Prescribed by: DoDI 1304.

02 CUI (when filled in)

ENLISTMENT/REENLISTMENT DOCUMENT - ARMED FORCES OF THE UNITED STATES

(Read Privacy Act Statement and Instructions on back before completing this form.)

A. ENLISTEE/REENLISTEE IDENTIFICATION DATA

1. NAME (Last, First, Middle) 2a. SOCIAL SECURITY NUMBER 2b. DoD ID NUMBER
(Use for new contracts) (Use for reenlistments)

3. HOME OF RECORD 4. PLACE OF ENLISTMENT/REENLISTMENT

(Street, City, County, State, Country, ZIP Code) (Mil. Installation, City, State, Zip Code)

5. DATE OF: 6. DATE OF BIRTH 7. PREV MIL SVC UPON ENL/REENLIST YEARS MONTHS DAYS
(YYYYMMDD)
a. TOTAL ACTIVE MILITARY SERVICE

b. TOTAL INACTIVE MILITARY SERVICE

B. AGREEMENTS
8. I am enlisting/reenlisting in the United States (list branch of service)
this date for years, months, and weeks beginning in pay grade
of which years, months, and weeks is considered an Active Duty Obligation, and
years, months, and weeks will be served in the Reserve Component of the Service in which I have enlisted.
If this is an initial enlistment, I must serve a total of eight (8) years, unless I am sooner discharged or otherwise extended by the appropriate authority. This eight
year service requirement is called the Military Service Obligation. The additional details of my enlistment/reenlistment are in Section C and Annex(es) (list name
of Annex(es) and describe)

a. FOR ENLISTMENT IN A DELAYED ENTRY/ENLISTMENT PROGRAM (DEP):

I understand that I am joining the DEP. I understand that by joining the DEP I am enlisting in the Ready Reserve component of the

United States (list branch of service) for a period not to exceed

365 days, unless this period of time is otherwise extended by the Secretary concerned. While in the DEP, I understand that I am in a nonpay status and that I
am not entitled to any benefits or privileges as a member of the Ready Reserve, to include, but not limited to medical care, liability insurance, death benefits,
education benefits, or disability retired pay if I incur a physical disability. I understand that the period of time while I am in the DEP is NOT creditable for pay
purposes upon entry into a pay status. However, I also understand that the period of time while I am in the DEP is counted toward fulfillment of my military
service obligation described in paragraph 10, below. While in the DEP, I understand that I must maintain my current qualifications and keep my recruiter
informed of any changes in my physical or dependency status, qualifications, and mailing address. I understand that I WILL be ordered

to active duty unless I report to the place shown in item 4 above by (list date (YYYYMMDD)) for enlistment in the Regular component

of the United States (list branch of service) for not less than

years, months, and weeks.

b. REMARKS: (lf none, so state.)

c. The agreements in this section and attached annex(es) are all the promises made to me by the Government. ANYTHING ELSE ANYONE HAS PROMISED
ME IS NOT VALID AND WILL NOT BE HONORED.

(Initials of Enlistee/Reenlistee)

DD FORM 4, MAY 2020 CUI (when filled in) Controlled by: OUSD(P&R) Page 1 of 4
CUI Category: PRVCY
PREVIOUS EDITION IS OBSOLETE. Distribution/Dissemination Control: FEDCON
POC: osd.pentagon.ousd-p-r.mbx.forms@mail.mil
 CUI (when filled in)

PRIVACY ACT STATEMENT FOR DD FORM 4

AUTHORITY: 10 U.S. Code §113: “Secretary of Defense”; 10 U.S. Code §136: “Under Secretary of Defense for Personnel and Readiness”; 10 U.S. Code
§502: “Enlistment oath: who may administer”; 10 U.S.C. §506: “Regular components: extension of enlistments during war”; 10 U.S. Code §507: “Extension of
enlistment for members needing medical care or hospitalization”; 10 U.S. Code §508: “Reenlistment: qualifications”; 10 U.S. Code §509: “Voluntary extension of
enlistments: periods and benefits”; 10 U.S. Code §510: “Enlistment incentives for pursuit of skills to facilitate national service”; 10 U.S. Code §513: “Enlistments:
Delayed Entry Program”; 10 U.S. Code §515: “Reenlistment after discharge as warrant officer”; 10 U.S.C. §516: “Effect upon enlisted status of acceptance of
appointment as cadet or midshipman”; 10 U.S. C. §518: “Temporary enlistments”; 10 U.S. C. §519: “Temporary enlistments: during war or emergency”; 10
U.S.C. §3258: “Regular Army: Reenlistment after service as an officer”; 10 U.S.C. §8252: “Regular Air Force: gender-free basis for acceptance of original
enlistments”; 10 U.S.C. §8258: “Regular Air Force: reenlistment after service as an officer”; 10 U.S. Code §12107: “Army National Guard of United States; Air
National Guard of the United States: enlistment in”; 10 U.S. Code §12108: “Enlisted members: discharge or retirement for years of service or for age”; 32 U.S.
Code §301: “Federal recognition of enlisted members”; 32 U.S. Code §302: “Enlistments, reenlistments, and extensions”; 32 U.S.C. §303: “Active and inactive
enlistments and transfers”; 32 U.S.C. §304: “Enlistment oath”; E.O. 9397 (SSN), as amended.

