dt >:  *  "-%<PP<<P- -%<PP<<P-.- #Univers (WN)-- 2 jPERSONNEL ACTION    #Univers (WN)--  2 ~ #Univers (WN)-- 2 ~YFor use of this form, see AR 600-8-6 and DA PAM 600-8-21; the proponent agency is ODCSPER       #Univers (WN)--  2 ~,  "Systemn--.- #Univers (WN)-#Univers (WN)-- 2 (Section III). --.- #Univers (WN)-- 2 kUsed by soldier in accordance with DA PAM 600-8-21 when requesting a personnel action on his/her own behalf      - -XX\\- -%<0<0<- -H-.- #Univers (WN)-- $2 eIdentification Card- -ll.- #Univers (WN)- - $2 yIdentification Tags-  -.- #Univers (WN)- - 2 Separate Rations-  -.- #Univers (WN)- - =2 $Leave - Excess/Advance/Outside CONUS    -  -.- #Univers (WN)- - (2 Change of Name/SSN/DOB   -  -%XXX- -%<tt<<t-.- #Univers (WN)- - I2 B,11. I certify that the duty status change  #Univers (WN)- - 2 H (Section II) #Univers (WN)- - I2 , or that the request for personnel action #Univers (WN)- - 2  (Section III) #Univers (WN)- - '2  contained herein - -  -%<<<-.- #Univers (WN)- - C2 `(DATA REQUIRED BY THE PRIVACY ACT OF 1974             -  -<<<-.- #Univers (WN)- - <2 P# SECTION II - DUTY STATUS CHANGE          #Univers (WN)-- 2 P (AR 600-8-6)   #Univers (WN)--  2  - -|<|||<<-.- #Univers (WN)-- <2 ~#SECTION I - PERSONAL IDENTIFICATION        - - <  ! <!<-.- #Univers (WN)-- +2  SECTION IV - REMARKS       #Univers (WN)-- j2 B(Applies to Sections II, III, and V) (Continue on separate sheet)    #Univers (WN)--  2  - -`<``u`<u<-.- #Univers (WN)-- L2 oK.SECTION V - CERTIFICATION/APPROVAL/DISAPPROVAL             --.- #Univers (WN)-- T2 B37. The above soldier's duty status is changed from --.- #Univers (WN)--  2 6to--.- #Univers (WN)-- 2  effective--.- #Univers (WN)-- 2 hours,- -0<00E0<E<-.- #Univers (WN)-- F2 ?a*SECTION III - REQUEST FOR PERSONNEL ACTION          --.- #Univers (WN)-- 2  IS APPROVED    --.- #Univers (WN)-- "2 RECOMMEND APPROVAL     --.- #Univers (WN)-- 2 >IS DISAPPROVED     --.- #Univers (WN)-- '2 RECOMMEND DISAPPROVAL      --.- #Univers (WN)-- 42 PREVIOUS EDITIONS ARE OBSOLETE        --.- #Univers (WN)-- (2 >DA FORM 4187, JAN 2000     --.- #Univers (WN)-- !2 hHAS BEEN VERIFIED    - -%<DDX<X<D-.- #Univers (WN)-- ?2 RB%8. I request the following action:  #Univers (WN)-- (2 R(Check as appropriate) #Univers (WN)--  2 R --.- #Univers (WN)-- 2 l USAPA V1.00--.- #Univers (WN)-- 2 B AUTHORITY:   --.- #Univers (WN)-- "2 BPRINCIPAL PURPOSE:     --.- #Univers (WN)-- 2 B DISCLOSURE:   --.