DD Form 293 Discharge Review

Section 1 of 18

Date of Discharge

Note: If you were discharged more than 15 years ago, you may not apply to the Discharge Review Board and must apply directly to the Board for Correction of Military/Naval Records using DD Form 149.

Date of Discharge: * Refer to the discharge you want changed.

Section 2 of 18

Branch and Component (Items 1 and 2)

Section 1: Service Member (the person whose discharge is to be reviewed).

2. Component at time:

Regular Reserve Guard

Section 3 of 18

Name (Items 3 and 4)

3. Name While Serving - Last: *

3. Name While Serving - First: *

4. Current Name - Last (if different):

4. Current Name - First (if different):

Section 4 of 18

Identifiers (Items 5a and 5b)

5a. SSN While Serving:

5b. DoD ID Number (if applicable):

Section 5 of 18

Mailing Address (Item 6)

It is the applicant's responsibility to report any changes to mailing address or contact information.

Street:

City, State/APO, Country/Foreign Address:

ZIP:

Email: *

Phone: *

Section 6 of 18

Grade / Rank (Items 7 and 8)

Section 2: Service Information (from DD Form 214).

7. Grade/Rank at Discharge:

8. Highest Grade/Rank Held:

Section 7 of 18

Discharge Characterization Received (Item 9)

For Dishonorable or Dismissal, submit DD Form 149 to the BCMR/BCNR instead.

Characterization received:

Honorable Under Honorable Conditions (General) Under Other Than Honorable Conditions Bad Conduct Discharge Uncharacterized / Entry Level Separation

Section 8 of 18

Action Requested (Item 10)

Enter applicable changes. Check all that apply.

Character of Service Separation Code Reentry Code Narrative Reason for Separation

Section 9 of 18

DD Form 214 Codes (Items 11 to 15)

11. Separation Code (box 26):

12. Reentry Code (box 27):

13. Separation Authority (box 25):

14. Narrative Reason (box 28):

15. Unit and Location at Discharge:

Section 10 of 18

Reconsideration (Items 16a and 16b)

Section 3: Request.

16a. Is this a request for reconsideration of a prior application to the Board?

Yes No

Section 11 of 18

Type of Review Requested (Item 17)

Note: The Discharge Review Boards do not have traveling boards.

Conduct initial record review; I and/or representative will NOT appear before the Board. I and/or representative wish to appear at my own expense before the Board.

Section 12 of 18

Related Wars or Contingency Operations (Item 18)

Is this request related to any of these operations? Check all that apply.

Operation Iraqi Freedom (OIF), 03/19/2003 to 08/31/2010 Operation Freedom Sentinel (OFS), 01/01/2015 to Present Operation Inherent Resolve (OIR), 08/08/2014 to Present Operation Enduring Freedom (OEF), 09/11/2001 to 12/31/2014 Operation New Dawn (OND), 09/01/2010 to 12/15/2011

Section 13 of 18

Related Issues or Conditions (Item 19)

Select all that apply.

Section 14 of 18

Statement (Item 20)

Based on propriety, equity, and/or clemency, briefly explain why the Board should grant the requested change. If the basis involves a physical, medical, mental, or behavioral health condition, attach VA rating decisions, relevant medical records, and counseling records where available.

Why should the Board grant the requested change?

Section 15 of 18

Evidence and Records (Item 21)

Section 4. List supporting documentation you are attaching. Do not submit irreplaceable originals; they will not be returned.

21a. Document:

21b. Document:

21c. Document:

Section 16 of 18

Representative or Counsel (Section 5, if applicable)

The following representative is authorized to receive and provide communication on the Service Member's or applicant's behalf. Leave blank if none.

Type:

Representative Attorney

22. Name - Last:

22. Name - First:

23. Street (skip if Service Member is deceased):

City, State/APO, Country:

ZIP:

Email:

Phone:

Section 17 of 18

Applicant (Section 6, if other than Service Member)

If the record in question is that of a deceased or incompetent person, legal proof of death or incompetency must accompany the application. Leave blank if you are the Service Member.

24. Applicant Name (type or print):

Section 18 of 18

Signature (Section 7, Items 25a to 25c)

Certification: I make the foregoing statements as part of this claim with full knowledge of the penalties involved for willfully making a false statement or claim (18 U.S.C. 287 and 1001). I authorize the release of post-service protected health information.

25a. I would like to receive all correspondence / documents electronically (may reduce processing time):