TEXAS ARMY NATIONAL GUARD TITLE 32 AGR VACANCY ANNOUNCEMENT

***KEY: CM - TXARNG AGR ONLY PM - TXARNG SOLDIERS ONLY NW - NATION WIDE***

Texas Army National Guard Adjutant General’s

Department Post Office Box 5218

Austin, TX 78763-5218

Announcement # PM 20-007

Opening Date 12 November 2019

Closing Date 11 December 2019 Position Title: G2 I&S CO

Location of Position: HHB 36 ID AUSTIN, TX MOS:

35F3O Grade: E6

Open to: TXARNG SOLDIERS ONLY 35F; ANY MOS MAY APPLY

Minimum Grade to apply: E5 Maximum Grade to apply: E6

REQUIRED DOCUMENTS TO BE SUBMITTED INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED

1. Cover Page - AGR vacancy announcement with Personal Contact Information listed below. 2. NGB Form 34-1 Traditional Soldiers (M-Day, Tech must fill this out!) 3. Memorandum for Consideration (AGR ONLY) - Application for Active Guard/Reserve (AGR). Application

must be signed. Attach a separate sheet fully explaining any "Yes" answers to any questions in section IV. On board AGR Soldiers may submit a Memorandum for Consideration IAW AR 25-52 in lieu of NGB Form 34-1.

4. Military Biography - IAW NGR 600-200 5. CERTIFIED copy of ERB - Certified by Army G1 OPM or Unit S-1. Line Scores must be included. 6. DD Form 214s - Copy Member 4 or Service 2 (indicating SPD Code) or NGB Form 22. 7. Copy of last five NCOERs - Submit a memorandum to the President of the Board explaining reason(s) for

any missing NCOERs/unrated time. A letter of recommendation or performance evaluation will be submitted on soldiers not yet due an NCOER.

8. Individual Medical Readiness (IMR) from MEDPROS - -PHA - must be within 1 YEAR of announcement OPENING DATE. -HIV Testing - must be within 2 YEARS of announcement OPENING DATE. -Dental Class - 1 or 2 - A deployable asset. -If applicable, include PERMANENT PROFILE. Soldiers must NOT be on a TEMPORARY PROFILE.

9. DA Form 705 (APFT) - must have successfully completed & passed most recent APFT within 6 MONTHS of announcement OPENING DATE. -Ensure DA 705 states "FOR RECORD GO" and is filled out properly with HT and WT. -If applicable must provide a passing copy of the OPAT within 1 YEAR of announcement OPENING DATE. -If applicable must include DA Form 5500-R or DA Form 5501-R (Body Fat Content Worksheet).

10. Certified Height and Weight Memorandum - From Unit Commander or authorized representative. -Height and weight must be CONDUCTED within 30 DAYS of announcement OPENING DATE.

11. Current NGB 23B RPAM Statement (PM / NW ONLY) - must be able to complete 3-YEAR INITIAL TOUR prior to the date of mandatory removal from an active status based on age, or service.

12. Statement of Security Verification - from Unit Security Manager (JPAS print out will not be accepted). 13. *DD Form 369 (Police Record Check) - applicant must complete Sections I, II, leave #10 & section III blank

(must be signed and dated). 14. *TXARNG Title 32 AGR - VA Disability Questionnaire - Applicant must complete, sign and date. 15. Letter of Input for President of Board - If applicable list any discrepancies or missing items on this checklist.

This is NOT a requirement.

RANK: PHONE:

NAME: EMAIL:

*** View Page FOUR of this announcement for optional documentation that may be ubmitted. (*Can be found at the end of the announcement.)

***PLEASE INCLUDE READINESS NCO IN EMAIL TRAFFIC*** POINT OF CONTACT FOR APPLICATION PROCESS:

SSG Crystal Alvarado at (512) 782-1244 SPC Alba, Alfredo at (512) 782-6821

Email at crystal.alvarado.mil@mail.mil or alfredo.j.alba.mil@mail.mil

POINT OF CONTACT FOR BOARD & POSITION:

MSG Richard R Gomez at 512-782-5001 x5493 or Richard.r.gomez6.mil@mail.mil

CONSIDERATION FACTORS:

• All applications will receive consideration for this position without regard to race, religion, color, national origin, sex, age, political affiliation or other non-merit factors.

