ࡱ> '` bjbjDD \&&EvvvvVVV$z$$$$Z%z>22&))))E.#12=======$?h?B=V6Q-E.66=vv))_>7776.v)V)=76=77:@V\:)&& ">$)7^(:|:<u>0>0:,B7B\:BV\: 3I4|74d)5333==7333>6666zzzD$zzz$zzzvvvvvv LEAVE REQUEST/AUTHORIZATION NAVCOMPT FORM 3065 (3PT) (REV. 2-83) 1. DATE OF REQUEST  FORMTEXT      2. FOR ADMIN. USE ONLY APPROVAL OF THIS LEAVE IS NOT VALID WITHOUT CONTROL NO, FORMTEXT      3. SSN  FORMTEXT      4. NAME (Last, First, MI)  FORMTEXT      5. PAY GRADE  FORMTEXT      6. SHIP/STATION  FORMTEXT      7. DEPT/DIV  FORMTEXT      8. DUTY SECTION  FORMTEXT      9. DUTY PHONE  FORMTEXT      10. TYPE LEAVE  FORMCHECKBOX  REGULAR  FORMCHECKBOX  SICK  FORMCHECKBOX  EMERGENCY  FORMCHECKBOX  SEPARATION  FORMCHECKBOX  RETIREMENT  FORMCHECKBOX  OTHER  FORMTEXT       FORMTEXT      FOR USE OUTUS ONLY12. MODE OF TRAVEL  FORMCHECKBOX  AIR  FORMCHECKBOX  BUS  FORMCHECKBOX  CAR  FORMCHECKBOX  TRAIN11a. Leaving Area of PERMDUSTA  FORMCHECKBOX  YES  FORMCHECKBOX  NO11b. Taking Leave INCONUS  FORMCHECKBOX  YES  FORMCHECKBOX  NO13. DAYS REQUESTED  FORMTEXT      14. FROM (Hour, Date) (YYMMDD)  FORMTEXT        FORMTEXT      15. TO (Hour, Date) (YYMMDD)  FORMTEXT        FORMTEXT      16. NORMAL WORKING HOURS DAY OF DEPARTURE:  FORMTEXT       FROM:  FORMTEXT       TO:  FORMTEXT       DAY OF RETURN:  FORMTEXT       FROM:  FORMTEXT       TO:  FORMTEXT      17. LEAVE BALANCE  FORMTEXT       DAYS AS OF  FORMTEXT      18. LEAVE USED THIS FY  FORMTEXT      19. LEAVE PHONE ( FORMTEXT      )  FORMTEXT      - FORMTEXT      20. LEAVE ADDRESS  FORMTEXT        FORMTEXT        FORMTEXT      21. RATION STATUS (Enlisted)  FORMCHECKBOX  COMMUTED RATIONS (COMRATS)  FORMCHECKBOX  Meal Pass No.  FORMTEXT       FORMTEXT       Entitled to EDF meals except during periods of leaveI CERTIFY THAT I HAVE SUFFICIENT FUNDS TO COVER THE COST OF ROUND TRIP TRAVEL. I UNDERSTAND THAT SHOULD ANY PORTION OF THIS LEAVE, IF APPROVED, RESULT IN MY TAKING MORE LEAVE THAN I CAN EARN ON MY CURRENT UN-EXTENDED ENLISTMENT OR CURRENT ACTIVE DUTY OBLIGATION, MY PAY WILL BE CHECKED FOR SUCH EXCESS LEAVE.22. SIGNATURE OF APPLICANTRECOMMENDED   FORMCHECKBOX  YES  FORMCHECKBOX  NODATE  FORMCHECKBOX  YES  FORMCHECKBOX  NO  FORMCHECKBOX  YES  FORMCHECKBOX  NO  FORMCHECKBOX  YES  FORMCHECKBOX  NO23. APPROVED DISAPPROVED  FORMCHECKBOX   FORMCHECKBOX 24. COMMENTS/REMARKS