CHEMICAL AND BIOLOGICAL PERSONNEL RELIABILITY PROGRAM (PRP) STATUS REPORT
For use of this form, see AR 50-6; the proponent agency is DCS, G-3/5/7.
PART I - ORGANIZATIONAL DATA
A. ORGANIZATION
B. CALENDAR YEAR (CY) (YYYY)
C.
Chemical PRP
Biological PRP
D. NAME OF POC FOR REPORT
E. POC PHONE NUMBER
F. DATE OF REPORT (YYYYMMDD)
PART II - PERSONNEL RELIABILITY PROGRAM ACTIVITY
Military
Civilian
Contractor
A. Personnel in PRP at the beginning of the CY
B. Personnel enrolled in (added to) the PRP during the CY
C. Personnel denied enrollment in the PRP during the CY
D. Personnel terminated for cause from the PRP during the CY
E. Personnel administratively terminated from the PRP during the CY
F. Personnel enrolled in the PRP at the end of the CY
PART III - REASONS FOR DENIED ENROLLMENT INTO THE PRP DURING THE CY
Military
Civilian
Contractor
A. Alcohol-related
B. Drug-related
C. Suicide attempt or threat and jeopardizing human life and safety
D. Medical, mental, physical conditions incompatible with PRP
E. Negligence or delinquency in performance of duty
F. Poor attitude or untrustworthiness with respect to PRP responsibilities
G. Personal conduct involving questionable judgment, untrustworthiness,
unreliability, lack of candor, or dishonesty
H. Lack of security clearance eligibility
PART IV - REASONS TERMINATION FOR CAUSE FROM THE PRP DURING THE CY
Military
Civilian
Contractor
A. Alcohol-related
B. Drug-related
C. Suicide attempt or threat and jeopardizing human life and safety
D. Medical, mental, physical conditions incompatible with PRP
E. Negligence or delinquency in performance of duty
F. Poor attitude or untrustworthiness with respect to PRP responsibilities
G. Personal conduct involving questionable judgment, untrustworthiness,
unreliability, lack of candor, or dishonesty
H. Revocation of security clearance eligibility
PART V - REMARKS
PREVIOUS EDITIONS OF THE DA FORM 3180 ARE OBSOLETE.
APD AEM v1.00
DA FORM 3180-3, APR 2018
CHEMICAL AND BIOLOGICAL PERSONNEL RELIABILITY PROGRAM (PRP) STATUS REPORT
For use of this form, see AR 50-6; the proponent agency is DCS, G-3/5/7.
PART I - ORGANIZATIONAL DATA
A. ORGANIZATION
B. CALENDAR YEAR (CY) (YYYY)
C.
Chemical PRP
Biological PRP
D. NAME OF POC FOR REPORT
E. POC PHONE NUMBER
F. DATE OF REPORT (YYYYMMDD)
PART II - PERSONNEL RELIABILITY PROGRAM ACTIVITY
Military
Civilian
Contractor
A. Personnel in PRP at the beginning of the CY
B. Personnel enrolled in (added to) the PRP during the CY
C. Personnel denied enrollment in the PRP during the CY
D. Personnel terminated for cause from the PRP during the CY
E. Personnel administratively terminated from the PRP during the CY
F. Personnel enrolled in the PRP at the end of the CY
PART III - REASONS FOR DENIED ENROLLMENT INTO THE PRP DURING THE CY
Military
Civilian
Contractor
A. Alcohol-related
B. Drug-related
C. Suicide attempt or threat and jeopardizing human life and safety
D. Medical, mental, physical conditions incompatible with PRP
E. Negligence or delinquency in performance of duty
F. Poor attitude or untrustworthiness with respect to PRP responsibilities
G. Personal conduct involving questionable judgment, untrustworthiness,
unreliability, lack of candor, or dishonesty
H. Lack of security clearance eligibility
PART IV - REASONS TERMINATION FOR CAUSE FROM THE PRP DURING THE CY
Military
Civilian
Contractor
A. Alcohol-related
B. Drug-related
C. Suicide attempt or threat and jeopardizing human life and safety
D. Medical, mental, physical conditions incompatible with PRP
E. Negligence or delinquency in performance of duty
F. Poor attitude or untrustworthiness with respect to PRP responsibilities
G. Personal conduct involving questionable judgment, untrustworthiness,
unreliability, lack of candor, or dishonesty
H. Revocation of security clearance eligibility
PART V - REMARKS
PREVIOUS EDITIONS OF THE DA FORM 3180 ARE OBSOLETE.
APD AEM v1.00
DA FORM 3180-3, APR 2018
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