NAVMC 11537 - Reenlistment Extension Lateral Move … · 2013-08-05 · NAVMC 11537 - Reenlistment Extension Lateral Move (RELM) Request Author: USMC Forms Mgr Subject: Revised to

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AUTHORITY: 10 U.S.C. 5013, Secretary of the Navy; 10 U.S.C. 5041, Headquarters, Marine Corps;

and E.O. 9397 (SSN).

PRINCIPAL PURPOSE: Information collected by this form will be used to determine that personnel meet the

reenlistment, extension, lateral move eligibility requirements and to obtain command recommendations. The

information collected on this form will be filed within a Privacy Act Systems of Records collection governed by

Privacy Act System of Records Notice MMN0013 which can be downloaded at :

http://privacy.defense.gov/notices/usmc/MMN0013.shtml.

In accordance with the Privacy Act of 1974 (Public Law 93-579), this notice informs you of the purpose

for collection of information on this form. Please read it before completing the form.

RETENTION AND SAFEGUARDS: The collected information will be maintained in a database with restricted,

limited access by personnel authorized to access this information. The database is protected by password,

unique user IDs, and applicable layers of security access within applications. Records in this file system will

only be retrieved by name and social security number. Disposition is pending (records are treated as

permanent until the National Archives and Records Administration has approved the retention and disposition

schedule).

ROUTINE USES: To various officials outside the DoD specifically identified as a Routine Use in Privacy Act

System of Records Notice MMN00013 for the stated specific purpose in addition to those set out in the

blanket routine uses established by the DoD Privacy Office and posted at:

http://www.defenselink.mil/privacy/notices/blanket-uses.html.

DISCLOSURE: Voluntary. However, failure to furnish personally identifiable information may negate

the application.

PRIVACY ACT STATEMENT

Reenlistment Extension Lateral Move (RELM) Request

NAVMC 11537 (Rev. 01-13)Previous editions will not be used.

FOUO - Privacy Sensitive when filled in.


FOR OFFICIAL USE ONLY

Adobe LiveCycle Designer 9

NAVMC 11537 (Rev. 01-13)

Reenlistment Extension Lateral Move (RELM) Request

28. Bonus Eligibility

27. UCMJ History

26. Draw Case Codes

29. Does SNM Require a Tattoo Waiver?

(SDA Only)

30. Does SNM Have Broken / Prior Service?

24. High School Graduate(FTAP Only)

25. Previous Requests(Within last 12 months.)

Yes

No

Yes

No

2) /

1) /

3) /

(This section will include all Military and Civilian convictions on current contract or within the last 5 years)

Conviction Type :

Articles(s) :

Date :

Conviction Type :

Articles(s) :

Date :

Conviction Type :

Articles(s) :

Date :

(If yes, attach Color Photo and descriptions.)

Yes

No

Yes

No

(If yes, attach Statement of Service (NAVMC 11501).)

Previous Bonus Payments

Zone :

Zone :

Zone :

Amount Paid :

Amount Paid :

Amount Paid :

Is SNM currently eligible for SRBP?

Does SNM plan to Maximize SRBP by

reenlisting for additional obligated service?

Zone :

Bonus Amount :

Yes

No

Yes

No

(If yes, SRB/BSSRB Eligibility Checklist must be completed.)

21. Test Scores

22. Duty Station Options

23. LATMOVE Choices

(FTAP / LatMove Only)

(FTAP Only)

(List only those MOS's SNM is qualified for.)

GT

MM

EL

CL

1st

2nd

3rd

1st

2nd

3rd

19. Conduct / Proficiency Marks

20. Fitness Report Validation

AVGCON in Enlistment

AVGPRO in Enlistment

(For ALL Cpls and below, to include Sgt's with less than 2 yrs TIG.)

FitRep Date Gap(s)

Date Verified :

Yes

No

1. Rank

2. Name(Last, First, MI)

3. EDIPI

4. MOS

5. DOR

6. AFADBD

7. PEBD

8. ECC

9. EAS

10. DCTB

11. RTD

12. FY

13. Type of Request

14. Length Requested

15. Category

16. SOE Code

17. Organization(Unit / Section)

18. Work Phone

31. Active Duty Spouse Information

31a. Name

31b. Rank

31c. MOS

31d. Branch

31e. EAS

31f. MCC

31g. RTD

32. Remarks

33. Member Certification. I certify that to the best of my knowledge all information provided above is accurate.

Marine's Signature :

Career Planner's Signature :

Date :

Date :


NAVMC 11537 (Rev. 01-13), Page 2

Rank

Name

EDIPI


34. Command Screening

34a. Medical Certification

34e. Legal Certification

34f. SACO Certification

34c. Security Screening (S-2)

34d. Training Certification (S-3)

34b. Dental Certification

SNM has beenSCREENED / EXAMINED and found

QUALIFIED / UNQUALIFIED for retention.

SNM has beenSCREENED / EXAMINED and found

QUALIFIED / UNQUALIFIED for retention.

(Medical MUST be recertified if SNM fails to submit request within 90 days.)

(If yes, documents must be provided. Annotate the level of Domestic Violence.)