PRINCIPAL PURPOSE(S): To record enlistment or reenlistment into the U.S. Armed Forces. This information becomes a part of the subject's military personnel
records which are used to document promotion, reassignment, training, medical support, and other personnel management actions. The purpose of soliciting
the Social Security Number (SSN) and the Electronic Data Interchange Personal Identifier (EDIPI), is for positive identification.

ROUTINE USE(S): This form becomes a part of the Service's Enlisted Master File and Field Personnel File. All uses of the form are internal to the relevant
Service. FOR ALL APPLICANTS: SSN collection is only authorized for newly enlisting military service members. SSN collection is not authorized for current
military personnel reenlisting in the Armed Forces. The EDIPI / DoD identification number should be used to identify the records of these individuals. Additional
routine uses are listed in the applicable system of records notice:

U.S. Military Processing Command Integrated Resources System (USMIRS), A0601-270 USMEPCOM DoD (November 03, 2010, 75 FR 67700)
https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570661/a0601-270-usmepcom-dod/

Department of the Army, A0601-210a USAREC Enlisted Eligibility Files (December 08, 2005, 70 FR 72998)
https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570071/a0601-210a-usarec.aspx

Department of the Air Force, F036 AETC R, Air Force Recruiting Information Support System (AFRISS) Records (October 23, 2008, 73 FR 63144)
https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/569780/f036-aetc-r/

Department of the Navy (Navy and Marine Corps) M01133-3, Marine Corps Recruiting Information Support System (MCRISS) (May 23, 2008, 73 FR 30095)
https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570628/m01133-3/

Department of the Navy (Navy and Marine Corps) N01133-2, Recruiting Enlisted Selection System (April 01, 2008, 73 FR 17336)
https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570318/n01133-2/

Coast Guard: DHS/USCG-027, Recruiting Files

http://www.gpo.gov/fdsys/pkg/FR-2011-08-10/html/2011-20225.htm

DISCLOSURE: Voluntary; however, failure to furnish personal identification information may negate the enlistment/reenlistment application.

WARNING

Information provided by you on this form is FOR OFFICIAL USE ONLY and will be maintained and used in strict compliance with Federal laws and
regulations. The information provided by you becomes the property of the United States Government, and it may be consulted throughout your military
service career, particularly whenever either favorable or adverse administrative or disciplinary actions related to you are involved.
YOU CAN BE PUNISHED BY FINE, IMPRISONMENT OR BOTH IF YOU ARE FOUND GUILTY OF MAKING KNOWING AND WILLFUL FALSE
STATEMENTS ON THIS DOCUMENT.

INSTRUCTIONS
(Read carefully BEFORE filling out this form.)

1. Read Privacy Act Statement above before completing form.

2. Type or print LEGIBLY all answers. If the answer is “None” or “Not Applicable”, so state. “Optional” questions may be left blank.

3. Unless otherwise specified, write all dates as 8 digits (with no spaces or marks) in YYYYMMDD fashion. June 1, 2014 is written 20140601.

DD FORM 4, MAY 2020 CUI (when filled in) Back of Page 1

PREVIOUS EDITION IS OBSOLETE.
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C. PARTIAL STATEMENT OF EXISTING UNITED STATES LAWS

9. FOR ALL ENLISTEES OR REENLISTEES: d. As a member of the Ready Reserve (to include Delayed Entry
I understand that many laws, regulations, and military customs will govern Program), in time of national emergency declared by the President, I may,
my conduct and require me to do things under this agreement that a civilian without my consent, be ordered to serve on active duty, and my military
does not have to do. I also understand that various laws, some of which are service may be extended without my consent, for not more than 24
listed in this agreement, directly affect this enlistment/reenlistment consecutive months (10 U.S.C. 12302). My enlistment may be extended
agreement. Some examples of how existing laws may affect this agreement during this period without my consent (see paragraph 10g).
are explained in paragraphs 10 and 11. I understand that I cannot change
these laws but that Congress may change these laws, or pass new laws, at e. As a member of the Ready Reserve, I may, at any time and without
any time that may affect this agreement, and that I will be subject to those my consent, be ordered to active duty to complete a total of 24 months of
laws and any changes they make to this agreement. I further understand active duty, and my enlistment may be extended so I can complete the total
that: of 24 months of active duty, if:

