DA Form 5074-1-R Record of Award of Entry Grade Credit (Health Services Officer)

DA Form 5074-1-R - also known as the "Record Of Award Of Entry Grade Credit (health Services Officer)" - is a United States Military form issued by the Department of the Army.

The form - often mistakenly referred to as the DD form 5074-1-R - was last revised on February 1, 1982. Download an up-to-date fillable PDF version of the DA 5074-1-R down below or look it up on the Army Publishing Directorate website.

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RECORD OF AWARD OF ENTRY GRADE CREDIT (HEALTH SERVICES OFFICERS)
For use of this form, see AR 135-101 and AR 601-100; the proponent agency is The Office of The Surgeon General.
2. CORPS
3. DATE OF APPOINTMENT
4. SPECIALTY IN WHICH APPOINTED
1. NAME (Last, first, MI)
(Or entry on Active Duty)
PART I - CONSTRUCTIVE SERVICE CREDIT
SECTION A - CREDIT FOR BASIC QUALIFYING DEGREE
5. TITLE OF DEGREE
6. DATE GRANTED
7. NAME OF ACADEMIC INSTITUTION
8. INCLUSIVE DATES OF ATTENDANCE
9. CREDIT AWARDED
SECTION B - CREDIT FOR ADVANCED EDUCATION BEYOND BASIC QUALIFYING DEGREE
13. CREDIT AWARDED
10. DEGREE
11. ACADEMIC INSTITUTION
12. INCLUSIVE DATES
SECTION C - CREDIT FOR POST BACCALAUREATE EDUCATION
17. CREDIT AWARDED
14. EDUC PROG & SPECIALTY
15. CERTIFYING BOARD
16. INCLUSIVE DATES
SECTION D - CREDIT FOR PROFESSIONAL EXPERIENCE
20. CREDIT AWARDED
18. BASIS FOR AWARD
19. INCLUSIVE DATES
21. JUSTIFICATION FOR CLASSIFICATION AS UNUSUAL CASE (Attach additional pages as necessary)
PART II - PRIOR ACTIVE COMMISSIONED SERVICE CREDIT
25. CREDIT AWARDED
22. UNIFORMED SERVICE & STATUS
23. CORPS OR SPECIALTY
24. INCLUSIVE DATES
PART III - COMPUTATION OF ENTRY GRADE AND DATE OF RANK
26. TOTAL CONSTRUCTIVE CREDIT
27. TOTAL PRIOR SERVICE CREDIT
28. TOTAL ENTRY GRADE
29. ADJUSTED TOTAL ENTRY GRADE
CREDIT (Years, Months, Days)
CREDIT (Years, Months, Days)
(Years, Months)
(Years, Months, Days)
30. GRADE FOR WHICH CREDIT QUALIFIES
ENTRY GRADE IS LIMITED, SEE AR 601-100 OR
AR 135-101 FOR CREDIT LIMITS, JUSTIFICATION,
AND WAIVER REQUIREMENTS FOR AMOUNTS
31. CREDIT REQUIRED FOR GRADE
IN EXCESS OF LIMITS.
32. CREDIT IN EXCESS OF THAT REQUIRED FOR GRADE
REMARKS
33. DATE OF ENTRY ON ACTIVE DUTY (Or date of appointment)
34. LESS EXCESS CREDIT
35. DATE OF RANK
PART IV - AUTHENTICATION
36. TYPED NAME/GRADE OF PREPARING OFFICIAL
SIGNATURE
DATE PREPARED
37. TYPED NAME/GRADE OF APPROVING OFFICIAL
SIGNATURE
DATE
DA FORM 5074-1-R, FEB 1982
APD LC v1.01ES
RECORD OF AWARD OF ENTRY GRADE CREDIT (HEALTH SERVICES OFFICERS)
For use of this form, see AR 135-101 and AR 601-100; the proponent agency is The Office of The Surgeon General.
2. CORPS
3. DATE OF APPOINTMENT
4. SPECIALTY IN WHICH APPOINTED
1. NAME (Last, first, MI)
(Or entry on Active Duty)
PART I - CONSTRUCTIVE SERVICE CREDIT
SECTION A - CREDIT FOR BASIC QUALIFYING DEGREE
5. TITLE OF DEGREE
6. DATE GRANTED
7. NAME OF ACADEMIC INSTITUTION
8. INCLUSIVE DATES OF ATTENDANCE
9. CREDIT AWARDED
SECTION B - CREDIT FOR ADVANCED EDUCATION BEYOND BASIC QUALIFYING DEGREE
13. CREDIT AWARDED
10. DEGREE
11. ACADEMIC INSTITUTION
12. INCLUSIVE DATES
SECTION C - CREDIT FOR POST BACCALAUREATE EDUCATION
17. CREDIT AWARDED
14. EDUC PROG & SPECIALTY
15. CERTIFYING BOARD
16. INCLUSIVE DATES
SECTION D - CREDIT FOR PROFESSIONAL EXPERIENCE
20. CREDIT AWARDED
18. BASIS FOR AWARD
