NGB Form 5435 (DD Form 4) Annex K "Montgomery Gi Bill Kicker Incentive Addendum"

What Is NGB Form 5435 (DD Form 4) Annex K?

This is a legal form that was released by the U.S. Department of Defense - National Guard Bureau on August 8, 2008 and used country-wide. The document is a supplement to DD Form 4, Army National Guard Split Training Option. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 8, 2008;
  • The latest available edition released by the U.S. Department of Defense - National Guard Bureau;
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  • Fill out the form in our online filing application.

Download a fillable version of NGB Form 5435 (DD Form 4) Annex K by clicking the link below or browse more documents and templates provided by the U.S. Department of Defense - National Guard Bureau.

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Page 1 of 2
ANNEX K TO DD FORM 4
MONTGOMERY GI BILL KICKER INCENTIVE ADDENDUM
KCN:K________________
THE ARMY NATIONAL GUARD OF THE UNITED STATES
The proponent agency is NGB-EDU. The prescribing directive is AR 135-7.
PRIVACY ACT STATEMENT
1. AUTHORITY: Title 10 USC, Chapter 1606; Title 5 USC, Section 552a; and Executive Order 9397.
2. PURPOSE: To encourage the enlistment and retention of applicant's/soldiers into critical skills or units. Used to explain obligation and eligibility
requirements for entitlement under the Army National Guard MGIB Kicker incentive and to ensure that the soldier's understanding of these conditions is a
matter of record. This form will be placed in the member's personnel record.
3. ROUTINE USES: None.
4. DISCLOSURE: Voluntary; However, if SSN is not provided, you will not be eligible for the ARNG MGIB Kicker Incentive.
SECTION I - APPLICABILITY
All eligible persons who apply for the ARNG MGIB Kicker Incentive will complete this Annex immediately upon swearing to or affirming the oath of enlistment,
reenlistment, extension or Officer Service Agreement (OSA).
SECTION II - INSTRUCTIONS
An ARNG representative will explain the ARNG MGIB Kicker incentive requirements outlined in this Addendum to the applicant/soldier and attach a completed
copy of it to the enlistment contract, extension document, or OSA as applicable.
SECTION III - ACKNOWLEDGMENT/ELIGIBILITY
1. In order to qualify for and receive the ARNG MGIB Kicker incentive, I hereby acknowledge that I must be eligible to receive benefits under either the MGIB Selected
Reserve (MGIB-SR) or MGIB Active Duty (MGIB-AD). At a minimum, this includes, but is not limited to; completion of Initial Active Duty for Training or equivalent and
possess a high school diploma or equivalent ; __________ (initials).
2. I am applying for and meet the criteria for the MGIB Kicker incentive category I have initialed below:
a.
Non Prior Service (NPS). I am a NPS, Category I-IIIB (31 or higher on the Armed Services Vocational Aptitude Battery) enlistee, enlisting into a MGIB
Kicker eligible MOS and/or unit in the ARNG ; __________ (initials) ; $ ________ (Rate).
b.
Current ARNG Soldier. I am a current ARNG soldier who has served the past three consecutive years in the ARNG without a break in service and has
never contracted for the MGIB Kicker in a reserve component before. I am immediately reenlisting or extending my current enlistment for a period of at least 6
years. I will serve in a MGIB Kicker eligible MOS and/or unit in the ARNG. I am in skill level 1 or 2 (sergeant or below) and hold as primary the MOS of the
position for which I am reenlisting or extending ; __________ (initials) ; $ ________ (Rate).
c.
I am a PS soldier who has never contracted for the MGIB Kicker in a reserve component before. I am enlisting or reenlisting into a MGIB Kicker
eligible MOS and/or unit in the ARNG. I am in skill level 1 or 2 (sergeant/E5 or below) and I am qualified (either directly or through the rules of substitution
and/or conversion) in the MOS of the position for which I am reenlisting or extending ; __________ (initials) ; $ ________ (Rate).
d.
Officer Candidate/Simultaneous Member. I am currently enrolled in a commissioning program (State Officer Candidate School (OCS) Phase II or III,
Accelerated OCS, Federal OCS, or the ROTC Simultaneous Membership Program (SMP), MS II, III or IV) or have been appointed as a Warrant Officer Candidate
and I am immediately reenlisting or extending my current enlistment to serve at least six years in the ARNG or I have graduated from an ARNG commissioning
program (including Federal OCS), and have accepted my commission in the ARNG and signed an OSA within 90 days of graduation from the course;
__________ (initials) ; $ ________ (Rate).
e.
