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Issues must be Privacy Act after the DD Form 293 has been submitted will stated clearly and specifically. A. SIGNATURE - REQUIRED Applicant or person in Item 11 above DD FORM 293 NOV 2012 CASE NUMBER Do not write in this space. Changes or additions to the waiver of your right to a hearing. list may be made on the DD Form 293 anytime before the Discharge Review Board closes the review process for deliberation. Please be ITEM 2. If the discharge you want reviewed was issued over 15 you want an Honorable Discharge the Board will respond to the issue years ago instead of applying on a DD Form 293 you must in terms of your request for a General Discharge. Of issues that should be submitted to the Board DD FORM 293 - PLEASE PRINT OR TYPE INFORMATION. one isolated incident in 28 months of service with no other adverse Items on the form are self-explanatory unless otherwise noted action. Example 1. Applicants are strongly encouraged to submit any request for If you were separated on or after 1 October 1982 while in an entry their military records prior to applying for a discharge review rather level status with an under other than honorable conditions discharge than after submitting a DD Form 293 in order to avoid substantial and less than 180 days of active service you can request a change of delays in processing of the application and scheduling of review. Pentagon.mil Air Force Review Boards Agency SAF/MRBR 550-C Street West Suite 40 Randolph AFB TX 78150-4742 NAVY AND MARINE CORPS Secretary of the Navy Council of Review Boards ATTN Naval Discharge Review Board 720 Kennon Ave S.E. Suite 309 Washington Navy Yard DC 20374-5023 Commandant CG-122 Attn Office of Military Personnel US Coast Guard 2100 2nd Street S.W. Stop 7801 Washington DC 20593-7801 INSTRUCTIONS FOR COMPLETION OF DD FORM 293 REQUESTING COPIES OF YOUR OFFICIAL MILITARY ITEM 5. E-MAIL h. FAX NUMBER Include Area Code 2. DATE OF DISCHARGE OR SEPARATION 4. DISCHARGE CHARACTERIZATION RECEIVED YYYYMMDD If date is more than 15 years ago submit a DD Form 149 X one 5. APPLICATION FOR THE REVIEW OF DISCHARGE FROM THE ARMED FORCES OF THE UNITED STATES OMB No* 0704-0004 OMB approval expires Oct 31 2014 Please read instructions on Pages 3 and 4 BEFORE completing this application* The public reporting burden for this collection of information is estimated to average 30 minutes per response including the time for reviewing instructions searching existing data sources gathering and maintaining the data needed and completing and reviewing the collection of information* Send comments regarding this burden estimate or any other aspect of this collection of information including suggestions for reducing the burden to the Department of Defense Washington Headquarters Services Executive Services Directorate Information Management Division 4800 Mark Center Drive Alexandria VA 22340-3100 0704-0004. Respondents should be aware that notwithstanding any other provision of law no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

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