19. INCLUSIVE DATES
21. JUSTIFICATION FOR CLASSIFICATION AS UNUSUAL CASE (Attach additional pages as necessary)
PART II - PRIOR ACTIVE COMMISSIONED SERVICE CREDIT
25. CREDIT AWARDED
22. UNIFORMED SERVICE & STATUS
23. CORPS OR SPECIALTY
24. INCLUSIVE DATES
PART III - COMPUTATION OF ENTRY GRADE AND DATE OF RANK
26. TOTAL CONSTRUCTIVE CREDIT
27. TOTAL PRIOR SERVICE CREDIT
28. TOTAL ENTRY GRADE
29. ADJUSTED TOTAL ENTRY GRADE
CREDIT (Years, Months, Days)
CREDIT (Years, Months, Days)
(Years, Months)
(Years, Months, Days)
30. GRADE FOR WHICH CREDIT QUALIFIES
ENTRY GRADE IS LIMITED, SEE AR 601-100 OR
AR 135-101 FOR CREDIT LIMITS, JUSTIFICATION,
AND WAIVER REQUIREMENTS FOR AMOUNTS
31. CREDIT REQUIRED FOR GRADE
IN EXCESS OF LIMITS.
32. CREDIT IN EXCESS OF THAT REQUIRED FOR GRADE
REMARKS
33. DATE OF ENTRY ON ACTIVE DUTY (Or date of appointment)
34. LESS EXCESS CREDIT
35. DATE OF RANK
PART IV - AUTHENTICATION
36. TYPED NAME/GRADE OF PREPARING OFFICIAL
SIGNATURE
DATE PREPARED
37. TYPED NAME/GRADE OF APPROVING OFFICIAL
SIGNATURE
DATE
DA FORM 5074-1-R, FEB 1982
APD LC v1.01ES
INSTRUCTIONS
(Paragraph references below refer to AR 135-101 unless otherwise indicated)
12. Items 30 and 31. If the officer is to enter
1. Items not discussed below are self explanatory.
on active duty compare the credit in item 29 with
the entry grade phase points in the appropriate
2. Item 2. Enter the Corps to which the appoint-
DA Circular 601 series for the fiscal year of entry
ment is to be made.
on active duty. If the officer is not to enter on
active duty compare the credit in item 29 with
3. Item 3. Enter the date of entry on active duty
the entries in para 3-2. Determine the grade which
unless the officer is not to enter on active duty in
the credit justifies. Enter the grade in item 30 and the
which case enter date of oath of office (effective
credit required for that grade in item 31.
date of appointment). Enter by year, month, and
day (numerals).
13. Item 32. Subtract item 31 from item 29 and
enter the result in item 32.
4. Item 4. Enter specific specialty, within the
Corps, in which being appointed.
14. Item 33. Enter the date from item 3 (year,
month and day).
5. Items 9, 13, 17, 20 and 25. Refer to Chapter
3 and its tables for amounts of credit authorized
15. Items 34 and 35. Enter the data from item
and maximum credit when applicable. Do not
32 in item 34. Subtract item 34 from item 33
credit any period of time more than once.
and enter the result in item 35. This is the date
of rank.
6. Items 18-21. See item 6, Table 3-1 for discussion
of unusual credit.
16. Items 36 and 37. See paragraph 3-1 for
discussion of form authentication.
7. Item 22. Enter Service and status, for example,
Army Reserve on active duty; Navy, Reserve not on
active duty.
8. Item 26. Enter total of items 9, 13, 17 and 20.
9. Item 27. Enter total from item 25.
10. Item 28. Enter total of items 26 and 27.
11. Item 29. Enter the smaller of item 28 or the
phase point to major as reflected in the appropriate
DA Circular 601 series, unless waiver of maximum
entry grade credit has been granted. If waiver
granted, enter total amount of credit awarded.
REVERSE OF DA FORM 5074-1-R, FEB 1982
APD LC v1.01ES

Download DA Form 5074-1-R Record of Award of Entry Grade Credit (Health Services Officer)

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