AF Form 63 "Active Duty Service Commitment (ADSC) Acknowledgement Statement"

What Is AF Form 63?

This is a legal form that was released by the U.S. Air Force on October 30, 2010 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 30, 2010;
  • The latest available edition released by the U.S. Air Force;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of AF Form 63 by clicking the link below or browse more documents and templates provided by the U.S. Air Force.

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ACTIVE DUTY SERVICE COMMITMENT (ADSC) ACKNOWLEDGMENT STATEMENT
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 8013; Secretary of the Air Force: powers and duties: delegation by; Executive Order 9397 (SSN), as amended.
PURPOSE: Documents ADSC acknowledgment. To make you aware of the ADSCs you will or have incurred as a result of training or education.
ROUTINE USES: May specifically be disclosed outside the DoD as a routine use pursuant to 5 U.S.C. 552a(b)(3).
DISCLOSURE: Voluntary. Failure to provide the SSN would make it difficult to identify you and your records when the ADSC Statement is processed
and filed. Do not complete this form for officers of the medical services receiving DoD-sponsored basic education (AFI 36-2107), and health related
education and training. Exception: PCS and PME.
SORNs: F036 AFPC Q, Personnel Data Systems and F036 AFPC C, Military Personnel Records System
I. ACTIVE DUTY SERVICE COMMITMENT(S)
According to AFI 36-2107:
A . Table
, Rule
, you will incur an ADSC of
for
, ADSCD-RSN-FOR Code
YOU MUST SIGN SECTION II OF THIS FORM NO LATER THAN 7 CALENDAR DAYS FROM RECEIPT OF ASSIGNMENT, TRAINING OR
EDUCATION NOTIFICATION.
II. ACKNOWLEDGMENT AND AGREEMENT
I acknowledge the ADSC(s) described in Section I and was given the opportunity to review and read AFI 36-2107. I hereby acknowledge and
agree to the following:
a. To accept and serve the ADSC(s) stated in Section I and obtain retainability when required.
b. I understand if the ADSC(s) will extend beyond my retirement eligibility date, I will be required to serve this commitment prior to retirement.
c. To accept and serve the ADSC(s) associated with withdrawal or elimination from education or training described in AFI 36-2107 and Title 10.
d. I have not received any ADSC information other than contained herein. No promises have been made to me, implied or otherwise, concerning
the possibility or probability of retirement or separation prior to serving my ADSC.
e. Once I have signed this statement, I cannot apply for retirement or separation except as authorized in AFIs 36-3202, 3207 or 3208 until the
ADSC(s) associated with the event(s) described here have been entered into my official personnel records.
f. That only the Secretary of the Air Force or his designee may excuse me from my obligation to serve on active duty for the period specified in
this agreement.
g. I understand that ADSCs begin upon completion of the ADSC-incurring event unless otherwise stated.
h. I understand that acceptance of this ADSC may affect my eligibility for application to some Air Force programs which include but are not
limited to Undergraduate Navigator or Pilot Training.
i. As a condition of receiving advanced education as defined in Title 10. U.S.C. Section 2005:
(1) That if I fail to complete the specified educational requirements, I will serve on active duty for the specified period described in Section I.
(2) That if I am voluntarily retired or separated, or if I am involuntarily separated because of misconduct, prior to completing the ADSC, I
understand and agree that the Secretary of the Air Force or his designated representative may direct reimbursement. The amount to be
reimbursed will be a percentage of the cost of the education for programs which include, but are not limited to the USAF Academy, ROTC
College Scholarship Program, Tuition Assistance and the Air Force Institute of Technology. The percentage will equal the percentage of the
ADSC not served in Section I.
(3) I understand that discharge in bankruptcy under Title 11, U.S.C., if less than five years after the last day of the specified period of active
duty, will not release me from my obligation to reimburse the United States as provided in this agreement.
(4) I understand I may not void the ADSC by repaying the educational expense after having completed the educational event.
DECLINATION STATEMENT : (OFFICERS ONLY) I desire to decline the ADSC in Section I. I understand I must submit an application for
retirement or separation within 7 calendar days following receipt of this notification. I understand that if I am ineligible to apply for retirement or
separation or if I fail to apply for retirement or separation within 7 calendar days, I will incur the ADSC associated with the event. IF DECLINED,
SECTION III must be endorsed by the MPF commander or DPH commander.
SSN
RANK
TYPED OR PRINTED NAME OF MEMBER (Last, First, Middle Initial)
DATE
SIGNATURE
III. I HAVE ENSURED THAT THE ABOVE NAMED MEMBER HAS BEEN ACKNOWLEDGED AS INDICATED
TYPED OR PRINTED NAME OF OFFICIAL
(Last, First, Middle Initial)