ARNG Lieutenants. I am a current ARNG Lieutenant without a baccalaureate degree ; __________ (initials) ; $ ________ (Rate).
f.
National Guard "College First" Enlistment Option. I am a non-prior service applicant, Category I-IIIA (50 or higher on the Armed Forces Vocational
Aptitude Test) enlisting into an ARNG Kicker eligible MOS and/or unit.__________ (initials) $350 rate
3. I qualify for the MGIB Kicker based on the following category (select one);
a.
Critical MOS
_________ (initials) ;
MOS _________
b.
Critical Unit
_________ (initials) ;
UIC _________
c.
Critical MOS and Unit
_________ (initials) ;
MOS _________
UIC _________
d.
College First
_________ (initials) ;
MOS _________
UIC _________
NGB 5435, 20080808 (EF) (Adobe v8.0)
(PREVIOUS EDITIONS ARE OBSOLETE.)
Page 1 of 2
ANNEX K TO DD FORM 4
MONTGOMERY GI BILL KICKER INCENTIVE ADDENDUM
KCN:K________________
THE ARMY NATIONAL GUARD OF THE UNITED STATES
The proponent agency is NGB-EDU. The prescribing directive is AR 135-7.
PRIVACY ACT STATEMENT
1. AUTHORITY: Title 10 USC, Chapter 1606; Title 5 USC, Section 552a; and Executive Order 9397.
2. PURPOSE: To encourage the enlistment and retention of applicant's/soldiers into critical skills or units. Used to explain obligation and eligibility
requirements for entitlement under the Army National Guard MGIB Kicker incentive and to ensure that the soldier's understanding of these conditions is a
matter of record. This form will be placed in the member's personnel record.
3. ROUTINE USES: None.
4. DISCLOSURE: Voluntary; However, if SSN is not provided, you will not be eligible for the ARNG MGIB Kicker Incentive.
SECTION I - APPLICABILITY
All eligible persons who apply for the ARNG MGIB Kicker Incentive will complete this Annex immediately upon swearing to or affirming the oath of enlistment,
reenlistment, extension or Officer Service Agreement (OSA).
SECTION II - INSTRUCTIONS
An ARNG representative will explain the ARNG MGIB Kicker incentive requirements outlined in this Addendum to the applicant/soldier and attach a completed
copy of it to the enlistment contract, extension document, or OSA as applicable.
SECTION III - ACKNOWLEDGMENT/ELIGIBILITY
1. In order to qualify for and receive the ARNG MGIB Kicker incentive, I hereby acknowledge that I must be eligible to receive benefits under either the MGIB Selected
Reserve (MGIB-SR) or MGIB Active Duty (MGIB-AD). At a minimum, this includes, but is not limited to; completion of Initial Active Duty for Training or equivalent and
possess a high school diploma or equivalent ; __________ (initials).
2. I am applying for and meet the criteria for the MGIB Kicker incentive category I have initialed below:
a.
Non Prior Service (NPS). I am a NPS, Category I-IIIB (31 or higher on the Armed Services Vocational Aptitude Battery) enlistee, enlisting into a MGIB
Kicker eligible MOS and/or unit in the ARNG ; __________ (initials) ; $ ________ (Rate).
b.
Current ARNG Soldier. I am a current ARNG soldier who has served the past three consecutive years in the ARNG without a break in service and has
never contracted for the MGIB Kicker in a reserve component before. I am immediately reenlisting or extending my current enlistment for a period of at least 6
years. I will serve in a MGIB Kicker eligible MOS and/or unit in the ARNG. I am in skill level 1 or 2 (sergeant or below) and hold as primary the MOS of the
position for which I am reenlisting or extending ; __________ (initials) ; $ ________ (Rate).
c.
I am a PS soldier who has never contracted for the MGIB Kicker in a reserve component before. I am enlisting or reenlisting into a MGIB Kicker
eligible MOS and/or unit in the ARNG. I am in skill level 1 or 2 (sergeant/E5 or below) and I am qualified (either directly or through the rules of substitution
and/or conversion) in the MOS of the position for which I am reenlisting or extending ; __________ (initials) ; $ ________ (Rate).
d.
Officer Candidate/Simultaneous Member. I am currently enrolled in a commissioning program (State Officer Candidate School (OCS) Phase II or III,
Accelerated OCS, Federal OCS, or the ROTC Simultaneous Membership Program (SMP), MS II, III or IV) or have been appointed as a Warrant Officer Candidate
and I am immediately reenlisting or extending my current enlistment to serve at least six years in the ARNG or I have graduated from an ARNG commissioning
program (including Federal OCS), and have accepted my commission in the ARNG and signed an OSA within 90 days of graduation from the course;
__________ (initials) ; $ ________ (Rate).
e.
