DA Form 2339 Application for Voluntary Retirement

What Is DA Form 2339?

DA Form 2339, Application for Voluntary Retirement is a form used to start the necessary administrative action on voluntary requests of retirement. The retirement procedure includes a medical examination of the applicant and a review of the application, that should be submitted at least nine months before the desired retirement date.

The latest version of the form - sometimes confused with the DD Form 2339, International Military Student Information - was released by the Department of the Army (DA) in June 1983. An up-to-date DA Form 2339 fillable version is available for digital filing and download below or can be found through the Army Publishing Directorate website.

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DATE
APPLICATION FOR VOLUNTARY RETIREMENT
For use of this form, see AR 635-200; the proponent agency is G-1.
DATA REQUIRED BY THE PRIVACY ACT
AUTHORITY:
Title 10, United States Code, Chapters 61, 63 and 67.
PRINCIPAL PURPOSE:
To initiate necessary administrative action in regard to voluntary requests for retirement.
ROUTINE USES:
Data contained on the form is used to complete administrative actions incident to retirement.
DISCLOSURE:
Disclosure is voluntary. However, failure to disclose required information may result in service member not
being considered for voluntary retirement.
TO: (Include ZIP Code)
THRU: (Include ZIP Code)
SECTION I - (TO BE COMPLETED BY ALL APPLICANTS)
1. NAME (Last, First, Middle)
2. SSN
3. ETS
4. DESIRED RETIREMENT
DATE
5. CURRENT GRADE, PAY GRADE, (Effective date of promotion)
6. HIGHEST GRADE SERVED ON ACTIVE DUTY AND BRANCH OF
AND MOS
SERVICE
7. UNIT OF ASSIGNMENT - DUTY STATION - MAJOR COMMAND
8. DESIRE RETIREMENT AT CURRENT OVERSEA ASSIGNMENT
(CONUS Residents only)
YES
NO
NOT APPLICABLE
9. MAIL ADDRESS UPON RETIREMENT (Will not be considered as
10. NON-CONUS PERSONNEL STATIONED OVERSEAS DESIRE
home of selection) (Include ZIP Code)
RETIREMENT
HOR
CONUS
CURRENT OVERSEAS STATION
11. REQUEST TRANSFER TO RETIRED RESERVE IN THE FOLLOWING STATUS
COMMISSIONED
WARRANT OFFICER
ENLISTED
12.
(TO BE COMPLETED ONLY BY RESERVE OFFICERS SERVING ON ACTIVE DUTY IN ENLISTED STATUS)
a. RESERVE COMMISSIONED STATUS
b. GRADE & PROMOTION
c. BRANCH
ELIGIBILITY DATE
RETIRED
ACTIVE
13. AWARDS
DISTINGUISHED SERVICE CROSS
MEDAL OF HONOR
NAVY CROSS
NONE
SOLDIERS MEDAL
DISTINGUISHED FLYING CROSS OR EQUIVALENT NAVY DECORATION
14.
CHRONOLOGICAL DATES OF MILITARY SERVICE
TIME
ACTIVE FEDERAL
INACTIVE SERVICE
(Enlistment and Discharge dates and change in status from active to
LOST
SERVICE
inactive service and vice versa.) (Para 12-13, AR 635-200)
ENL. WO.
FROM
TO
TOTAL
TOTAL
COM-
COM
PONENT
YEAR
MO
DAY
YEAR
MO
DAY
YEARS
MONTHS
DAYS
YEARS
MONTHS
DAYS
DAYS
(Indicate)
15. TOTAL TIME LOST (If no time lost, enter "None")
16. TOTAL ACTIVE SERVICE CREDITABLE FOR RETIREMENT
(Do not include time lost)
17. TOTAL INACTIVE SERVICE CREDITABLE FOR BASIC PAY ONLY
18. TOTAL SERVICE FOR BASIC PAY PURPOSES (Item 16 + 17)
EDITION OF APR 78 WILL BE USED UNTIL EXHAUSTED.
APD LC v4.02ES
DA FORM 2339, JUN 1983
DATE
APPLICATION FOR VOLUNTARY RETIREMENT
For use of this form, see AR 635-200; the proponent agency is G-1.
DATA REQUIRED BY THE PRIVACY ACT
AUTHORITY:
Title 10, United States Code, Chapters 61, 63 and 67.
PRINCIPAL PURPOSE:
To initiate necessary administrative action in regard to voluntary requests for retirement.
ROUTINE USES:
Data contained on the form is used to complete administrative actions incident to retirement.
DISCLOSURE:
Disclosure is voluntary. However, failure to disclose required information may result in service member not
being considered for voluntary retirement.
TO: (Include ZIP Code)
THRU: (Include ZIP Code)
SECTION I - (TO BE COMPLETED BY ALL APPLICANTS)
1. NAME (Last, First, Middle)
2. SSN
3. ETS
4. DESIRED RETIREMENT
DATE
5. CURRENT GRADE, PAY GRADE, (Effective date of promotion)
6. HIGHEST GRADE SERVED ON ACTIVE DUTY AND BRANCH OF
AND MOS
SERVICE
7. UNIT OF ASSIGNMENT - DUTY STATION - MAJOR COMMAND
8. DESIRE RETIREMENT AT CURRENT OVERSEA ASSIGNMENT
(CONUS Residents only)
YES
NO
NOT APPLICABLE
9. MAIL ADDRESS UPON RETIREMENT (Will not be considered as
10. NON-CONUS PERSONNEL STATIONED OVERSEAS DESIRE
home of selection) (Include ZIP Code)
RETIREMENT
HOR
CONUS
CURRENT OVERSEAS STATION
11. REQUEST TRANSFER TO RETIRED RESERVE IN THE FOLLOWING STATUS
COMMISSIONED