CDO Pager: 241-7795 CDO CELL: 564-4446 Q-DECK: 791-261325. SHIP OR STATION (Including telegraphic address) NSGA Fort Gordon Fort Gordon, GA 30905 COMM: (706) 791-2613 DSN: 780-2613 26. REPORT ON EXPIRATION OF LEAVE TO (if other than block 25)DEPARTED ON LEAVERETURNED FROM LEAVEGRANTED EXTENSION OF LEAVE ENDING27a. HOUR 27b. DATE (*YYMMDD) 28a. HOUR 28b. DATE (*YYMMDD) 29a. HOUR 29b. DATE (*YYMMDD) 27c. OODS SIGNATURE28c. OODS SIGNATURE29c. OODS SIGNATURE IN CONSIDERATION OF THE MEMBERS COMPLETION OF A FULL WORKDAY (AS DEFINED IN MILPERSMAN, NAVPERS 15560) ON THE DAYS OF DEPARTURE AND RETURN, THE INCLUSIVE DAYS SHOWN ARE CORRECT AND PROPER FOR CHARGING AS LEAVE.30. INCLUSIVE LEAVE PERIOD TO BE CHARGED FIRST: (YY) (MM) (DD)LAST: (YY) (MM) (DD)31. NO. OF DAYSI CERTIFY THAT THE ABOVE IS CORRECT AND PROPER TO THE BEST OF MY KNOWLEDGE.32. CERTIFYING OFFICER S TYPED NAME/RANK/TITLE  FORMTEXT      33. CERTIFYING OFFICER S SIGNATUREFORWARD THIS COPY TO PERSONNEL OFFICE VIA COMMAND ONLY ON COMPLETION OF LEAVE. S/N 0104-LF-703-0656 PART 1  1. Completion of this form must be in ballpoint or typewriter. The form must be completed in triplicate with all copies legible. 2. Print or type the appropriate date in block 1 and 3 through 21. Leave block 2 blank. 3. When completing blocks 14 and 15, follow these rules: a. Block 14 - The hour for starting leave may not be prior to the end of your normal workaday if leave starts on a workday. Of leave starts on a non-workday, the starting hour may be 0001 if not contrary to command policy. b. Block 15 - The hour for ending<  ¶{eUIe¶3*jhLCJOJQJU^JmHnHuhLCJOJQJ^JjhLCJOJQJU^J*jhLCJOJQJU^JmHnHu%jhLCJOJQJU^JhLCJOJQJ^JjhLCJOJQJU^JhLCJ OJQJ^JhLCJOJQJ^JhLCJOJQJ^JhL5CJOJQJ\^JhL5CJOJQJ\^JhLjhLCJUmHnHu< d  qkd$$Ifl4FY*a 06    4 laf4$If { b x  4 ˜}q^}H}q*jhLCJOJQJU^JmHnHu%jhLCJOJQJU^JhLCJOJQJ^JjhLCJOJQJU^JhL5CJOJQJ\^J&jhLOJQJU^JmHnHu!jthLOJQJU^JhLOJQJ^JjhLOJQJU^JhLCJOJQJ^JhL5CJOJQJ\^JhLCJOJQJ^J 8 ` | 2 T | ull $$Ifa$kd+$$Ifl4F> p#* 2,06    4 laf4$If 4 8 : N P R \ ^ ` h z | ~ ᝑrՑ_Ց%jhLCJOJQJU^J%jhLCJOJQJU^JhLCJOJQJ^JhLCJOJQJ^JhL6CJOJQJ]^J*jhLCJOJQJU^JmHnHu%jChLCJOJQJU^JhLCJOJQJ^JjhLCJOJQJU^JhL6CJOJQJ]^J " $ . 