- #Univers (WN)-- O2 0Title 5, Section 3012; Title 10, USC, E.O. 9397.       --.- #Univers (WN)-- 2 uVoluntary. Failure to provide social security number may result in a delay or error in processing of the request for   #Univers (WN)-- !2 personnel action.--.- #Univers (WN)-- 2 B ROUTINE USES:    --.- #Univers (WN)-- 2 RTo initiate the processing of a personnel action being requested by the soldier. -.- #Univers (WN)--.-   CG Times (WN)-  "- [MhZ[ZhM ---  -- - -l<l`.- #Univers (WN)--.-   CG Times (WN)-  "- oM|ZoZ|M ---  -- - -<`.- #Univers (WN)--.-   CG Times (WN)-  "- MZZM ---  -- - -<`.- #Univers (WN)--.-   CG Times (WN)-  "- MZZM ---  -- - -<`.- #Univers (WN)--.-   CG Times (WN)-  "- MZZM ---  -- - -<`.- #Univers (WN)--.-   CG Times (WN)-  "- MZZM ---  -- - -<`.- #Univers (WN)--.-   CG Times (WN)-  "- MZZM ---  -- - -%<X`X`<<X- -%-.- #Univers (WN)-- .2 5. GRADE OR RANK/PMOS/AOC     #Univers (WN)-- -%-.- #Univers (WN)-- .2 6. SOCIAL SECURITY NUMBER       #Univers (WN)-- -%<<<-.- #Univers (WN)-- 2 B 4. NAME  #Univers (WN)-- !2 (Last, First, MI) #Univers (WN)--  2  #Univers (WN)-- -}- -m- -%\|\|\-.- #Univers (WN)-- 2 (b2. TO  #Univers (WN)-- "2 ((Include ZIP Code) #Univers (WN)--  2 ( #Univers (WN)-- -%||-.- #Univers (WN)-- 2 ( 3. FROM  #Univers (WN)-- "2 ((Include ZIP Code) #Univers (WN)--  2 (C #Univers (WN)-- -1- -%<\\|<|<-.- #Univers (WN)-- 2 (B 1. THRU  #Univers (WN)- - "2 ((Include ZIP Code) #Univers (WN)-!-  2 ( #Univers (WN)-"-".- #Univers (WN)-"- :2 e"Special Forces Training/Assignment  -" -ll.- #Univers (WN)-"- '2 zOn-the-Job Training #Univers (WN)-#- 2 z (Enl only)#Univers (WN)-$-  2 z2 -$ -.- #Univers (WN)-$- 92 !Retesting in Army Personnel Tests  -$ -.- #Univers (WN)-$- 92 !Reassignment Married Army Couples    -$ -.- #Univers (WN)-$- 2 Reclassification-$ -.- #Univers (WN)-$- +2 Officer Candidate School -$ -.- #Univers (WN)-$- K2 -Asgmt of Pers with Exceptional Family Members      -$ -%XXX-.- #Univers (WN)-$- 2 fdService School #Univers (WN)-%- 2 f (Enl only)#Univers (WN)-&-  2 f -& -l`l\.- #Univers (WN)-&- 42 ydROTC or Reserve Component Duty  -& -`\.- #Univers (WN)-&- 72 d Volunteering For Oversea Service -& -`\.- #Univers (WN)-&- 2 dRanger Training-& -`\.- #Univers (WN)-&- =2 d$Reassignment Extreme Family Problems    -& -`\.- #Univers (WN)-&- *2 dExchange Reassignment  #Univers (WN)-'- 2  (Enl only)#Univers (WN)-(-  2 * -( -`\.- #Univers (WN)-(- !2 dAirborne Training -( -%`X\X\``X-.- #Univers (WN)-(-(.