WARRANT OFFICER
ENLISTED
12.
(TO BE COMPLETED ONLY BY RESERVE OFFICERS SERVING ON ACTIVE DUTY IN ENLISTED STATUS)
a. RESERVE COMMISSIONED STATUS
b. GRADE & PROMOTION
c. BRANCH
ELIGIBILITY DATE
RETIRED
ACTIVE
13. AWARDS
DISTINGUISHED SERVICE CROSS
MEDAL OF HONOR
NAVY CROSS
NONE
SOLDIERS MEDAL
DISTINGUISHED FLYING CROSS OR EQUIVALENT NAVY DECORATION
14.
CHRONOLOGICAL DATES OF MILITARY SERVICE
TIME
ACTIVE FEDERAL
INACTIVE SERVICE
(Enlistment and Discharge dates and change in status from active to
LOST
SERVICE
inactive service and vice versa.) (Para 12-13, AR 635-200)
ENL. WO.
FROM
TO
TOTAL
TOTAL
COM-
COM
PONENT
YEAR
MO
DAY
YEAR
MO
DAY
YEARS
MONTHS
DAYS
YEARS
MONTHS
DAYS
DAYS
(Indicate)
15. TOTAL TIME LOST (If no time lost, enter "None")
16. TOTAL ACTIVE SERVICE CREDITABLE FOR RETIREMENT
(Do not include time lost)
17. TOTAL INACTIVE SERVICE CREDITABLE FOR BASIC PAY ONLY
18. TOTAL SERVICE FOR BASIC PAY PURPOSES (Item 16 + 17)
EDITION OF APR 78 WILL BE USED UNTIL EXHAUSTED.
APD LC v4.02ES
DA FORM 2339, JUN 1983
19. CONUS LOCATION OF CHOICE TRANSFER ACTIVITY
I ELECT TO BE PROCESSED FOR RETIREMENT AT:
I ATTEST THAT I HAVE BEEN COUNSELED AS SPECIFIED BY PARAGRAPH 2-18, AR 635-10. I ALSO FULLY UNDERSTAND
THE PROVISIONS OF SECTION V, CHAPTER 2, AR 635-10 CONCERNING MY ENTITLEMENTS PERTAINING TO PER DIEM,
TRAVEL AND TRANSPORTATION ALLOWANCES, BASED ON MY RETIREMENT AT A CONUS LOCATION OF CHOICE.
I DO NOT ELECT TO BE PROCESSED FOR RETIREMENT AT A CONUS LOCATION OF CHOICE.
SIGNATURE OF APPLICANT
I am familiar with the provisions of AR 635-200 pertaining to
withdrawal of this application for retirement once it has been
accepted by the retirement approval authority.
- (TO BE COMPLETED BY COMMANDER HAVING CUSTODY OF PERSONNEL RECORDS)
SECTION II
DATE
TO: (Include ZIP Code)
FROM: (Include ZIP Code)
20. RECOMMEND
APPROVAL
DISAPPROVAL (Indicate reason(s) in Remarks)
21. AUTHORIZED TRANSFER ACTIVITY (If other than current installation, specify)
22. APPLICANT
IS
IS NOT SUBMITTING REQUEST IN LIEU OF ELIMINATION OR FURTHER ELIMINATION PROCEEDINGS.
(If "YES" application must be attached to board proceedings.)
23. APPLICANT
HAS
HAS NOT INCURRED A SERVICE OBLIGATION (If "HAS"
24. THIS ACTION
IS
IS NOT
indicate reason and expiration date in Remarks)
IN CONTRAVENTION WITH
AR 600-31
25. SERVICE SHOWN (Items 14-18) HAS BEEN VERIFIED AS CORRECT BY:
MPRJ
AGPERSCEN:
OTHER (Specify)
(If other than MPRJ, attach verification)
26. DATE APPLICANT ARRIVED AT PRESENT ASSIGNMENT (Other than Oversea Command - see Item 27)
27. DATE APPLICANT OR DEPENDENT ARRIVED IN OVERSEA COMMAND (Whichever is later - specify applicant or dependent)
DATE:
NOT APPLICABLE
28. DATE OF RECEIPT OF ALERT (Nomination for assignment) OR ASSIGNMENT ORDERS (Not applicable for unit alert - see Item 31)
29. DATE MEMBERS OF UNIT WERE NOTIFIED OF UNIT ALERT
DATE:
NOT APPLICABLE
30. STATEMENT OF UNDERSTANDING
1. I have read Section V, Chapter 12, AR 635-200. I understand that I must undergo a medical examination prior to my retirement. I
am responsible for insuring that the examination is scheduled not earlier than 4 months, nor later than 1 month prior to my approved
retirement date (subject examination to be arranged through coordination with my unit of assignment). I am aware that the purpose of
this examination is to provide a better health assessment of me and, in particular, to continue cardiovascular attention, to record as
accurately as possible, my state of health on retirement and to protect my interests and those of the Government. I also understand
that my retirement will take effect on the requested date and that I will not be held on active duty to complete this examination.
2. I have been briefed concerning the Survivor Benefit Plan. I understand that I will automatically be in the plan and will pay the full
cost of coverage for my wife, and children if applicable, unless I submit an election form to the contrary prior to my retirement.
3. I am/am not (STRIKE THE INAPPROPRIATE WORDS) being considered by a HQDA Selection Board for promotion to the next higher
grade.
(Signature of member)
31. REMARKS (Continue on additional sheet if necessary)
has requested and had approved
days of transitional leave
(DDALV) to be taken in conjunction with the requested retirement action. This leave will begin
on
and end on
TYPED NAME, GRADE AND TITLE OF COMMANDER/PERSONNEL
SIGNATURE
OFFICER
APD LC v4.02ES
DA FORM 2339, JUN 1983