0 2 : R T V j l n x z | ܺܺܺܺ|ܺp]%jhL5CJOJQJU\^JhLCJOJQJ^J%jThLCJOJQJU^J%jhLCJOJQJU^JhLCJOJQJ^JhLCJOJQJ^JhLCJOJQJ^J*jhLCJOJQJU^JmHnHujhLCJOJQJU^J%jlhLCJOJQJU^J b\$Ifkd$$Ifl4\F*t 064 laf4$If   ( * F H J v x  ( * F ȼȼzȼjWjj%j{hLCJOJQJU^JjhLCJOJQJU^J+jhL5CJOJQJU\^J+jhL5CJOJQJU\^J+jhL5CJOJQJU\^JhLCJOJQJ^J%jhL5CJOJQJU\^J+jhL5CJOJQJU\^JhL5CJOJQJ\^JF H J X Z n p r | оpl`PDhLCJOJQJ^JjhLCJOJQJU^JhLCJOJQJ^JhL(j hL>*CJOJQJU^J-jhL>*CJOJQJU^JmHnHu(jc hL>*CJOJQJU^JhL>*CJOJQJ^J"jhL>*CJOJQJU^JhLCJOJQJ^JjhLCJOJQJU^J%jhLCJOJQJU^J   "#1239:HIJ^_mnovнЪЗЋ{h{{U{{%j hLCJOJQJU^J%j hLCJOJQJU^JjhLCJOJQJU^JhLCJOJQJ^J%j hLCJOJQJU^J%j9 hLCJOJQJU^J%j hLCJOJQJU^JhLCJOJQJ^JjhLCJOJQJU^J%jO hLCJOJQJU^J 89vwxsj $$Ifa$kd% $$Ifl4F*`! ` 06    4 laf4$If()yssjs $$Ifa$$Ifkd $$Ifl4F* !   06    4 laf4"#$/=>?IJ  JLNbdfpr|~нбСlбСYlMhLCJOJQJ^J%j,hLCJOJQJU^J*jhLCJOJQJU^JmHnHu%jhLCJOJQJU^JhLCJOJQJ^JjhLCJOJQJU^JhLCJOJQJ^J%jYhLCJOJQJU^JhLCJOJQJ^JjhLCJOJQJU^J%jhLCJOJQJU^J)*>L8lHJysjsjsjsssss $$Ifa$$Ifkd$$Ifl4F* !   06    4 laf4 &(*468Bܺܖܺܖpܺ`M`%jhLCJOJQJU^JjhLCJOJQJU^J%jhLCJOJQJU^J%jhLCJOJQJU^JhLCJOJQJ^JhLCJOJQJ^JhLCJOJQJ^JhLCJOJQJ^J*jhLCJOJQJU^JmHnHujhLCJOJQJU^J%jhLCJOJQJU^J   "68:DFHJXrxzζΣζΐζ}ζj%jhLCJOJQJU^J%jfhLCJOJQJU^J%jhLCJOJQJU^J%jzhLCJOJQJU^JhLCJOJQJ^JhLCJOJQJ^JhLCJOJQJ^JjhLCJOJQJU^J*jhLCJOJQJU^JmHnHu)J "H(`W $$Ifa$kd$$Ifl4X\*7   064 laf4$If ,FHJ^`blnpͮ͞i͞Vi%j0hLCJOJQJU^J*jhLCJOJQJU^JmHnHu%jhLCJOJQJU^JhLCJOJQJ^JjhLCJOJQJU^J%jRhLCJOJQJU^JhLCJOJQJ^JhLCJOJQJ^J*jhLCJOJQJU^JmHnHujhLCJOJQJU^J!&(*,@BDNPTVjlnxz|~؄q^%jhLCJOJQJU^J%jhLCJOJQJU^J%jhLCJOJQJU^JhLCJOJQJ^JhLCJOJQJ^J*jhLCJOJQJU^JmHnHu%jhLCJOJQJU^JhLCJOJQJ^JjhLCJOJQJU^JhLCJOJQJ^J$Fj`kd~$$Ifl4X\ *     064 laf4$If   468BDF|lYlMlhLCJOJQJ^J%jhLCJOJQJU^JjhLCJOJQJU^JhLCJOJQJ^JhLCJOJQJ^J%jHhLCJOJQJU^J%jhLCJOJQJU^J*jhLCJOJQJU^JmHnHu%j\hLCJOJQJU^JhLCJOJQJ^JjhLCJOJQJU^J246@DXZ\fhvĸmXmĸĸĸB*jhLCJOJQJU^JmHnHu(j hL>*CJOJQJU^J-jhL>*CJOJQJU^JmHnHu(jhL>*CJOJQJU^JhL>*CJOJQJ^J"jhL>*CJOJQJU^JhLCJOJQJ^JhLCJOJQJ^JhLCJOJQJ^JjhLCJOJQJU^J%j4hLCJOJQJU^J$Ifskd$$Ifl4%0*B 064 laf4}}$If $$Ifa$skde$$Ifl40b*:064 laf4   '()9:HIJMQRSabcstزئؓ؀ئmZ%j@#hLCJOJQJU^J%j"hLCJOJQJU^J%ju!hLCJOJQJU^J%j hLCJOJQJU^JhLCJOJQJ^J%jhLCJOJQJU^J%j4hLCJOJQJU^JhLCJOJQJ^JjhLCJOJQJU^JhLCJOJQJ^J#NOPyppjj$If $$Ifa$kd $$Ifl4F "* a06    4 laf4PQRyppjj$If $$Ifa$kd!$$Ifl4F "* a06    4 laf4yppjj$If $$Ifa$kd#$$Ifl4F "* a06    4 laf4!"