a. My enlistment/reenlistment agreement is more than an employment (1) I am not assigned to, or participating unsatisfactorily in, a unit of the
agreement. It effects a change in status from civilian to military member of Ready Reserve; and
the Armed Forces. As a member of the Armed Forces of the United States,
I will be: (2) I have not met my Reserve obligation; and
(1) Required to obey all lawful orders and perform all assigned duties.
(3) I have not served on active duty for a total of 24 months (10 U.S.C.
(2) Subject to separation during or at the end of my enlistment. If my 12303).
behavior fails to meet acceptable military standards, I may be discharged
and given a certificate for less than honorable service, which may hurt my f. As a member of the Selected Reserve or as a member of the
future job opportunities and my claim for veteran's benefits. Individual Ready Reserve mobilization category, when the President
determines that it is necessary to augment the active forces for any
(3) Subject to the military justice system, which means, among other operational mission or for certain emergencies, I may, without my consent,
things, that I may be tried by military courts-martial. be ordered to active duty for not more than 365 days (10 U.S.C. 12304).
My enlistment may be extended during this period without my consent (see
(4) Required upon order to serve in combat or other hazardous situations. paragraph 10g).

(5) Entitled to receive pay, allowances, and other benefits as provided by g. During any period members of a Reserve component are serving on
law and regulation. active duty pursuant to an order to active duty under authority of 10 U.S.C.
12301, 12302, or 12304, the President may suspend any provision of law
b. Laws and regulations that govern military personnel may change relating to my promotion, retirement, or separation from the Armed Forces if
without notice to me. Such changes may affect my status, pay, allowances, he or his designee determines I am essential to the national security of the
benefits, and responsibilities as a member of the Armed Forces United States. Such an action may result in an extension, without my
REGARDLESS of the provisions of this enlistment/ reenlistment document. consent, of the length of service specified in this agreement. Such an
extension is often called a "stop-loss" extension (10 U.S.C. 12305).
10. MILITARY SERVICE OBLIGATION, SERVICE ON ACTIVE
h. I may, without my consent, be ordered to perform additional active
DUTY AND STOP-LOSS FOR ALL MEMBERS OF THE ACTIVE
duty training for not more than 45 days if I have not fulfilled my military
AND RESERVE COMPONENTS, INCLUDING THE NATIONAL service obligation and fail in any year to perform the required training duty
GUARD. satisfactorily. If the failure occurs during the last year of my required
membership in the Ready Reserves, my enlistment may be extended until I
a. FOR ALL ENLISTEES: If this is my initial enlistment, I must serve perform that additional duty, but not for more than six months (10 U.S.C.
a total of eight (8) years, unless I am sooner discharged or otherwise 10148).
extended by the appropriate authority. This eight year service requirement
is called the Military Service Obligation. Any part of that service not served 11. FOR ENLISTEES/REENLISTEES IN THE NAVY, MARINE CORPS,
on active duty must be served in the Reserve Component of the service in OR COAST GUARD: I understand that if I am serving on a naval vessel in
which I have enlisted. If this is a reenlistment, I must serve the number of foreign waters, and my enlistment expires, I will be returned to the United
years specified in this agreement, unless I am sooner discharged or States for discharge as soon as possible consistent with my desires.
otherwise extended by the appropriate authority. Some laws that affect However, if essential to the public interest, I understand that I may be
when I may be ordered to serve on active duty, the length of my service on retained on active duty until the vessel returns to the United States. If I am
active duty, and the length of my service in the Reserve Component, even retained under these circumstances, I understand I will be discharged not
beyond the eight years of my Military Service Obligation, are discussed in later than 30 days after my return to the United States; and, that except in
the following paragraphs. time of war, I will be entitled to an increase in basic pay of 25 percent from
the date my enlistment expires to the date of my discharge.
b. I understand that I can be ordered to active duty at any time while I
am a member of the DEP. In a time of war, my enlistment may be extended 12. FOR ALL MALE APPLICANTS: Completion of this form constitutes
without my consent for the duration of the war and for six months after its registration with the Selective Service System in accordance with the
end (10 U.S.C. 506, 12103(c)). Military Selective Service Act. Incident thereto the Department of Defense
may transmit my name, permanent address, military address, Social
c. As a member of a Reserve Component of an Armed Force, in time of Security Number, and birthdate to the Selective Service System for
war or of national emergency declared by the Congress, I may, without my recording as evidence of the registration.
consent, be ordered to serve on active duty, for the entire period of the war
or emergency and for six (6) months after its end (10 U.S.C. 12301(a)). My
enlistment may be extended during this period without my consent (10
U.S.C. 12103(c)).

