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The referral EPR memorandum is the document that the referring evaluator must prepare and present to the ratee, along with the referral EPR. It informs the recipient of his rights and serves as a routing document. The example below is taken word for word from AFI 36-2406, Officer and Enlisted Evaluation Systems, Figure 1.1. which shows an example referral EPR memorandum.
Refer to AFI 36-2406, Officer and Enlisted Evaluation Systems, Figure 1.1., for memorandum content requirements
Refer to AFM 33-326, Preparing Official Communications, for Official Memorandum format
MEMORANDUM FOR (NAME OF INDIVIDUAL)
FROM: Unit/OFFICE SYMBOL
SUBJECT: Referral Enlisted Performance Report
1. I am referring the attached Enlisted Performance Report to you in accordance with AFI 36-2406, Military Performance Evaluations, paragraph 1.10. Specifically, my rating of Does Not Meet Standards and my comments in section III, items 2 and 3, pertaining to your failure to meet and enforce both fitness and dress and appearance standards in yourself and your subordinates, cause this evaluation to be referred.
2. Acknowledge receipt of this correspondence by signing and dating in reproducible ink. Your signature on this memo merely acknowledges that a referral report has been rendered; it does not imply acceptance of or agreement with the ratings or comments on the evaluation. Once this memo is signed, you are entitled to a copy. You may submit comments to rebut the evaluation. Send your comments to (name and address of next evaluator) not later than 3 duty days (30 calendar days for non-EAD members) from the date you receive this memo. If you need additional time, you may request an extension from the individual named above. You may submit attachments, limited to a total of 10 pages (5 pages front and back), but they must directly relate to the reason the evaluation was referred. Pertinent attachments not maintained elsewhere will remain attached to the evaluation for filing in your personnel record. Copies of previous evaluations, etc., submitted as attachments, will be removed from your rebuttal package prior to filing the referral evaluation since these documents are already filed in your records. Your rebuttal comments and any attachments may not contain any reflection on the character, conduct, integrity, or motives of the evaluator unless you fully substantiate and document them. Contact your MPS/CSS/HR specialist if you require any assistance in preparing your reply to the referral evaluation.
3. It is important for you to be aware that receiving a referral evaluation may affect your eligibility for other personnel related actions (i.e. assignments, promotion, etc.). I Recommend you consult your first sergeant, commander, or MPS if you desire more information on this subject. If you believe this evaluation is inaccurate, unjust, or unfairly prejudicial to your career, you may apply for a review of the evaluation under Chapter 10, AFI 36-2401, Correction of Officer and Enlisted Evaluation Reports, once the evaluation becomes a matter of record as defined in AFI 36-2406, paragraph 1.4.3.
cc: 123 SFS/MA (Office Symbol of next evaluator/rater's rater)
1st Ind, Dennis L. Franko, SrA (Ratee's Name and Rank)
MEMORANDUM FOR: 123 SFS/MA, MSgt Rivers (office symbol and name of next evaluator) Receipt acknowledged at ____________ (time), on _____________ (date). I understand I have 3 calendar days to provide a response. ____________________________(ratee's signature)
Receipt acknowledged at ____________ (time), on _____________ (date). I understand I have 3 calendar days to provide a response.
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