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Copy Directly on to Unit Letter Head!
## MON YEAR (Not before Close Out)
MEMORANDUM FOR SSgt Jane Doe
I am referring the attached (indicate Enlisted/Officer Performance Reports or Education/Training Report) to you according to AFI 36-2406, Military Performance Evaluations, paragraph (3.9. for OPRs/EPRs or 6.4 for TRs). It contains comment(s)/rating(s) that make(s) the report a referral as defined in AFI 36-2406, paragraph 3.9. Specifically, (state why the report is being referred, i.e., “Specifically, my rating of Does Not Meet Standards in section V, items 2 and 3, and my comments in section VI pertaining to your failure to meet and enforce both weight and dress and appearance standards in yourself and your subordinates, causes this report to be referred.”)
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 report. Once signed, you are entitled to a copy of this memo. You may submit comments to rebut the report. Send your comments to reach (name and address of next evaluator) not later than 10 calendar days (30 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 10 pages), but they must directly relate to the reason the report was referred. Pertinent attachments not maintained elsewhere will remain attached to the report for file in your personnel record. Copies of previous reports, etc., submitted as attachments, will be removed from your rebuttal package prior to filing the referral report 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 the MPF career enhancement section if you require and assistance in preparing your reply to the referral report.
It is important for you to be aware that receiving a referral report may affect your eligibility for other personnel related actions (i.e. assignments, promotions, etc.). Recommend you consult your first sergeant, commander and/or MPF if you desire more information on this subject. If you believe this report is inaccurate, unjust, unfairly prejudicial to your career, you may apply for a review of the report under AFI 36-2401, Correction of Officer and Enlisted Evaluation Reports, once the report becomes a matter of record as defined in AFI 36-2406, Attachment 1.
1st Ind, (Ratee)
MEMORANDUM FOR (<RANK> <LNAME>, <FLT>/<OFFICE SYMBOL>)
Receipt acknowledge at (time) on (date) .
Reminder, the Signature Block is 5 spaces below the last line of text and attachments are 2 lines below the signature block
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