ARNG Lieutenants. I am a current ARNG Lieutenant without a baccalaureate degree ; __________ (initials) ; $ ________ (Rate).
f.
National Guard "College First" Enlistment Option. I am a non-prior service applicant, Category I-IIIA (50 or higher on the Armed Forces Vocational
Aptitude Test) enlisting into an ARNG Kicker eligible MOS and/or unit.__________ (initials) $350 rate
3. I qualify for the MGIB Kicker based on the following category (select one);
a.
Critical MOS
_________ (initials) ;
MOS _________
b.
Critical Unit
_________ (initials) ;
UIC _________
c.
Critical MOS and Unit
_________ (initials) ;
MOS _________
UIC _________
d.
College First
_________ (initials) ;
MOS _________
UIC _________
NGB 5435, 20080808 (EF) (Adobe v8.0)
(PREVIOUS EDITIONS ARE OBSOLETE.)
Page 2 of 2
KCN:K________________
SECTION IV - OBLIGATION
1. I agree to remain in the ARNG as a satisfactory participant for six years ; __________ (initials).
2. I understand that failure to complete my six year obligation entitling me to the MGIB Kicker may result in either suspension, termination or recoupment of any MGIB
Kicker payments I have received ; __________ (initials).
3. I understand that I must remain qualified in a MGIB Kicker eligible MOS and/or unit and that failure to do so may result in either suspension, termination or
recoupment of any MGIB Kicker payments I have received ; __________ (initials).
4. I understand that I must have at least a 6 year obligation with the Selected Reserve from the date this contract is signed: _________(Initials)
SECTION V - ENTITLEMENT
1. I am entitled to the MGIB Kicker incentive for each month of basic MGIB benefits I have remaining for a maximum of 36 months of full time enrollment. The
Department of Veterans Affairs will adjust the amount and the number of months for less than full-time pursuit of qualifying educational programs ; _________ (initials).
2. I understand that I cannot receive any portion of my MGIB Kicker until I have received my secondary school diploma or authorized equivalent and have completed
initial active duty for training or its equivalent ; __________ (initials).
3. I understand that if I voluntarily or involuntarily transfer within or between units of the ARNG or USAR, including the IRR, due to unit transition as described in
AR 135-7, paragraph 1-14.1, or complete my six year Kicker obligation, and have not used the maximum 36 months of my basic MGIB benefits, I will continue to receive
the Kicker incentive until my basic MGIB benefits are exhausted up to 36 months of full time enrollment ; __________ (initials).
SECTION VI – SUSPENSION, TERMINATION and RECOUPMENT
I understand that my MGIB Kicker incentive can be suspended, terminated and/or recouped if I fail to meet the eligibility criteria for my MGIB Kicker category and/or
complete the required MGIB Kicker obligation as outlined in this Annex and my enlistment contract, extension or OSA. The specific conditions regarding MGIB Kicker
incentive suspension, termination and recoupment are outlined in the current fiscal year MGIB Kicker policy distributed by National Guard Bureau (NGB-EDU) and is
available to me upon request to the unit ; __________ (initials).
SECTION VII - STATEMENT OF UNDERSTANDING
I have read and understand each of the statements above. I understand the statements above are intended to constitute all promises and agreements concerning
my ARNG MGIB Kicker incentive.
APPLICANT'S SIGNATURE
DATE SIGNED
TYPED OR PRINTED NAME AND RANK
SSN
SECTION VIII - CERTIFICATION BY AUTHORIZED ARNG REPRESENTATIVE
As an authorized ARNG representative, I certify that I have witnessed the reading and signing of this document and the signature appearing above is that of the
applicant. Per the current fiscal year MGIB Kicker policy distributed by NGB-EDU, I have verified that the applicant above meets the MGIB Kicker eligibility requirements
and that the applicant's unit of assignment and MOS are currently eligible for the MGIB-SR Kicker incentive. No other promises were made to the applicant as a
condition of entitlement to the MGIB Kicker. I have obtained an MGIB Kicker control number from the State MGIB Manager or Education Service Officer (ESO) and will
provide the applicant and the MGIB Manager/ESO with a copy of this form.
SERVICE REPRESENTATIVE SIGNATURE
DATE SIGNED
TYPED OR PRINTED NAME AND RANK
TITLE
UNIT / LOCATION
PHONE
NGB 5435, 20080808 (REVERSE) (EF) (Adobe v8.0)
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