RANK
DATE
SIGNATURE
REMARKS
IV. FOR AFPC USE ONLY
A . Initial Date
B. Update Verification
PRIVACY ACT INFORMATION: The information in this form is
AF FORM 63, 20101030
PREVIOUS EDITIONS ARE OBSOLETE
FOR OFFICIAL USE ONLY. Protect IAW the Privacy Act of 1974.
ACTIVE DUTY SERVICE COMMITMENT (ADSC) ACKNOWLEDGMENT STATEMENT
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 8013; Secretary of the Air Force: powers and duties: delegation by; Executive Order 9397 (SSN), as amended.
PURPOSE: Documents ADSC acknowledgment. To make you aware of the ADSCs you will or have incurred as a result of training or education.
ROUTINE USES: May specifically be disclosed outside the DoD as a routine use pursuant to 5 U.S.C. 552a(b)(3).
DISCLOSURE: Voluntary. Failure to provide the SSN would make it difficult to identify you and your records when the ADSC Statement is processed
and filed. Do not complete this form for officers of the medical services receiving DoD-sponsored basic education (AFI 36-2107), and health related
education and training. Exception: PCS and PME.
SORNs: F036 AFPC Q, Personnel Data Systems and F036 AFPC C, Military Personnel Records System
I. ACTIVE DUTY SERVICE COMMITMENT(S)
According to AFI 36-2107:
A . Table
, Rule
, you will incur an ADSC of
for
, ADSCD-RSN-FOR Code
YOU MUST SIGN SECTION II OF THIS FORM NO LATER THAN 7 CALENDAR DAYS FROM RECEIPT OF ASSIGNMENT, TRAINING OR
EDUCATION NOTIFICATION.
II. ACKNOWLEDGMENT AND AGREEMENT
I acknowledge the ADSC(s) described in Section I and was given the opportunity to review and read AFI 36-2107. I hereby acknowledge and
agree to the following:
a. To accept and serve the ADSC(s) stated in Section I and obtain retainability when required.
b. I understand if the ADSC(s) will extend beyond my retirement eligibility date, I will be required to serve this commitment prior to retirement.
c. To accept and serve the ADSC(s) associated with withdrawal or elimination from education or training described in AFI 36-2107 and Title 10.
d. I have not received any ADSC information other than contained herein. No promises have been made to me, implied or otherwise, concerning
the possibility or probability of retirement or separation prior to serving my ADSC.
e. Once I have signed this statement, I cannot apply for retirement or separation except as authorized in AFIs 36-3202, 3207 or 3208 until the
ADSC(s) associated with the event(s) described here have been entered into my official personnel records.
f. That only the Secretary of the Air Force or his designee may excuse me from my obligation to serve on active duty for the period specified in
this agreement.
g. I understand that ADSCs begin upon completion of the ADSC-incurring event unless otherwise stated.
h. I understand that acceptance of this ADSC may affect my eligibility for application to some Air Force programs which include but are not
limited to Undergraduate Navigator or Pilot Training.
i. As a condition of receiving advanced education as defined in Title 10. U.S.C. Section 2005:
(1) That if I fail to complete the specified educational requirements, I will serve on active duty for the specified period described in Section I.
(2) That if I am voluntarily retired or separated, or if I am involuntarily separated because of misconduct, prior to completing the ADSC, I
understand and agree that the Secretary of the Air Force or his designated representative may direct reimbursement. The amount to be
reimbursed will be a percentage of the cost of the education for programs which include, but are not limited to the USAF Academy, ROTC
College Scholarship Program, Tuition Assistance and the Air Force Institute of Technology. The percentage will equal the percentage of the
ADSC not served in Section I.
(3) I understand that discharge in bankruptcy under Title 11, U.S.C., if less than five years after the last day of the specified period of active
duty, will not release me from my obligation to reimburse the United States as provided in this agreement.
(4) I understand I may not void the ADSC by repaying the educational expense after having completed the educational event.
DECLINATION STATEMENT : (OFFICERS ONLY) I desire to decline the ADSC in Section I. I understand I must submit an application for
retirement or separation within 7 calendar days following receipt of this notification. I understand that if I am ineligible to apply for retirement or
separation or if I fail to apply for retirement or separation within 7 calendar days, I will incur the ADSC associated with the event. IF DECLINED,
SECTION III must be endorsed by the MPF commander or DPH commander.
SSN
RANK
TYPED OR PRINTED NAME OF MEMBER (Last, First, Middle Initial)
DATE
SIGNATURE
III. I HAVE ENSURED THAT THE ABOVE NAMED MEMBER HAS BEEN ACKNOWLEDGED AS INDICATED
TYPED OR PRINTED NAME OF OFFICIAL
(Last, First, Middle Initial)
RANK
DATE
SIGNATURE
REMARKS
IV. FOR AFPC USE ONLY
A . Initial Date
B. Update Verification
PRIVACY ACT INFORMATION: The information in this form is
AF FORM 63, 20101030
PREVIOUS EDITIONS ARE OBSOLETE
FOR OFFICIAL USE ONLY. Protect IAW the Privacy Act of 1974.