• All applicants must be able to attend appearance board. • A applicants require a background check prior to selection notification

AGR POSITION DESCRIPTION G2 I&S CO Assists the G2 with conducting all-source analysis; develops the threat situation; and fuses, produces and disseminates all-source intelligence to support mission command. Performs, coordinates, and/or directs the Intelligence Preparation of the Battle (IPB) process; assesses collection, and provides support to targeting. Supports and advises the command and staff on intelligence activities and operations. Serves as Unit Security Manager and Division Foundry Manager. Assists the G2 in managing Intelligence Programs such as Information Security, Personnel Security, Foundry, Command Language, Intelligence Oversight, and Threat Awareness and Reporting. Assists the G2 in personnel management and logistics management. Develops monthly, quarterly, and annual training plans. Performs other duties as assigned. Additional or unique position requirements include: - AGR only - Male or Female - CMF 35 MOS specific or willing to reclass if prerequisite are met - Minimum rank to apply is SGT / E5 - Must already have and be able to maintain a security clearance of TS/SCI. - Must be able to appear in person for personal appearance board at a DTGL TBP. Applicants will be notified a minimum of 5 days in advance of board via phone call and email.

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AGR QUALIFICATIONS 1. TXARNG Enlisted membership not to exceed application pay grade. Selected applicants in pay grade that exceeds authorized MTOE assignment on application will take a voluntary reduction in grade prior to assignment. 2. Must be qualified for initial entry into or continued service in the AGR Program IAW AR 135-18, NGR 600-5, AR 40-501, and be capable of performing the duties assigned and implied by grade, MOS and position as prescribed above. 3. Must be able to meet all military education and FTUS requirements in accordance with NGR 600-5, NGR 600-100, NGR 600-101, and current policies/directives. 4. Must attend and successfully complete the appropriate TXARNG and NGB mandated Full Time Unit Support (FTUS) Training Requirement at the Brownwood Training Site and the National Guard Professional Education Center (PEC) within 12 months of assignment. Failure to do so will result in separation. 5. Must not have any unfavorable actions of any kind; must not be flagged, and must not have any temporary or permanent profile that would prevent successful completion of a retention/period physical. 6. Must be a deployable asset. 7. Must attend all Inactive Duty for Training (IDT) and Annual Training (AT) periods and performs duty in the assigned duty MOS. 8. Must be able to complete a 3 year initial tour of AD or FTNGD prior to completing 18 years of active service. 9. Must be at least 18 years of age and not reached 55th birthday. 10. Must have completed Initial Entry Training (IET). 11. If PULHES numerical indicator of P3 or P4, then the requirements of AR 600-60 must be met prior to accessioning into the AGR program. DA PAM 611-21 – PHYSICAL DEMANDS RATING AND QUALIFICATIONS FOR INITIAL AWARD OF MOS

(4) MOSC 35F4O. Performs duties shown in preceding skill level, provides guidance, validates and manages planned all Source intelligence training. Coordinates flow of intelligence information between intelligence disciplines and supervises the all-source production process. Integrates Information Collection to include coordination with the operations officer for asset management and dissemination. Integrates intelligence targeting with operations. Supervises intelligence operations. b. Physical demands rating and qualifications for initial award of MOS. Intelligence analysts must possess the following qualifications: (1) A physical demands rating of moderate (Gold). (2) A physical profile of 222221. (3) Normal color vision. (4) Qualifying scores. (a) A minimum score of 105 in aptitude area ST in Armed Services Vocational aptitude Battery (ASVAB) tests administered prior to 2 January 2002. (b) A minimum score of 102 in aptitude area ST on ASVAB tests administered on and after 2 January 2002 and prior to 1 July 2004. (c) A minimum score of 101 in aptitude area ST on ASVAB tests administered on and after 1 July 2004. (d) A minimum OPAT score of Long Jump (LJ) - 120 cm, seated Power Throw (PT) - 350 cm, Strength Deadlift (SD) - 120 lbs., and Interval Aerobic Run (IR) - 36 shuttles in Physical Demand Category “Moderate” (Gold). (5) The Soldier must meet TOP SECRET (TS) Sensitive Compartmented Information (SCI) access eligibility requirements to be awarded this MOS. The clearance requirements to attend training are an Interim TS/SCI reflected within JPAS or current SSBI with TS/SCI eligibility reflected within JPAS.