-   CG Times (WN)-(  "-) [mhz[zhm --- ) -- -( -l\l.- #Univers (WN)-(-(.-   CG Times (WN)-(  "-) om|zoz|m --- ) -- -( -\.- #Univers (WN)-(-(.-   CG Times (WN)-(  "-) mzzm --- ) -- -( -\.- #Univers (WN)-(-(.-   CG Times (WN)-(  "-) mzzm --- ) -- -( -\.- #Univers (WN)-(-(.-   CG Times (WN)-(  "-) mzzm --- ) -- -( -\.- #Univers (WN)-(-(.-   CG Times (WN)-(  "-) mzzm --- ) -- -( -\.- #Univers (WN)-(-(.-   CG Times (WN)-(  "-) mzzm --- ) -- -( -%\XX\\X-.- #Univers (WN)-(-(.-   CG Times (WN)-(  "-) [h[h --- ) -- -( -ll.- #Univers (WN)-(-(.-   CG Times (WN)-(  "-) o|o| --- ) -- -( -.- #Univers (WN)-(-(.-   CG Times (WN)-(  "-)  --- ) -- -( -.- #Univers (WN)-(-(.-   CG Times (WN)-(  "-)  --- ) -- -( -.- #Univers (WN)-(-(.-   CG Times (WN)-(  "-)  --- ) -- -( -%XXX- -%-.- .-   CG Times (WN)-(  "-)  --- ) -- -( -%-.- #Univers (WN)-(- 2 Other #Univers (WN)-)- 2  (Specify)#Univers (WN)-*-  2  -* -%< < <-.- #Univers (WN)-*#Univers (WN)-+- 02 B9. SIGNATURE OF SOLDIER        #Univers (WN)-,- 2 (When required) #Univers (WN)---  2 f #Univers (WN)-.-. -%<  `<`< - -%NaaNN-.- .-   #Univers (WN)-.  "-/ Q^^Q --- / -- -. -%-.- .-   #Univers (WN)-.  "-/    --- / -- -. -%-.- .-   #Univers (WN)-.  "-/  --- / -- -. -%-.- .-   #Univers (WN)-.  "-/  --- / -- -. -%$77$$-.- .-   #Univers (WN)-.  "-/ '44' --- / -- -. -%<<<-.- #Univers (WN)-.- C2 B(12. COMMANDER/AUTHORIZED REPRESENTATIVE         #Univers (WN)-/#Univers (WN)-0-0 -%-.- #Univers (WN)-0- 2 13. SIGNATURE   #Univers (WN)-1#Univers (WN)-2-2.- #Univers (WN)-2- @2 7&Circle the appropriate copy designator -2.- #Univers (WN)-2- 2 HCopy 1 -2.- #Univers (WN)-2- 2 HCopy 2 -2.- #Univers (WN)-2- 2 HBCopy 3 -2.- #Univers (WN)-2- 2 HCopy 4 -2 -x- -%  -.- #Univers (WN)-2- 2  10. DATE  #Univers (WN)-3- 2  (YYYYMMDD) #Univers (WN)-4#Univers (WN)-5-5 -%-.- #Univers (WN)-5- 2  14. DATE  #Univers (WN)-6- 2 8 (YYYYMMDD) #Univers (WN)-7#Univers (WN)-8#Univers (WN)-9-9?o '' ' '''' W '' FormFlow 0.3x1.166600/00+ 1/10ʾ 1/1  a  10 10: 10:37 10:37a0000000,0000000 0.50.5, 0.5,4.9996FormFlow 2.0688%2%2 TOUlt @. FROMlt @. NAMElt @. <GRADEt @. <DUTY_FROM @. <DUTY_TO4 @. <EFFECITIVE@. HOURSTIVE @.  THRUlt @. SSNEt @. .2.2.2.2--TYPACT_A@ /2! /2 /2/2 TYPACT_B@ j! j jj TYPACT_C@ .j! .j DjDj TYPACT_D@ jj!jj0 jj OTHERY @. $j@$j :j:j[TYPACT_D]=1SOLDR_SIGN @. <REMARKS @. BEEN_VER@ jj>j(([BEEN_VER]=0)&([REC_APPROV]=0)&([REC_DISAPP]=0)&([IS_APPROV]=0))CMD_AUTH @. <CMD_SIGN @. <YEARTIVE@.  