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Navcompt 3065 Sample

LEAVE REQUEST/AUTHORIZATION

SEE PAGE 2 FOR

NAVCOMPT 3065 (REV. 01/2007)

INSTRUCTIONS FOR COMPLETING THIS FORM ARE ON PAGE 2.

PRIVACY ACT STATEMENT

1. DATE OF REQUEST

2. FOR ADMIN. USE ONLY

 

 

►

APPROVAL OF THIS LEAVE IS

LEAVE CONTROL NO.

 

 

 

 

 

NOT VALID WITHOUT CONTROL NO.

 

 

 

3. SSN

4.NAME (Last, First, MI)

5. PAYGRADE

6. SHIP/STATION

 

 

 

 

 

 

7. DEPT/DIV

8. DUTY SECTION

9. DUTY PHONE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10. TYPE LEAVE

 

 

 

 

 

 

FOR USE OUTUS ONLY

 

12. MODE OF TRAVEL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11a. Leaving Area of PERMDUTYSTA

 

AIR

BUS

REGULAR

 

SICK

 

EMERGENCY

 

 

 

 

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SEPARATION

 

RETIREMENT

OTHER

 

11b. Taking Leave INCONUS

 

CAR

TRAIN

 

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

13. DAYS REQUESTED

14. FROM (Hour, Date) (YYMMDD)

15. TO (Hour, Date) (YYMMDD)

 

16. NORMAL WORKING HOURS

 

 

 

 

 

 

 

 

 

 

DAY OF DEPARTURE:

 

 

 

 

 

 

 

 

 

 

FROM:

TO:

17. LEAVE BALANCE

 

 

 

18. LEAVE USED THIS FY

19. LEAVE PHONE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DAY OF RETURN:

 

DAYS AS OF

 

 

 

 

 

 

 

 

 

FROM:

TO:

 

 

 

 

 

 

 

 

 

 

20. LEAVE ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

21. RATION STATUS (Enlisted)

 

 

 

 

 

 

 

 

 

 

COMMUTED RATIONS (COMRATS)

 

 

 

 

 

 

 

 

 

 

Meal Pass No.

 

 

 

 

 

 

 

 

 

 

 

 

Entitled to EDF meals except

 

 

 

 

 

 

 

 

 

 

during periods of leave

 

 

 

 

 

 

 

 

I CERTIFY THAT I HAVE SUFFICIENT FUNDS TO COVER THE COST OF ROUND TRIP TRAVEL. I UNDERSTAND

22. SIGNATURE OF APPLICANT

THAT SHOULD ANY PORTION OF THIS LEAVE, IF APPROVED, RESULT IN MY TAKING MORE LEAVE THAN I CAN

 

 

 

 

EARN ON MY CURRENT UNEXTENDED ENLISTMENT OR CURRENT ACTIVE DUTY OBLIGATION, MY PAY WILL BE

 

 

 

 

CHECKED FOR SUCH EXCESS LEAVE.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RECOMMENDED

 

 

 

 

 

 

DATE

 

 

 

NO

 

 

 

 

 

 

 

 

 

YES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

23. APPROVED

DISAPPROVED

REVIEWING OFFICER'S NAME AND SIGNATURE

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

24. COMMENTS/REMARKS

25. SHIP OR STATION (Including telegraphic address)

26. REPORT ON EXPIRATION OF LEAVE TO (If other than block 25)

 

DEPARTED ON LEAVE

 

RETURNED FROM LEAVE

 

 

 

GRANTED EXTENSION OF LEAVE ENDING

 

27a. HOUR

27b. DATE (DD MMM YYYY)

28a. HOUR

28b. DATE (DD MMM YYY)

 

29a. HOUR

 

29b. DATE (DD MMM YYYY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

27c. OOD'S SIGNATURE

 

28c. OOD'S SIGNATURE

 

 

 

 

29c. AUTHORIZING OFFICER'S SIGNATURE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IN CONSIDERATION OF THE MEMBER'S COMPLETION OF A FULL WORKDAY

 

30. INCLUSIVE

 

 

FIRST:

LAST:

 

31. NO.

 

 

 

 

 

OF

 

 

►

 

 

 

 

 

 

 

 

 

 

 

(AS DEFINED IN MILPERSMAN, NAVPERS 15560) ON THE DAYS OF DEPARTURE

 

 

(YY) (MM) (DD)

(YY) (MM) (DD)

 

 

LEAVE PERIOD

 

 

DAYS

 

AND RETURN, THE INCLUSIVE DAYS SHOWN ARE CORRECT AND PROPER FOR

TO BE

 

 

 

 

 

 

 

 

 

 

 

 

CHARGING AS LEAVE.