Page 3 of 5

CONDITIONS OF EMPLOYMENT 1. Current on-board Technician applicants - Full time technicians selected for an AGR position are responsible for submitting the Uniformed Services Employment and Reemployment Rights Act paperwork thru their fulltime chain of command to the Human Resource Office. In addition, technicians are responsible for ensuring their time and attendance is accurately documented to reflect the appropriate leave status. Failure to submit documentation may result in a debt to the technician. 2. Current on-board AGR applicants are ineligible to apply if within a stabilization period IAW TXARNG 600-5. 3. Must possess and be able to maintain a SECRET Security Clearance for continuation in the AGR Program. Failure to maintain SECRET Security Clearance will result in separation from Title 32 AGR Program. 4. Must demonstrate the ability to effectively communicate verbally and in writing. 5. Human Immune Deficiency Virus (HIV) testing for all Soldiers will be accomplished within 24 months prior to initial entry. 6. Must possess a valid state driver’s license and be able to become qualified to operate vehicles organic to the unit. 7. Favorable drug screening test within 15 days of initial entry into the AGR Program is mandatory. 8. IAW TXARNG 600-5, Initial Hire AGR Soldiers will be stabilized for 30 Months from date of assignment (automatically waived to 24 months if Soldier is fully qualified upon assignment). 9. Soldiers who have filed for or are receiving Veterans Affairs (VA) disability benefits must pass an Active Duty Physical conducted at Military Entrance Processing Station (MEPS) IAW AR 40-501 within 30 days of notification of Selection for AGR Positions.

PLEASE NOTE: ACCEPTANCE OF AN AGR POSITION MAY RESULT IN TERMINATION AND/OR

REPAYMENT OF MILITARY INCENTIVES. PLEASE CHECK YOUR CONTRACT AND CONTACT YOUR SERVICING EDUCATION/INCENTIVES OFFICE OR THE RECRUITING/RETENTION OFFICE.

OPTIONAL DOCUMENTS THAT MAY BE SUBMITTED 1. Copy of any Certificate of Training that is not listed on ERB. 2. Copy of special skill certification or license that is pertinent to the position. 3. Recommendation letters from current or previous employers, commanders, organizations etc. 4. Federal Employee Performance Appraisals or civilian performance evaluation and/or incentive award certificate. 5. Counter Drug, Drug Interdiction, or Law Enforcement performance appraisal. 6. Official DA Photograph. 7. Formal explanation for any discrepancy listed in your official military records. Must be in memorandum format IAW AR 25-50, For the President of the Selection Board. Cannot be for a “bad” NCOER.

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WHERE TO SUBMIT THE APPLICATION (All applications must be received prior to 1600hrs (CST) on the closing date of announcement)

Applicants must contact AGR Staffing if they are not contacted within five business days after the

announcement closing date to verify their packet has been received. *3 Methods for submitting an application: Preferred: EMAIL to: ng.tx.txarng.mbx.agr-staffing@mail.mil E-mail Subject Line should only contain Announcement # - Rank, Last Name, First Name (Example: PM 18-XX – SGT Snuffy, Joe). Please allow up to 48 business hours following closure of announcement to receive EMAIL confirmation. Soldier(s) may contact AGR Staffing Section at anytime to verify their application has been received and/or to correct any deficiencies prior to announcement closing date. (All documents scanned as one PDF/TIF document preferred). Hand Delivered: Applications may be hand delivered by applicant or on behalf of applicant to the AGR Staffing office located on Camp Mabry BLDG 8 RM C104 by 1600 hours COB. An email confirmation will be sent once application is received. (No binders, staples, or tabs). Mailed: Address to the Adjutant General of Texas, ATTN: NGTX-AGR (BLDG 8/RM C104), PO Box 5218, Austin, TX 78763-5218. Express Mail: 2200 W 35th ST, Austin, TX 78703-1222. Application must be received and stamped in by 1600 HOURS on closing date. *Note: Mailing your application through Overnight delivery a day prior to the closing date is not a guarantee it will be received before applications are sent to the unit for board proceedings* An email confirmation will be sent once application is received. (No binders, staples, or tabs). Applicants will not submit an AGR application using Military Postage IAW NGR 600-5 and AR 135-18

INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED

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MOS TITLE

PHYSICAL

DEMANDS

CATEGORY

00Z Sergeant Major Nominative MODERATE

09B Trainee Unassigned MODERATE

09C Trainee Language MODERATE

09D College Trainee MODERATE

09E Trainee Language, Fort Allen PR MODERATE

09J GED Completion Program MODERATE

09L Interpreter/Translator MODERATE

09M March 2 Success MODERATE

09N Nurse Corps Candidate MODERATE

09Q Army Legal Immigrant Healthcare Professional Officer Candidate MODERATE

09R Simultaneous Member Program MODERATE

09S Commissioned Officer Candidate MODERATE

09T College Student Army National Guard Officer Program MODERATE

09U Unqualified In Authorized Army MOS MODERATE

09W Warrant Officer Candidate MODERATE

11B Infantryman HEAVY

11C Indirect Fire Infantryman HEAVY

11X Infantry Recruit HEAVY

11Z Infantry Senior Sergeant MODERATE

12A Engineer Senior Sergeant MODERATE

12B Combat Engineer HEAVY

12C Bridge Crewmember HEAVY

12D Diver HEAVY

12G Quarrying Specialist (RC) SIGNIFICANT

12H Construction Engineering Supervisor MODERATE

12K Plumber MODERATE

12M Firefighter HEAVY

12N Horizontal Construction Engineer MODERATE

12P Prime Power Production Specialist MODERATE

12Q Power Line Distribution Specialist (RC) MODERATE

12R Interior Electrician MODERATE

12T Technical Engineer MODERATE

12V Concrete & Asphalt Equipment Operator (RC) SIGNIFICANT

12W Carpentry & Masonry Specialist MODERATE

12X General Engineering Supervisor MODERATE

12Y Geospatial Engineer MODERATE

12Z Combat Engineering Senior Sergeant MODERATE

13B Cannon Crewmember HEAVY

13D Field Artillery Automated Tactical Data System Specialist MODERATE

13F Joint Fire Support Specialist HEAVY

13J Fire Control Specialist HEAVY

13M Multiple Launch Rocket System (MLRS)/High Mobility Artillery Rocket Syst Em (HIMARS) Crewmember HEAVY

13P Multiple Launch Rocket System (MLRS) Operational Fire Direction Specialist MODERATE

13R Field Artillery Firefinder Radar Operator HEAVY

13T Field Artillery Surveyor/Meteorological Crewmember MODERATE

13X Field Artillery Computer Systems Specialist MODERATE

13Z Field Artillery Senior Sergeant MODERATE

14E Patriot Fire Control Enhanced Operator/Maintainer MODERATE

14G Air Defense Battle Management System Operator MODERATE

14H Air Defense Enhanced Early Warning Operator MODERATE

14P Air & Missile Defense (AMD) Crewmember SIGNIFICANT

14S Avenger Crewmember SIGNIFICANT

14T Patriot Launching Station Enhanced Operator/Maintainer MODERATE

14X Space and Missile Defense Operations MODERATE

14Z Air Defense Artillery Senior Sergeant MODERATE

15B Aircraft Powerplant Repairer MODERATE

15C MQ-1 Operator (Effective 202010) MODERATE

15D Aircraft Powertrain Repairer MODERATE

15E Unmanned Aircraft Systems Repairer MODERATE

15F Aircraft Electrician MODERATE

15G Aircraft Structural Repairer MODERATE

15H Aircraft Pneudraulics Repairer MODERATE

15J OH-58D Armament/Electrical/Avionics Systems Repairer SIGNIFICANT

15K Aircraft Components Repair Supervisor MODERATE

15L Armament/Electrical/Avionics Repair Supervisor (Arm/Elect/Avionics Rep Supv) (Effective 201910) MODERATE

The occupational physical assessment test (OPAT), allows the Army to screen applicants for their ability to succeed in their assigned specialty prior to entering active duty or

The OPAT categories for each enlisted specialty are:

10-2-1. Enlisted OPAT Physical Demands Categores

1 of 4

MOS TITLE

PHYSICAL

DEMANDS

CATEGORY

15M MQ-1 Repairer (Effective 202010) MODERATE

15N Avionic Mechanic MODERATE

15P Aviation Operations Specialist MODERATE

15Q Air Traffic Control Operator MODERATE

15R AH-64 Attack Helicopter Repairer MODERATE

15S OH-58D Helicopter Repairer SIGNIFICANT

15T UH-60 Helicopter Repairer MODERATE

15U CH-47 Helicopter Repairer MODERATE

15W Unmanned Aircraft Systems Operator MODERATE

15Y AH-64D Armament/Electrical/Avionic Systems Repairer MODERATE

15Z Aircraft Senior Sergeant MODERATE

17C Cyber Operations Specialist MODERATE

17E Electronic Warfare Specialist (Eff 201810) MODERATE

18B Special Forces Weapons Sergeant HEAVY

18C Special Forces Engineer Sergeant HEAVY

18D Special Forces Medical Sergeant HEAVY

18E Special Forces Communications Sergeant HEAVY

18F Special Forces Assistant Operations & Intelligence Sergeant HEAVY

18X Special Forces Recruit HEAVY

18Z Special Forces Senior Sergeant MODERATE

19D Cavalry Scout HEAVY

19K M1 Armor Crewman HEAVY

19Z Armor Senior Sergeant MODERATE

25B Information Technology Specialist MODERATE

25C Radio Operator-Maintainer MODERATE

25D Cyber Network Defender MODERATE

25E Electromagnetic Spectrum Manager MODERATE

25L Cable Systems Installer-Maintainer SIGNIFICANT

25M Multimedia Illustrator MODERATE

25N Nodal Network Systems Operator-Maintainer MODERATE

25P Microwave Systems Operator-Maintainer MODERATE

25Q Multichannel Transmission Systems Operator- Maintainer MODERATE

25R Visual Information Equipment Operator-Maintainer SIGNIFICANT

25S Satellite Communication Systems Operator- Maintainer MODERATE

25T Satellite/Microwave Systems Chief MODERATE

25U Signal Support Systems Specialist MODERATE

25V Combat Documentation/Production Specialist MODERATE

25W Telecommunications Operations Chief MODERATE

25X Chief Signal NCO MODERATE

25Z Visual Information Operations Chief MODERATE

27D Paralegal Specialist MODERATE

29E Electronic Warfare Specialist (Res 201810) MODERATE

31B Military Police SIGNIFICANT

31D CID Special Agent MODERATE

31E Internment/Resettlement Specialist MODERATE

31K Military Working Dog (MWD) Handler SIGNIFICANT

35F Intelligence Analyst MODERATE

35G Geospatial Intelligence Imagery Analyst MODERATE

35L Counter Intelligence Agent MODERATE

35M Human Intelligence Collector MODERATE

35N Signals Intelligence Analyst MODERATE

35P Cryptologic Linguist MODERATE

35Q Cryptologic Network Warfare Specialist MODERATE

35S Signals Collector/Analyst MODERATE

35T Military Intelligence Systems Maintainer/Integrator MODERATE

35V Signals Intelligence (SIGINT) Senior Sergeant/SIGINT Chief MODERATE

35X Intelligence Senior Sergeant/Chief Intelligence Sergeant MODERATE

35Y Chief Counter Intelligence/Human Intelligence Sergeant MODERATE

35Z Intelligence Sergeant Major MODERATE

36B Financial Management Technician MODERATE

37F Psychological Operations Specialist SIGNIFICANT

38B Civil Affairs Specialist SIGNIFICANT

42A Human Resources Specialist MODERATE

42R Musician MODERATE

42S Special Band Musician MODERATE

46Q Public Affairs Specialist MODERATE

46R Public Affairs Broadcast Specialist MODERATE

2 of 4

MOS TITLE

PHYSICAL

DEMANDS

CATEGORY

46S Public Affairs Mass Communications Specialist MODERATE

46Z Chief Public Affairs NCO MODERATE

51C Acquisition, Logistics & Technology (Al&T) Contracting NCO MODERATE

56M Religious Affairs Specialist MODERATE

68A Biomedical Equipment Specialist MODERATE

68B Orthopedic Specialist MODERATE

68C Practical Nursing Specialist MODERATE

68D Operating Room Specialist MODERATE

68E Dental Specialist MODERATE

68F Physical Therapy Specialist MODERATE

68G Patient Administration Specialist MODERATE

68H Optical Laboratory Specialist MODERATE

68J Medical Logistics Specialist MODERATE

68K Medical Laboratory Specialist MODERATE

68L Occupational Therapy Specialist MODERATE

68M Nutrition Care Specialist MODERATE

68N Cardiovascular Specialist MODERATE

68P Radiology Specialist MODERATE

68Q Pharmacy Specialist MODERATE

68R Veterinary Food Inspection Specialist MODERATE

68S Preventive Medicine Specialist MODERATE

68T Animal Care Specialist MODERATE

68U Ear, Nose & Throat (ENT) Specialist MODERATE

68V Respiratory Specialist MODERATE

68W Health Care Specialist SIGNIFICANT

68X Behavioral Health Specialist MODERATE

68Y Eye Specialist MODERATE

68Z Chief Medical NCO MODERATE

74D Chemical, Biological, Radiological & Nuclear (CBRN) Specialist MODERATE

79R Recruiter MODERATE

79S Career Counselor MODERATE

79T Recruiting & retention NCO (Army National Guard of the United States) MODERATE