SOLDR_DATE @. "j"j8j8jCMD_DATE @. *j*j@j@jdBASESwiss"Univers (E1)"Univers (WN)"Courier1Modern2Arial"CG Times (E1)CG Times (WN)RomanUnivers (W1)"CG Times (W1)Univers"CG TimesYa2?'$?'ϵ\KhC?_K?WUUШS'XUs^U P'XЈsUeUgS G_qUWG_G_(.UU2 Đ\^?'?U?'? ј^ip"U^?lRsVS18cԔp )D[()\KhC&1$B&2X11$Bs&2XW1a  ~j|L2~jL2PERSONNEL ACTION For use of this form, see AR 600-8-6 and DA PAM 600-8-21; the proponent agency is ODCSPER  єpX ju2ju2 (Section III).єpX jo|2j|2Used by soldier in accordance with DA PAM 600-8-21 when requesting a personnel action on his/her own behalf!cw1a 1O|&X^1X;ys-EQ1X  DUTY_TO4  x?BwX1X3Xx? !X1  jjffGGGG(DGDG&G&GIdentification CardIdentification TagsSeparate RationsLeave - Excess/Advance/Outside CONUSChange of Name/SSN/DOB1&X1X j&2j&211. I certify that the duty status change (Section II) or that the request for personnel action (Section III) contained herein - 1sH&WXd1X j,2j2DATA REQUIRED BY THE PRIVACY ACT OF 19741kO|&X1a  ,j?޼2,j޼2 SECTION II - DUTY STATUS CHANGE (AR 600-8-6) 1+:J&X1a  j'2j2SECTION I - PERSONAL IDENTIFICATION1߄h&X1a  jj2j2 SECTION IV - REMARKS (Applies to Sections II, III, and V) (Continue on separate sheet) 1&X1a  j242j42SECTION V - CERTIFICATION/APPROVAL/DISAPPROVAL1،lGa&,8X Pj7*2Pj*27. The above soldier's duty status is changed from،a,8X j*2j*2to}6s!EMQX Zj2Zj2effective 3sEQX j2j2hours,1&^Xj1a  j.@2j@2SECTION III - REQUEST FOR PERSONNEL ACTIONnD~X |j|jIS APPROVED4%X jjRECOMMEND APPROVALXX jhjhIS DISAPPROVED$^U?_&WtпU?_"ζ jU:ΔS|U!S2!UϦS|UU?'?Θ^ipU^^\?l\kG\\\U8 d1\G\ 1j$^U?_&WtпU?_"ζ FX,X LjLjRECOMMEND DISAPPROVALvB @" X j"&j&PREVIOUS EDITIONS ARE OBSOLETE1@"& X  j.j.DA FORM 4187, JAN 2000VTf@X :j~6:j~6HAS BEEN VERIFIED1&jXw1XjK:>j:>8. I request the following action: (Check as appropriate) Vk' X$X jbFjbFUSAPA V1.001Hє&dp jNjNAUTHORITY:1єZ&p} jUjUPRINCIPAL PURPOSE:1l& j]j]DISCLOSURE:HєdXp *j46e*j6eTitle 5, Section 3012; Title 10, USC, E.O. 9397.l~X j0mj0mVoluntary. Failure to provide social security number may result in a delay or error in processing of the request for personnel action.1l& jujuROUTINE USES:lX jV}j}To initiate the processing of a personnel action being requested by the soldier. 1`Oc&w<3X3X 1 `O!