DA Form 5138 Separation Action Control Sheet

DD Form 5138 or the "Separation Action Control Sheet" is a Department of Defense-issued form used by and within the United States Army.

The form - often mistakenly referred to as the DA form 5138 - was last revised on September 1, 2010. Download an up-to-date fillable PDF version of the DD 5138 down below or find it on the Department of Defense documentation website.

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TAB
TAB
TAB
SEPARATION ACTION CONTROL SHEET
For use of this form, see AR 635-200; the proponent agency is DCS, G-1.
NAME (Last, First, Middle Initial)
UNIT
DATE PREPARED
DAYS
TOTAL
ITEM
ACTION
DATE
NO.
REQUIRED
ELAPSED DAYS
1.
Notification to service member of initiation of separation procedures.
2.
Service member acknowledges receipt of notification.
3.
Service member indicates election of rights.
Unit Commander's recommendation for separation forwarded to:
4.
5.
Separation case received at:
Actions completed (Specify):
6.
and/or case forwarded to:
7.
Separation case received at:
Actions completed (Specify):
8.
and/or case forwarded to:
Service member entitled to and elected
9.
hearing before Administrative Board.
Board convened on:
10.
Separation case received at:
11.
Final Disposition (Specify):
12.
Service member separated from the service.
13.
Total days required to process case.
REMARKS
DA FORM 5138, SEP 2010
PREVIOUS EDITIONS ARE OBSOLETE.
APD LC v1.00
M
TAB
TAB
TAB
SEPARATION ACTION CONTROL SHEET
For use of this form, see AR 635-200; the proponent agency is DCS, G-1.
NAME (Last, First, Middle Initial)
UNIT
DATE PREPARED
DAYS
TOTAL
ITEM
ACTION
DATE
NO.
REQUIRED
ELAPSED DAYS
1.
Notification to service member of initiation of separation procedures.
2.
Service member acknowledges receipt of notification.
3.
Service member indicates election of rights.
Unit Commander's recommendation for separation forwarded to:
4.
5.
Separation case received at:
Actions completed (Specify):
6.
and/or case forwarded to:
7.
Separation case received at:
Actions completed (Specify):
8.
and/or case forwarded to:
Service member entitled to and elected
9.
hearing before Administrative Board.
Board convened on:
10.
Separation case received at:
11.
Final Disposition (Specify):
12.
Service member separated from the service.
13.
Total days required to process case.
REMARKS
DA FORM 5138, SEP 2010
PREVIOUS EDITIONS ARE OBSOLETE.
APD LC v1.00

Download DA Form 5138 Separation Action Control Sheet

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