DA Form 5646 Statement of Conditions of Service - Active Guard Reserve (Agr)

DA Form 5646 - also known as the "Statement Of Conditions Of Service - Active Guard Reserve (agr)" - is a Military form issued and used by the United States Department of the Army.

The form - often mistakenly referred to as the DD form 5646 - was last revised on March 1, 2017. Download an up-to-date PDF version of the DA 5646 below or request a copy through the chain of command.

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STATEMENT OF CONDITIONS OF SERVICE - ACTIVE GUARD RESERVE (AGR)
For use of this form, see AR 135-18; the proponent agency is HQDA, G-1
Information required by the Privacy Act of 1974
10 USC 672 (d) and Executive Order 9397, 22 November 1943.
AUTHORITY:
PRINCIPLE PURPOSE: To explain the obligations and conditions that are, or will be, in force for members of the U.S. Army Reserve
ordered to active duty with their consent in an Active Guard/Reserve (AGR) status.
Confirmation that the individual understands and agrees to the obligations and conditions that will be incurred
ROUTINE USES:
upon entry, or continued services on, active duty in an AGR status.
Disclosure is voluntary; however, failure to provide information may impede processing of this application packet.
DISCLOSURE:
I. APPLICATION
A. All individuals applying for voluntary active duty in an AGR status must read and sign this form.
B. The form shall only be completed once and shall remain in force during the entire period the individual serves on active duty in the AGR
program, to include periods of active duty for training
performed while in the AGR program. Should the individual incur a break in
(ADT)
continuous active duty in the AGR program in excess of 48 hours, the form must again be completed upon reentry on active duty in the AGR
program.
C. A copy of this form will be given to the individual as a personal copy. A copy will be retained in the individual's Army Management Human
Resource Record.
II. ACTIVE GUARD/RESERVE CONDITIONS AND OBLIGATIONS
(The following provisions are applicable to all personnel signing this form.)
1. I, _________________________________, understand that upon voluntary entry on active duty in an AGR status:
Type or Print Name
a. I will be subject to the Uniform Code of Military Justice
(UCMJ)
b. I will be managed under the rules and regulations governing the USAR AGR centralized management system to
include assignments, promotion, and reduction.
c. I will be considered for continuation or renewal on AGR status under the criteria of AR 135-18.
2. I am aware that my job assignment may require successful completion of a course, or courses, of instruction by military
institutions. Residency at such institutions may require periods of time away from my family and may require that I be placed in an active duty
for training
status during such training.
(ADT)
3. I am aware that my voluntary entry on active duty in an AGR status does not guarantee that I will be offered a
subsequent AGR tour or that I will attain 20 years of Active Federal Service for retirement purposes.
4. I am aware that I will be subject to all regulations applicable to Active Component personnel, except as specified in AR
135-18 and other regulations pertaining to the AGR program.
5. I am aware that I will be subject to involuntary relief from active duty under the provisions of AR 135-18, AR 635-100
(officers)
or AR 635-200
(enlisted).
APD LC v1.00ES
DA FORM 5646, MAR 2017
PREVIOUS EDITIONS ARE OBSOLETE
STATEMENT OF CONDITIONS OF SERVICE - ACTIVE GUARD RESERVE (AGR)
For use of this form, see AR 135-18; the proponent agency is HQDA, G-1
Information required by the Privacy Act of 1974
10 USC 672 (d) and Executive Order 9397, 22 November 1943.
AUTHORITY:
PRINCIPLE PURPOSE: To explain the obligations and conditions that are, or will be, in force for members of the U.S. Army Reserve
ordered to active duty with their consent in an Active Guard/Reserve (AGR) status.
Confirmation that the individual understands and agrees to the obligations and conditions that will be incurred
ROUTINE USES:
upon entry, or continued services on, active duty in an AGR status.
Disclosure is voluntary; however, failure to provide information may impede processing of this application packet.
DISCLOSURE:
I. APPLICATION
A. All individuals applying for voluntary active duty in an AGR status must read and sign this form.
B. The form shall only be completed once and shall remain in force during the entire period the individual serves on active duty in the AGR
program, to include periods of active duty for training
performed while in the AGR program. Should the individual incur a break in
(ADT)
continuous active duty in the AGR program in excess of 48 hours, the form must again be completed upon reentry on active duty in the AGR
program.
C. A copy of this form will be given to the individual as a personal copy. A copy will be retained in the individual's Army Management Human
Resource Record.
II. ACTIVE GUARD/RESERVE CONDITIONS AND OBLIGATIONS
(The following provisions are applicable to all personnel signing this form.)
1. I, _________________________________, understand that upon voluntary entry on active duty in an AGR status:
Type or Print Name
a. I will be subject to the Uniform Code of Military Justice
(UCMJ)
b. I will be managed under the rules and regulations governing the USAR AGR centralized management system to
include assignments, promotion, and reduction.
c. I will be considered for continuation or renewal on AGR status under the criteria of AR 135-18.
2. I am aware that my job assignment may require successful completion of a course, or courses, of instruction by military
institutions. Residency at such institutions may require periods of time away from my family and may require that I be placed in an active duty
for training
status during such training.
(ADT)
3. I am aware that my voluntary entry on active duty in an AGR status does not guarantee that I will be offered a
subsequent AGR tour or that I will attain 20 years of Active Federal Service for retirement purposes.
4. I am aware that I will be subject to all regulations applicable to Active Component personnel, except as specified in AR
135-18 and other regulations pertaining to the AGR program.
5. I am aware that I will be subject to involuntary relief from active duty under the provisions of AR 135-18, AR 635-100
(officers)
or AR 635-200
(enlisted).
APD LC v1.00ES
DA FORM 5646, MAR 2017
PREVIOUS EDITIONS ARE OBSOLETE
6. If entering on my initial AGR tour, I understand that I will not be involuntarily reassigned during that initial tour if such
reassignment involves the expenditure of funds, except:
a. In time of war or national emergency declared by the President or by Congress;
b. If the unit or position to which I am assigned or attached is inactivated or relocated; or
c. I am relieved from my duty assignment or attachment for cause. I understand that if I enter on a subsequent AGR
tour I will be subject to paragraph 8 below.
7. If entering on an AGR tour including the initial AGR tour, I am aware that I may be involuntarily reassigned to meet the
needs of the Army at any time.
8. Unless on a one time occasional tour, I understand that I will be automatically considered for successive tours of active
duty in the AGR program, and this form is also my consent to be ordered to active duty for those tours if I am selected. I further understand
that I may withdraw my consent to a new tour of active duty in writing but must do so within 10 days of receipt of orders to a new tour of
active duty or I will be obligated to serve on active duty for the period of that tour.
III. STATEMENT ACKNOWLEDGING CONDITIONS AND OBLIGATIONS
I, the undersigned, acknowledge that I have read and understand all of the conditions and obligations of service as specified on this statement.
No other conditions or promises were made to me in conjunction with my entry or continuation in the AGR program.
TYPED OR PRINTED NAME
RANK
SIGNATURE
DATE SIGNED
APD LC v1.00ES
Reverse of DA Form 5646, MAR 2017
PREVIOUS EDITIONS ARE OBSOLETE

Download DA Form 5646 Statement of Conditions of Service - Active Guard Reserve (Agr)

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