(If yes, certificate of completion must be provided.)

(If yes, provide letter from the security Manager/SSO stating

what level and the date it was adjudicated.)

If unqualified give reason :

SNM's Duty Status is :

Full Duty

Light Duty

Limited Duty

No Duty

Name

Rank

Medical Officer / IDC

Signature

Date

If unqualified give reason :

Name

Rank

Dental Officer / IDC

Signature

Date

SNM's Dental Class :

Comments :

Name

Rank

Security (S-2) Signature

Date

Comments :

Name

Rank

Training (S-3) Signature

Date

Comments :

Name

Rank

Legal (S-1) Signature

Date

Comments :

Name

Rank

SACO Signature

Date

Does SNM have a security clearance?

Yes

No

BCP Program :

Yes

No

PFT Date :

Score :

Class :

Ht :

Wt :

Max :

BF% :

Legal action may include actions taken by civilian authorities.

Is SNM pending any legal action at this time?

Yes

No

Has SNM been assigned to any treatment program during the current

contract?

Yes

No

Class :

Score :

CFT Date :

(Ht/Wt MUST be verified within 90 days of submitting RELM.)

No

Has SNM had any Domestic Violence incidents?

Yes

FOR OFFICIAL USE ONLY.


NAVMC 11537(Rev. 05-11)

Page 3

Rank

Name

Last 4 SSN

35. Command Recommendations

35a.

35d.

35c.

35b.

(Please check the appropriate boxes and make brief comments justifying your recommendations.)

*RETURN TO CAREER PLANNING OFFICE*

Comments :

Name

Rank

Signature

Date

Recommended with Enthusiasm

(Top 25 %)

Comments Mandatory

Recommended with Reservation

Recommended with Confidence

Not Recommended

(Top 50 %)

Comments Mandatory

Comments :

Name

Rank

Signature

Date


(Top 25 %)

Comments Mandatory



Not Recommended

(Top 50 %)

Comments Mandatory

Comments :

Name

Rank

Signature

Date


(Top 25 %)

Comments Mandatory



Not Recommended

(Top 50 %)

Comments Mandatory

Comments :

Name

Rank

Signature

Date


(Top 25 %)

Comments Mandatory



Not Recommended

(Top 50 %)

Comments Mandatory



NAVMC 11537(Rev. 01-13), Page 3

Rank

Name

EDIPI

35. Command Recommendations

35a.

35d.

35c.

35b.

(Please check the appropriate boxes and make brief comments justifying your recommendations.)

*RETURN TO CAREER PLANNING OFFICE*

Comments :

Name

Rank

Signature

Date

Recommended

Not Recommended

Comments :

Name

Rank

Signature

Date

Recommended

Not Recommended

Comments :

Name

Rank

Signature

Date

Recommended

Not Recommended

Comments :

Name

Rank

Signature

Date

Recommended

Not Recommended



NAVMC 11537(Rev. 01-13), Page 4

Rank

Name

EDIPI

35e.

35f.

Comments :

Name

Rank

Signature

Date

Yes

No

Comments :

Name

Rank

Signature

Date

Yes

No

Is SNM recommended for reenlistment:




NAVMC 11537(Rev. 01-13), Page 5

Rank

Name

EDIPI

Must have Special Courts-Martial convening authority or be properly designated as "Acting", via an Assumption of Command or Appointment Letter.

35g. Commanding Officer / Commander Recommendation

Comments to HQMC (MMEA):

Name

Rank

Signature

Date

Does SNM meet all reenlistment prerequisites :

Yes

No

No

Yes


Commander's Tier Evaluation:

Tier I -Does superior work in all duties. Even extremely difficult or unusual assignments can be given with full confidence that they will be handled in a thoroughly competent manner. Demonstrates positive effect on others by example and persuasion. A Tier I Marine may not have any NJP, court martial, or civilian conviction on his current contract.

Tier II -Does excellent work in all regular duties, but needs assistance in dealing with extremely difficult or unusual assignments. Demonstrates reliability, good influence, sobriety, obedience, and industry. A Tier II Marine may have only one form of jeopardy on contract in the form of NJP or misdemeanor civilian conviction, but may have no courts martial.

Tier III -Can be depended upon to discharge regular duties thoroughly and competently but usually needs assistance in dealing with problems not of a routine nature. A Tier III Marine may have no more than two incidents of jeopardy in the form of NJP or misdemeanor civilian conviction, but have no courts martial conviction.

Tier IV-May or may not meet minimum standards. Any Marine with a courts martial conviction will be categorized as Tier IV.

**Note - The Career Planner should ensure that the TFRS Tier evaluation accompanies this RELM request for all FTAP reenlistment requests.

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NAVMC 11537 - Reenlistment Extension Lateral Move (RELM) Request

20130101

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Revised to replace SSN with EDIPI; minor change to 34C per sponsor

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Documents

NAVMC 11537 - Reenlistment Extension Lateral Move … · 2013-08-05 · NAVMC 11537 - Reenlistment Extension Lateral Move (RELM) Request Author: USMC Forms Mgr Subject: Revised to