DA Form 3575 "Certificate of Acknowledgement and Understanding of Service Requirements for Individuals Applying for Appointment in the USAR Under the Provisions of Ar 135-100 or Ar 135-101, as Applicable - Individuals Without a Statutory Service Obligation"

What Is DA Form 3575?

This is a military form that was released by the U.S. Department of the Army (DA) on June 1, 1984. The form, often mistakenly referred to as the DD Form 3575, is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DA.

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Download DA Form 3575 "Certificate of Acknowledgement and Understanding of Service Requirements for Individuals Applying for Appointment in the USAR Under the Provisions of Ar 135-100 or Ar 135-101, as Applicable - Individuals Without a Statutory Service Obligation"

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CERTIFICATE OF ACKNOWLEDGEMENT AND UNDERSTANDING OF SERVICE REQUIREMENTS
FOR INDIVIDUALS APPLYING FOR APPOINTMENT IN THE USAR UNDER THE PROVISIONS OF
AR 135-100, OR AR 135-101, AS APPLICABLE - INDIVIDUALS WITHOUT A STATUTORY SERVICE OBLIGATION
For use of this form, see AR 135-100; proponent agency is ODCSPER
DATA REQUIRED BY THE PRIVACY ACT OF 1974
AUTHORITY:
10 USC 270.
PRINCIPAL PURPOSE:
Used together with application for appointment to insure individual understanding of the service requirements.
ROUTINE USES:
Information is used to establish and record the contractual service obligation incurred by the officer. The SSN is used to identify
the member.
DISCLOSURE:
Disclosure of your Social Security Number is voluntary. However, failure to disclose your SSN may be cause for denying your
application for appointment.
INSTRUCTIONS:
This Certificate of Acknowledgement and Understanding of Service Requirements will be executed and submitted in 3 copies with
application for appointment as a commissioned or warrant officer in the USAR by all interested applicants who do not have a statutory
service obligation.
In connection with your application for appointment as a commissioned or warrant officer in the Army Reserve under the provisions
of
* there are certain service obligations that you will incur if a commission is offered and you accept.
(Applicable AR)
They are explained in detail below. Individuals discharged prior to completing their statutory obligation incur a contractual obligation
upon service reentry and are required to serve the number of years, months and days that were not served in their previous
statutory obligation. This information should be carefully studied prior to acknowledgement.
This form with your signature will be submitted with your request for appointment and indicates that you understand and accept all
of the contractual service requirements contained herein. Copies of this form with your signature will become part of your Official
File if selected for appointment.
CERTIFICATION
If I accept an appointment as a commissioned or warrant officer in the US Army Reserve, I understand and agree to comply with the
following service requirements for the entire period that I hold a USAR appointment. If an AMEDD volunteer, I agree to fulfill my
contractual obligation under my active duty commitment. When I am released from active duty as an AMEDD officer, I will comply with
the following USAR service requirements should a contractual obligation remain.
1. I agree to participate satisfactorily in the Army Reserve during the entire period that I am a commissioned or warrant officer in
accordance with the rules and regulations now in effect or which may hereafter be placed into effect by proper authority.
2. I will enter on active duty or active duty for training when ordered by competent authority. Upon completion of active duty or active
duty for training, I will participate in the Army Reserve as follows:
a. As a member of a Reserve Unit, I will attend all scheduled unit training assemblies (at least 48 per year) unless excused by proper
authority.
b. As a member of a unit, I will satisfactorily complete one period of annual active duty for training of not less than 14 days per year
exclusive of travel time.
c. If I am not assigned to a unit, I will be assigned to the individual Ready Reserve (IRR) and while so assigned, if so ordered by
competent authority, will perform not more that 30 days active duty for training annually.
d. I will keep my commander advised of my current mailing address at which I will receive official correspondence.
e. I will reply to, and comply with all official orders and correspondence which I may receive.
During the time that I am a commissioned or warrant officer and a member of the Ready Reserve, I may at any time be ordered to active
duty involuntarily as an individual, or as a member of a unit in the event of war or emergency declared by Congress, or the President of
the United States, or under any other conditions authorized by law in effect at the time of my appointment, or which may hereafter be
enacted into law.
