Assignment Worksheet - Conus W/dependents - Royal Canadian Mounted Police printable pdf download

Assignment Worksheet – CONUS W/Dependents

Rank/Name:

Contact Phone:

****************************************************************************************************

The items listed below are required to process your PCS orders:

Completed Assignment Worksheet

AF FM 4380

Page 8 (from vMPF on-line brief)

DD FM 1172 (see MPS Cust Svs/Rapids Info Sheet)

PPC requirements (only applies if “Visit Required is marked

PCS Orders to JBER (for Command Sponsored dependent

on your vOP Checklist)

verification)

* If dependents were acquired after arrival at JBER,

Driving MFR (if driving through Canada)

Command Sponsored Approval letter is required

* If dependents were born in Alaska after arrival at JBER, copy

of Alaska birth certificate verifies Command Sponsorship

AF Form 1466 (if Q-Coded or answered yes to one or more

* Memorandums/letters must be signed with a digital or wet

questions on AF Form 4380) - see Admissions at the Hospital

signature

for processing

* All items listed above must be returned to Outbound Assignments before we can process your orders. So that we may provide you

with the best customer support, we request that all required items be brought in at one time. We are located in the People Center,

room 111A (the Customer Support waiting area); our walk-in hours are (0730 – 1100, Mon – Fri) -- one of our assignment counselors

will be available to meet with you to confirm that all required items have been turned in. Or, if you prefer, we also have a drop box

located in the same area that is accessible 0730 – 1500, Mon – Fri, and will send you email confirmation of documents received.

* Outbound Assignments Contact Info:

Walk-in Hours: 0730 – 1100 (appointments possible after 1100)

Drop box in Customer Service Waiting Area (available 0730 – 1530 daily)

PHONE: 552-8080, Option 2

Email: 673fsscareerdevelopmen@us.af.mil

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My requested departure date is ________________________________________________

__________________________________________________________________________________________

______________________________

Supervisor’s printed Rank/Name and Signature

Date Signed

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My dependents will/will not accompany me on my next assignment. If applicable, list names of dependents who will not relocate:

______________________________________________________________________________________________________________________________

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Please complete the following statement if you are driving through Canada:

I am/am not hand-carrying weapons to my next duty station. I acknowledge that handguns are not allowed entry into Canada and

the USAF is not responsible for reimbursement for any firearms/weapons confiscated by border authorities. I have reviewed

guidelines and information regarding entry into Canada:

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Please initial next to each statement below indicating that you understand the following:

_____

I must be in uniform for my final out-processing appointment.

_____

If I have returned dependents to the CONUS on an Early Return of Dependents (ERD) order, I must provide a copy of the

order (front and back) to Outbound Assignments to process my PCS orders.

_____

I have reviewed the information regarding entry into Canada, passport requirements, and traveling with children, weapons,

and pets from the Canada Border Services Agency

_____

I must depart JBER during my DEROS month within 2 duty days of final out-processing, unless my commander has approved

leave in the local area (leave dates and contact info must be included on my PCS orders).

_____

My PT test must be current at least 42 days past my RNLTD. If it expires prior to that date, I understand I must retest prior to

my final out-processing appointment. If my PT scores are not current at least 42 days past my RNLTD, I will not be allowed

to out-process even if I intend on reporting to my next base prior to my RNLTD.

_____

If I am placed on a profile or medical hold that will expire after my departure date, I must provide an AF Form 422 or

memorandum signed by my provider at my final out-processing appointment. The document provided must specifically state

that I am cleared to PCS and must be dated after I was put on the profile/medical hold.

Printed Name and Signature: ____________________________________________________

Date:_____________________

Assignment Worksheet - Conus W/dependents - Royal Canadian Mounted Police

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