#$,=v| FGYqmhLhL5CJOJQJ\^J%j&hLCJOJQJU^J%j`&hLCJOJQJU^JhLCJOJQJ^J%j %hLCJOJQJU^J%j$hLCJOJQJU^JjhLCJOJQJU^JhLCJOJQJ^JhLCJOJQJ^J*$%&yssss$Ifkd%$$Ifl4F "* a06    4 laf4&'=Qdvyssss$IfkdL'$$Ifl4F "* a06    4 laf4vwF$If`kd+($$Ifl4*+064 laf4FGYm$If$Ifpkd($$Ifl0*064 layssssssssssss$Ifkd)$$Ifl4F D*XXX06    4 laf4 %,=?./E\by~8:NPR\^`j趪҇{lhL5CJOJQJ\^JhLCJOJQJ^JjhLCJOJQJU^J%j0hLCJOJQJU^JhLCJOJQJ^JjhLCJOJQJU^JhLCJOJQJ^J*jhLCJOJQJU^JmHnHuhLCJOJQJ^JhLCJOJQJ^J*&<=>@:::::$IfkdN*$$Ifl4Eֈ Dp#*,,,,,,064 laf4>?!.5>E\byysssssssssss$Ifkd)+$$Ifl4EF D*XXX06    4 laf4 SMMMMMMM$Ifkd+$$Ifl4r^b&*`XY`064 laf48`HJniid$a$$a$kd0$$Ifl4F[ * 06    4 laf4Ff.$If HJ"v{{{{||||~||³j^ZN?hL5CJOJQJ\^JhLCJOJQJ^JhLhLCJOJQJ^J*jhLCJOJQJU^JmHnHuhLCJOJQJ^JUhLCJOJQJ^J0jhL5CJOJQJU\^JmHnHuhL5CJOJQJ\^JhL5CJOJQJ\^JhL5CJ OJQJ\^JhL5CJOJQJ\^JhL5>*CJOJQJ\^JS T v!!!vwwxx\xxyyzzz{{h^h & F leave may not be later than the beginning of your normal workday if the day of return is a workday. If leave ends on a non-workday the ending hour may be 2400 if not contrary to command policy. 4. Block 16 requires the following information: Normal working hours for day of departure Normal working hours for day of return If day of departure is not a workday, enter  NONE 5. Information required in blocks 17 and 18 may be obtained from Block 59 of your latest Leave and Earnings-Statement or you re your activity s Commanding Officer s Leave Listing. 6. You are advised that you must immediately return your original leave authorization to the appropriate office designated by your command upon return from leave.  LEAVE CONTROL NO. INSTRUCTIONS FOR COMPLETING THIS FORM ARE ON THE REVERSE OF PART 3. SEE REVERSE FOR PRIVACY ACT STATEMENT INSTRUCTIONS FOR COMPLETING THE LEAVE REQUEST PORTION OF THIS FORM PRIVACY ACT STATEMENT FOR NAVCOMPT 3065 LEAVE REQUEST/AUTHORIZATION This statement is provided in compliance with the provisions of the Privacy Act of 1974 (PL 93-579), which require that Federal agencies must inform individuals who are requested to furnish information about themselves as to the following facts concerning the information requested. 1. AUTHORITY: Title 10 and 37 USC 2. PRINCIPAL PURPOSE(S): To authorize military leave of absence. 3. ROUTINE USE(S): To deduct leave taken from member s accrued leave balances. To pay leave rations to enlisted members. 4. MANDATORY OR VOLUNTARY DISCLOSURE: voluntary. 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