DA Form 5118 Reassignment Status and Election Statement Page 3

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PART II - BATTALION STATUS
INSTRUCTIONS: The Battalion S1 will answer all the questions in Part II (Sections D and E). A checkmark in any of the "Yes" blocks will require a
comment in the "Remarks" block indicating the reason for further action, review, or possible removal from this assignment. If a question does not
apply, check the "N/A" block. The Battalion S1 must sign the completed statement and return it to the MPD/Personnel Service Company with the
completed Soldier Status and Election Statement attached.
1. NAME
2. SSN
3. GRADE
4. PMOS
5. ASI
6. CONTROL LANGUAGE
7. CURRENT UNIT
8. CURRENT UPC
9. GAINING UNIT
10. EDAS CYCLE NO.
11. TODAY'S DATE (YYYYMMDD)
12. ARRIVAL DATE (YYYYMMDD)
13. AI MOS
14. AI ASI
15. AI LANGUAGE
Section D - Duty Status
YES
NO
N/A
Is the Soldier currently attached to another installation for the purpose of processing a personnel action?
37.
Is the Soldier currently assigned to another unit?
38.
39.
Is the Soldier currently assigned to a unit scheduled for permanent overseas deployment (other than unit TDY
movement such as a REFORGER)?
40.
Is the Soldier in an AWOL status?
41.
Is the Soldier presently confined?
42.
Is the Soldier currently TDY from his/her home station and not scheduled to return at least 60 days prior to the first day
of the arrival month?
Is the Soldier presently undergoing any medical or dental treatment that would prevent this reassignment?
43.
44.
Is the Soldier awaiting court or trial appearance as a defendant?
Section E - Pending Action Status
45.
Is the Soldier pending an early release from active duty?
46.
Is the Soldier pending a Medical Evaluation Board (MMRB/PEB)?
47.
Is the Soldier pending a PMOS reclassification?
48.
Is the Soldier under suspension of favorable personnel actions (FLAGGED)?
49.
Is the Soldier enrolled in phase III of the Alcohol and Drug Abuse Prevention and Control Program (ADAPCP)?
50.
Is the Soldier scheduled for any schooling not in conjunction with this assignment?
51.
Has the Soldier applied for specialized training?
Is the Soldier being delayed from complying with these assignment instructions due to administrative processing
52.
errors?
Are there any circumstances not listed above that would preclude the Soldier from complying with these assignment
53.
instructions?
54.
Medical Readiness Code (MRC):
55a.
I am not
aware of any medical conditions that would prevent me from worldwide deployability.
I am
55b. Date (YYYYMMDD):
Initials:
56a.
DEPLOYABILITY CERTIFICATION: I certify that this Soldier's deployable status is:
Ready
Not Ready
56b.
Physician's Name and title or position:
56c.
Physician's Signature:
56d. DATE (YYYYMMDD)
57.
REMARKS (Annotate any additional information or discrepancies):
58a. BATTALION COMMANDER'S SIGNATURE
58b. DATE (YYYYMMDD)
Page 3 of 5
DA FORM 5118, OCT 2012
APD LC v1.00ES

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