 

 

 

 

CHARGED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I CERTIFY THAT THE ABOVE IS

32. CERTIFYING OFFICER'S TYPED NAME/RANK/TITLE

 

 

33. CERTIFYING OFFICER'S SIGNATURE

 

CORRECT AND PROPER TO THE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BEST OF MY KNOWLEDGE.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FORWARD A COPY TO PERSONNEL OFFICE VIA COMMAND ONLY ON COMPLETION OF LEAVE.

Page 1 of 2

IMPORTANT

THIS IS YOUR "OFFICIAL" LEAVE AUTHORIZATION.

NOTICE !!

DO NOT DESTROY OR LOSE!

1.Leave is granted subject to immediate recall, therefore maintain communication with your leave address. Keep this leave authorization in your possession at all times. In the event of a general recall, individual orders may not be issued. Inform your commanding officer of permanent change of leave address.

2.Save sufficient money or obtain round-trip ticket to insure you have return transportation. Keep yourself informed of transportation schedules and weather conditions through your return route and make sufficient allowances for normal delays.

3.While it is desirable to tell the public about your Navy, do not discuss any subject unless you are certain it is unclassified. If you are asked to participate in a press conference, talk to reporters, or speak over the radio or television on matters pertaining to the naval service, and you are not certain that all your remarks are unclassified, consult with and obtain guidance of the commanding officer of the nearest naval unit prior to participation.

4.Cooperate with Military or Air Police, Shore Patrol, and civil authorities at all times. You are subject to orders of your superior officers in all branches of the U.S. Armed Forces. Be an outstanding Navy ambassador at all times.

5.If necessary to request an extension of leave, communicate with your commanding officer by telegram. SINCE YOU NEED

POSITIVE APPROVAL FOR REMAINING ABSENT BEYOND THE TIME ORIGINALLY AUTHORIZED, IF NO REPLAY IS RECEIVED YOU MUST CONSIDER YOUR REQUEST NOT APPROVED.

6.In case of serious illness or injury incurred while on leave which requires medical attention or hospitalization, report facts to your commanding officer. If in the immediate vicinity of a naval activity, such as recruiting station or naval station, advise them of your condition and status. You are advised that costs incident to hospitalization or medical treatment received at other than Federal medical activities (Army, Air Force, Public Health Service, or Veterans' Administration) may be defrayed by the Navy Department in EMERGENCY cases only.

7.In the event that conditions beyond your control indicate late return to the command to which you are ordered to report, obtain written evidence from transportation agency or others (physician, military or civil police, recruiting station, etc.) for consideration by your commanding officer.

8.Request leave sufficiently in advance to allow processing via official channels. Leave is computed as follows: The day of departure on leave, shall be counted as a day of duty, except when leave commences prior to the end of the normal workday; the day of return from leave shall be counted as a day of leave, except when such return is made at or before commencement of your normal workday in which case it shall be counted as a day of duty.

OPERATION DRIVESAFE REMINDER

Statistics show the major causes of motor vehicle accidents are attributable to:

Excessive speed

Intoxicating liquor, and

Driving while fatigued or sleepy.

PLAN YOUR TRIP CAREFULLY. Be sure you allow yourself sufficient travel time and keep your travel to a minimum during hours of darkness.

INSTRUCTIONS FOR COMPLETING THE LEAVE REQUEST PORTION OF THIS FORM

1.Completion of this form must be in ballpoint or typewriter. The form must be completed in triplicate with all copies egible.

2.Print or type the appropriate data in blocks 1, and 3 through 21. Leave block 2 blank.

3.When completing blocks 14 and 15, follow these rules:

a.Block 14 - The hour for starting leave may not be prior to the end of your normal workday if leave starts on a workday. If leave starts ona non-workday, the starting hour may be 0001 if not contrary to command policy.

b.Block 15 - The hour for ending leave may not be later than the beginning of your normal workday if the day of return is a workday. If leave ends on a non-workday, the ending hour may be 2400 if not contrary to command policy.

4.Block 16 requires the following information:

Normal working hours for day of departure.

Normal working hours for day of return.

If day of departure or return is not a workday, enter "NONE"

5.Information required in blocks 17 and 18 may be obtained from Block 59 of your latest Leave and Earnings Statement or from your activity's Commanding Officer's Leave Listing.

6.You are advised that you must immediately return your original leave authorization to the appropriate office designated by your command upon return from leave.

PRIVACY ACT STATEMENT

This statement is provided in compliance with the provisions of the Privacy Act of 1974 (PL 93-579) which require that Federal agencies must inform individuals who are requested to furnish information about themselves as to the following facts concerning the information requested.