I, the undersigned having voluntarily elected to apply for appointment as a commissioned or warrant officer of the United States Army
Reserve acknowledge that all of the conditions of said appointment are understood and acceptable.
DATE
SOCIAL SECURITY NUMBER
NAME (Typed) (Last, First, MI)
SIGNATURE
*Enter applicable regulation that appointment is being tendered under (AR 135-100, or AR 135-101)
DA FORM 3575, JUN 1984
EDITION OF MAR 82 IS OBSOLETE.
APD LC v1.01ES
CERTIFICATE OF ACKNOWLEDGEMENT AND UNDERSTANDING OF SERVICE REQUIREMENTS
FOR INDIVIDUALS APPLYING FOR APPOINTMENT IN THE USAR UNDER THE PROVISIONS OF
AR 135-100, OR AR 135-101, AS APPLICABLE - INDIVIDUALS WITHOUT A STATUTORY SERVICE OBLIGATION
For use of this form, see AR 135-100; proponent agency is ODCSPER
DATA REQUIRED BY THE PRIVACY ACT OF 1974
AUTHORITY:
10 USC 270.
PRINCIPAL PURPOSE:
Used together with application for appointment to insure individual understanding of the service requirements.
ROUTINE USES:
Information is used to establish and record the contractual service obligation incurred by the officer. The SSN is used to identify
the member.
DISCLOSURE:
Disclosure of your Social Security Number is voluntary. However, failure to disclose your SSN may be cause for denying your
application for appointment.
INSTRUCTIONS:
This Certificate of Acknowledgement and Understanding of Service Requirements will be executed and submitted in 3 copies with
application for appointment as a commissioned or warrant officer in the USAR by all interested applicants who do not have a statutory
service obligation.
In connection with your application for appointment as a commissioned or warrant officer in the Army Reserve under the provisions
of
* there are certain service obligations that you will incur if a commission is offered and you accept.
(Applicable AR)
They are explained in detail below. Individuals discharged prior to completing their statutory obligation incur a contractual obligation
upon service reentry and are required to serve the number of years, months and days that were not served in their previous
statutory obligation. This information should be carefully studied prior to acknowledgement.
This form with your signature will be submitted with your request for appointment and indicates that you understand and accept all
of the contractual service requirements contained herein. Copies of this form with your signature will become part of your Official
File if selected for appointment.
CERTIFICATION
If I accept an appointment as a commissioned or warrant officer in the US Army Reserve, I understand and agree to comply with the
following service requirements for the entire period that I hold a USAR appointment. If an AMEDD volunteer, I agree to fulfill my
contractual obligation under my active duty commitment. When I am released from active duty as an AMEDD officer, I will comply with
the following USAR service requirements should a contractual obligation remain.
1. I agree to participate satisfactorily in the Army Reserve during the entire period that I am a commissioned or warrant officer in
accordance with the rules and regulations now in effect or which may hereafter be placed into effect by proper authority.
2. I will enter on active duty or active duty for training when ordered by competent authority. Upon completion of active duty or active
duty for training, I will participate in the Army Reserve as follows:
a. As a member of a Reserve Unit, I will attend all scheduled unit training assemblies (at least 48 per year) unless excused by proper
authority.
b. As a member of a unit, I will satisfactorily complete one period of annual active duty for training of not less than 14 days per year
exclusive of travel time.
c. If I am not assigned to a unit, I will be assigned to the individual Ready Reserve (IRR) and while so assigned, if so ordered by
competent authority, will perform not more that 30 days active duty for training annually.
d. I will keep my commander advised of my current mailing address at which I will receive official correspondence.
e. I will reply to, and comply with all official orders and correspondence which I may receive.
During the time that I am a commissioned or warrant officer and a member of the Ready Reserve, I may at any time be ordered to active
duty involuntarily as an individual, or as a member of a unit in the event of war or emergency declared by Congress, or the President of
the United States, or under any other conditions authorized by law in effect at the time of my appointment, or which may hereafter be
enacted into law.
I, the undersigned having voluntarily elected to apply for appointment as a commissioned or warrant officer of the United States Army
Reserve acknowledge that all of the conditions of said appointment are understood and acceptable.
DATE
SOCIAL SECURITY NUMBER
NAME (Typed) (Last, First, MI)
SIGNATURE
*Enter applicable regulation that appointment is being tendered under (AR 135-100, or AR 135-101)
DA FORM 3575, JUN 1984
EDITION OF MAR 82 IS OBSOLETE.
APD LC v1.01ES