Download DA Form 2339 Application for Voluntary Retirement

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How to Fill out DA Form 2339?

An overview of the form and filing guidelines can be found in the Army Regulation 635-200, Active Duty Enlisted Administrative Separations, released in December 2016. DA Form 2339 instructions are as follows:

  1. The first section of the form is completed by the applicant with the assistance of the officer having custody on the applicants' personnel records.
  2. Blocks 1 to 11 are mandatory. First, the applicant has to provide their full name, SSN, ETS, and desired retirement date. Then the form requires their current grade, pay grade and MOS and their highest grade on the AD with their branch of service. The applicant has to provide their unit of assignment, duty station, and major command. CONUS residents should fill Block 8 if they desire retirement at their current overseas assignment. Non-CONUS residents should fill Block 10 if they desire oversea retirement. The form also requires the applicants mailing address upon retirement and their transfer request status.
  3. Blocks 12 to 19 are completed only by Reserve officers serving on the AD in Enlisted status. They should state their reserve commission status, grade and promotion eligibility date and branch of service. All awards received should be listed in Block 13. Block 14 is designed as a table with four main columns: the chronological dates of military service, time lost in days, active federal service and inactive service. Blocks 15 through 18 are for submitting total active service or inactive service to state the eligibility for retirement, basic pay or basic pay purposes. Block 19 is for stating readiness to retire at a CONUS location of choice.
  4. Section II consists of 11 blocks and is filed by the applicants' personnel officer. They must approve or disapprove the application, verify whether the applicant decided to proceed with a request or elimination, state the dates of arrival at the current assignment or overseas command, the receipt of the alert and the notification of unit alert.

The applicant has to read all conditions listed in Block 30 and sign the form. Any additional information should be listed in Block 31. If the provided space is not enough a continuation sheet may be added to the form. The commander should provide their full name and signature for the DA 2339 to be complete.

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