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Reason for Emergency Leave

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Date: ____________________ Name: ______________________________________________________________________________________________________ NIA #: __________________________________Roster #: ______________________________________________________ Unit: ________________________________________ Reason for Emergency Leave: ___________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ Destination: _________________________________________________________________________________________________ From: Date__________/Time__________ To: Date__________/Time__________ This individual is authorized emergency leave for ______ hours. Approved/Disapproved Company Commander: Signature:_______________________________________________ Date:_______________________ Battalion Commander: Signature:________________________________________________ Date:_______________________ ____________________________________________________________________________________________________________ I understand the dates and time of my leave authorized. I understand that I could be subject to recycle for missed training. I understand that if I fail to report on time is grounds for recycle or dismissal. I understand that all advance pay will be deducted from my pay. I understand all the stated above, and will inform NIATC if any difficulties arise or report to the nearest Recruiting Station for assistance. ___________________________________________ Printed Name ___________________________________________ Signed Requested Advance Pay in the amount of $________ CMATT APROVAL: Approved Advance Pay in the amount of $________ NAME: ___________________________________ RANK: ___________________________________ SIGNATURE: _____________________________ CMATT Coalition Military Assistance Training Team Tadji, Iraq EMERGENCY LEAVE FORM NIA IDENTIFICATION CARD