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Air Force Letter of Counseling Example




AF Form 174.

6. UNIT/OFFICE SYMBOL

7. REASON FOR COUNSELING

8. OTHER INFORMATION

Violation Article 92, UCMJ
Failure to Follow Orders
 

COUNSELING

9. SUMMARY OF COUNSELING (Give details, facts, specific dates, times, names, sequence of events, etc.)

On 19 July 2011, you were told at 2300 to relieve A1C Blank from the Passenger Service Counter at midnight. At 1201am SSgt Smith intercepted you going to have a cigarette before relieving or checking with A1C Blank. After been told by SSgt Smith twice to report to the PSC you were found outside smoking seconds later. You have continually demonstrated irresponsible and selfish behavior toward SSgt Smith. Your failure to adhere to these standards leaves you in violation of Article 92 of the UCMJ, Failure to obey order or regulation by a noncommissioned officer.

 

 

 

 

 

10. RECOMMENDATIONS AND ADVICE OF COUNSELOR

 

 

 

Privacy Act statement: AUTHORITY: 10 U.S.C. 8013. PURPOSE: To obtain any comments you desire to submit (on a voluntary basis) for consideration concerning this action. ROUTINE USES: Provides you an opportunity to submit comments or documents for consideration. If provided, the comments and documents you submit become a part of the action. DISCLOSURE: Your written acknowledgment of receipt and signature are mandatory. Any other comment or document you provide is voluntary.

 

 

 

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ACKNOWLEDGMENT OF COUNSELING

14. SUMMARY OF COUNSELEE'S COMMENTS

I acknowledge receipt of this counseling on 19 Jul 11. I do / do not intend to submit information in rebuttal to these charges. I understand I have 3 duty days in which to submit my rebuttal.

 

 

 

 

 

 

 




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