79V Retention & Transition NCO, USAR MODERATE

88H Cargo Specialist HEAVY

88K Watercraft Operator HEAVY

88L Watercraft Engineer SIGNIFICANT

88M Motor Transport Operator HEAVY

88N Transportation Management Coordinator SIGNIFICANT

88U Railway Specialist (RC) MODERATE

88Z Transportation Senior Sergeant MODERATE

89A Ammunition Stock Control & Accounting Specialist MODERATE

89B Ammunition Specialist SIGNIFICANT

89D Explosive Ordnance Disposal Specialist HEAVY

91A M1 Abrams Tank System Maintainer MODERATE

91B Wheeled Vehicle Mechanic MODERATE

91C Utilities Equipment Repairer MODERATE

91D Tactical Power Generation Specialist MODERATE

91E Allied Trades Specialist MODERATE

91F Small Arms/Towed Artillery Repairer MODERATE

91G Fire Control Repairer MODERATE

91H Track Vehicle Repairer MODERATE

91J Quartermaster & Chemical Equipment Repairer MODERATE

91L Construction Equipment Repairer MODERATE

91M Bradley Fighting Vehicle System Maintainer MODERATE

91P Artillery Mechanic MODERATE

91S Stryker Systems Maintainer MODERATE

91X Maintenance Supervisor MODERATE

91Z Mechanical Maintenance Supervisor MODERATE

92A Automated Logistical Specialist SIGNIFICANT

92F Petroleum Supply Specialist SIGNIFICANT

92G Culinary Specialist SIGNIFICANT

92L Petroleum Laboratory Specialist MODERATE

92M Mortuary Affairs Specialist HEAVY

92R Parachute Rigger SIGNIFICANT

92S Shower & Laundry Specialist (S&L SPC) SIGNIFICANT

92W Water Treatment Specialist SIGNIFICANT

92Y Unit Supply Specialist MODERATE

3 of 4

MOS TITLE

PHYSICAL

DEMANDS

CATEGORY

92Z Senior Noncommissioned Logistician MODERATE

94A Land Combat Electronic Missile System Repairer MODERATE

94D Air Traffic Control Equipment Repairer MODERATE

94E Radio Equipment Repairer MODERATE

94F Computer Detection Systems Repairer MODERATE

94H Test, Measurement, & Diagnostic Equipment (TMDE) Maintenance Support Specialist MODERATE

94M Radar Repairer MODERATE

94P Multiple Launch Rocket System Repairer MODERATE

94R Avionic & Survivability Equipment Repairer MODERATE

94S Patriot System Repairer MODERATE

94T Short Range Air Defense System Repairer MODERATE

94W Electronic Maintenance Supervisor MODERATE

94Y Integrated Family of Test Equipment (IFTE) Operator & Maintainer MODERATE

94Z Senior Electronic Maintenance Supervisor MODERATE

4 of 4

TEXAS ARMY NATIONAL GUARD TITLE 32 AGR

VA Disability Benefits Questionnaire

1. Are you receiving VA disability benefits? YES NO (CIRCLE ONE)

2. Are you entitled to receive VA disability benefits, but for YES NO (CIRCLE ONE)

_)the receipt of the retired pay?

3. Have you received VA disability benefits in the past? YES NO (CIRCLE ONE)

4. If you are not receiving VA disability, have you filed for YES NO (CIRCLE ONE)

_)the VA disability benefits?

5. If you are drawing VA disability benefits at what percentage? _________ %

If you answered yes to any question above, I understand that I must take an Active Duty physical at

Military Entrance Processing Station (MEPS) IAW AR 40-501 within 30 days of notification of selection

for an AGR position. I understand that I must take all medical documents and VA Disability documents

with me to MEPS on the day of the physical.

____________________________ ________________________ __________________

Full name (Last, First Middle) Signature Date

As of 19 February 2014