1.AUTHORITY: Title 10 and 37 USC.

2.PRINCIPAL PURPOSE(S): To authorize military leave of absence.

3.ROUTINE USE(S): To deduct leave taken from member's accrued leave balance. To pay leave rations to enlisted members.

4.MANDATORY OR VOLUNTARY DISCLOSURE: Voluntary. If the member does not request a specific period of leave and furnish his leave address, leave is not granted.

Page 2 of 2

⇓ PDF File

Instructions on Utilizing Navcompt 3065

After gathering the necessary information, the next step involves accurately completing the Navcompt 3065 form to request leave. This form must be filled out in triplicate and submitted through the appropriate channels within the command. Ensure all sections are completed clearly and legibly.

  1. Fill in the Date of Request in block 1.
  2. Leave block 2 blank for administrative use.
  3. Enter your Social Security Number in block 3.
  4. Provide your Name (Last, First, Middle Initial) in block 4.
  5. Indicate your Paygrade in block 5.
  6. Specify your Ship/Station in block 6.
  7. List your Department/Division in block 7.
  8. Fill in your Duty Section in block 8.
  9. Provide your Duty Phone in block 9.
  10. Select the Type of Leave in block 10 and mark the appropriate options.
  11. Indicate if you are Leaving Area of Permanent Duty Station in block 11a.
  12. Specify if you are Taking Leave In CONUS in block 11b.
  13. Enter the Days Requested in block 13.
  14. Fill in the From (Hour, Date) in block 14.
  15. Fill in the To (Hour, Date) in block 15.
  16. Provide Normal Working Hours for the day of departure in block 16.
  17. Check your Leave Balance in block 17.
  18. Indicate Leave Used This Fiscal Year in block 18.
  19. Provide your Leave Phone in block 19.
  20. Fill in your Leave Address in block 20.
  21. Indicate your Ration Status in block 21.
  22. Sign and date the form in block 22.
  23. Leave blocks 23 to 24 for the reviewing officer's use.
  24. Complete blocks 25 to 29 with relevant information regarding your ship or station and leave details.
  25. Sign the form in block 32 as the certifying officer.
  26. Submit the completed form to the designated office for processing.

Misconceptions

Misconceptions about the Navcompt 3065 form can lead to confusion and errors in the leave request process. Here are five common misconceptions:

  • 1. The Navcompt 3065 form is only for sick leave. This form is used for various types of leave, including regular leave, emergency leave, separation, and retirement. It is not limited to sick leave.
  • 2. Approval of leave is guaranteed once the form is submitted. Submission of the Navcompt 3065 does not guarantee approval. Each request is subject to review and must be approved by the appropriate authority.
  • 3. The leave balance is automatically updated. Leave balances are not updated automatically upon submission of the form. It is the responsibility of the service member to check their leave balance and ensure it is sufficient for the requested time off.
  • 4. The form can be completed in any format. The Navcompt 3065 must be completed in ballpoint pen or typewriter. Other formats may not be accepted and could delay processing.
  • 5. Communication during leave is not necessary. Service members must maintain communication with their leave address. They are subject to immediate recall, and it is essential to stay informed about any changes in orders or requirements.

Documents used along the form

The Navcompt 3065 form is an essential document for requesting leave in the military. However, several other forms and documents may accompany it during the leave process. Each of these documents plays a crucial role in ensuring that leave is properly authorized and managed. Below is a list of these additional forms and documents.

  • Leave Authorization Form: This document officially grants permission for the service member to take leave. It outlines the specific dates and type of leave approved.
  • Travel Orders: Issued by the command, travel orders provide details about the service member's travel arrangements, including destinations and modes of transport.
  • Leave Balance Statement: This statement shows the amount of leave a service member has accrued and used. It helps ensure that the member does not exceed their available leave.
  • Medical Documentation: If leave is taken for medical reasons, relevant medical documentation may be required to justify the leave and ensure proper care.
  • Emergency Leave Request Form: This form is used when a service member needs to take leave due to an urgent family matter or personal emergency.
  • Extension Request Form: If a service member needs to extend their leave beyond the originally approved dates, this form is submitted for additional approval.
  • Non-disclosure Agreement: To protect sensitive information, consider utilizing the essential Non-disclosure Agreement guidelines for effective confidentiality management.
  • Return from Leave Notification: This document is submitted to inform the command of the service member's return from leave, ensuring proper accountability.
  • Commanding Officer's Approval: A signature or written approval from the commanding officer is often required to finalize leave requests and ensure compliance with military regulations.

Each of these documents supports the leave process and helps maintain clear communication between service members and their commands. Properly managing these forms ensures that all parties are informed and that leave is taken in accordance with military policies.