&<3TYPACT_A njnjXQJ(gk1X  GRADE jʅjʅ 5. GRADE OR RANK/PMOS/AOC (gJkX1X  SSNE jj 6. SOCIAL SECURITY NUMBER 1JXQk&1X  NAME j,jjj 4. NAME (Last, First, MI)  sJEQ1X  EFFECITIVE  5LsE$Q1X  HOURSTIVE  ~+:1X  TOU "j+T"jT 2. TO (Include ZIP Code) ~+:X1X  FROM 02-<02< 3. FROM (Include ZIP Code) vB،a,81X  DUTY_FROM  1~+:&1X  THRU L32-(L32( 1. THRU (Include ZIP Code) =!cw1X3X=!!221  4242&/%%tt@P@PV V t1tSpecial Forces Training/AssignmentOn-the-Job Training (Enl only) Retesting in Army Personnel TestsReassignment Married Army CouplesReclassificationOfficer Candidate SchoolAsgmt of Pers with Exceptional Family Members`Oc<w1X3X`O <1  v72v72*ΉjΉj"̇̇ʈj$ʈj j| j| j(4 j4j1jj j Service School (Enl only) ROTC or Reserve Component DutyVolunteering For Oversea ServiceRanger TrainingReassignment Extreme Family ProblemsExchange Reassignment (Enl only) Airborne Training=cw1X3X !=221TYPACT_B ::2::2!x?Bw1X3X !!x?321TYPACT_C ;2;2!Bx?c1X TYPACT_D  x?BcX1X  OTHERY  >2!.' >2.' Other (Specify) 1c!߄&1X  SOLDR_SIGN ?2A/?2/ 9. SIGNATURE OF SOLDIER (When required) 1h&X1X  REMARKS  ~@]P1=1X BEEN_VER  \;1X REC_APPROV  $^U?_&WtпU?_"ζ @2U:ΔS|U!S2!UϦS|UU?'?Θ^ipU^^\?l\kG\\\U8 d1\G\ 1$^U?_&WtпU?_"ζ y)1X REC_DISAPP  0u@1X IS_APPROV  Ę1X IS_DISAPP  1XQ&1X  CMD_AUTH E2.7E27 12. COMMANDER/AUTHORIZED REPRESENTATIVE XQ(g1X  CMD_SIGN F2?F2? 13. SIGNATURE 1!1&X%1 BG2*FBG2FCircle the appropriate copy designatorԔ1 $Bq%21 G2NG2NCopy 1le the)1$B%,21 H2VVH2VVCopy 2le the|1!$BR%21 $I2^$I2^Copy 3le thePS1$B% 21 I2eI2eCopy 4le the8 s+EMQ1X  YEARTIVE  !c߄X1X  SOLDR_DATE nK2$lmnK2lm 10. DATE (YYYYMMDD) (gX1X  CMD_DATE dL2%FudL2Fu 14. DATE (YYYYMMDD) PerForm Pro DEFDB 2.01C:\WINDOWS\TEMP\DF000001\EXAMPLE.DBFPrimary DatabasedBASEi%THRUCTOCFROMCNAMEC<GRADEC<SSNC DUTY_FROMC<DUTY_TOC<EFFECITIVENHOURSC YEARNTYPACT_ALTYPACT_A2LTYPACT_A3LTYPACT_A4LTYPACT_A5LTYPACT_A6LTYPACT_A7LTYPACT_BLTYPACT_B2LTYPACT_B3LTYPACT_B4LTYPACT_B5LTYPACT_B6LTYPACT_B7LTYPACT_CLTYPACT_C2LTYPACT_C3LTYPACT_C4LTYPACT_C5LTYPACT_DLOTHERC;SOLDR_SIGNC<SOLDR_DATEC REMARKSM BEEN_VERLREC_APPROVLREC_DISAPPLIS_APPROVLIS_DISAPPLCMD_AUTHC<CMD_SIGNC<CMD_DATEC Commander 13th COSCOM Fort Hood, Texas 76544 Commander III Corps and Fort Hood Fort Hood, Texas 76544 (Soldier's Unit Example) Commander HHC, 13th COSCOM Fort Hood, Texas 76544 Doe, John 1LT/42B 123-45-6789 YCombat Action Badge (Soldier Signature Required) 20050815 0000000001NYNNN(Company/ BN Commander) (CO Signature) 20059999 EXAMPLE1. Request that 1LT John Doe be awarded the Combat Action Badge for personally (engaging or being engaged) by the enemy 2. The following information is provided: a. Date of Incident b. Location of Incident c. See narrativeForm DataBase Set FiledBASEDBEDBASE.DLLK C:\WINDOWS\TEMP\DF000001\EXAMPLE.DBFC:\WINDOWS\TEMP\DF000001\EXAMPLE.DBF