(Initials of Enlistee/Reenlistee)

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 CUI (when filled in)
NAME OF ENLISTEE/REENLISTEE (Last, First, Middle) SOCIAL SECURITY NUMBER DoD ID NUMBER
(Use for new contracts) (Use for reenlistments)

D. CERTIFICATION AND ACCEPTANCE

13a. My acceptance for enlistment is based on the information I have given in my application for enlistment. If any of that information is false or incorrect, this
enlistment may be voided or terminated administratively by the Government or I may be tried by a Federal, civilian, or military court and, if found guilty, may be
punished.
I certify that I have carefully read this document, including the partial statement of existing United States laws in Section C and how they may affect
this agreement. Any questions I had were explained to my satisfaction. I fully understand that only those agreements in Section B and Section C of
this document or recorded on the attached annex(es) will be honored. I also understand that any other promises or guarantees made to me by
anyone that are not set forth in Section B or the attached annex(es) are not effective and will not be honored.
b. SIGNATURE OF ENLISTEE/REENLISTEE c. DATE SIGNED (YYYYMMDD)

14. SERVICE REPRESENTATIVE CERTIFICATION

a. On behalf of the United States (list branch of service) ,
I accept this applicant for enlistment. I have witnessed the signature in item 13b to this document. I certify that I have explained that only those agreements in
Section B of this form and in the attached Annex(es) will be honored, and any other promises made by any person are not effective and will not be honored.
b. NAME (Last, First, Middle) c. PAY GRADE d. UNIT/COMMAND NAME

e. SIGNATURE f. DATE SIGNED (YYYYMMDD) g. UNIT/COMMAND ADDRESS (City, State, ZIP Code)

E. CONFIRMATION OF ENLISTMENT OR REENLISTMENT

15. IN THE ARMED FORCES EXCEPT THE NATIONAL GUARD (ARMY OR AIR):
I, , do solemnly swear (or affirm) that I will support and defend
the Constitution of the United States against all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; and that I will obey the
orders of the President of the United States and the orders of the officers appointed over me, according to regulations and the Uniform Code of Military Justice.
So help me God.
16. IN THE NATIONAL GUARD (ARMY OR AIR):
I, , do solemnly swear (or affirm) that I will support and defend
the Constitution of the United States and the State of against all enemies, foreign and
domestic; that I will bear true faith and allegiance to the same; and that I will obey the orders of the President of the United States
and the Governor of and the orders of the officers appointed over me, according to law
and regulations. So help me God.
17. IN THE NATIONAL GUARD (ARMY OR AIR):
I do hereby acknowledge to have voluntarily enlisted/reenlisted this day of ,
in the National Guard and as a Reserve of the United States (list branch of service)
with membership in the
National Guard of the United States for a period of years, months, weeks, days, under the
conditions prescribed by law, unless sooner discharged by proper authority.
18a. SIGNATURE OF ENLISTEE/REENLISTEE b. DATE SIGNED (YYYYMMDD)

19. ENLISTMENT/REENLISTMENT OFFICER CERTIFICATION

a. The above oath was administered, subscribed, and duly sworn to (or affirmed) before me this date.
b. NAME (Last, First, Middle) c. PAY GRADE d. UNIT/COMMAND NAME

e. SIGNATURE f. DATE SIGNED (YYYYMMDD) g. UNIT/COMMAND ADDRESS (City, State, ZIP Code)

(Initials of Enlistee/Reenlistee)

DD FORM 4, MAY 2020 CUI (when filled in) Page 3 of 4

PREVIOUS EDITION IS OBSOLETE.

 CUI (when filled in)
NAME OF ENLISTEE/REENLISTEE (Last, First, Middle) SOCIAL SECURITY NUMBER DoD ID NUMBER
(Use for new contracts) (Use for reenlistments)

F. DISCHARGE FROM/DELAYED ENTRY/ENLISTMENT PROGRAM

20a. I request to be discharged from the Delayed Entry/Enlistment Program (DEP) and enlisted in the Regular Component of the

United States (list branch of service) for a period of years,

months, and weeks. No changes have been made to my enlistment options OR if changes were made they are recorded on

Annex(es)

which replace(s) Annex(es)

b. SIGNATURE OF DELAYED ENTRY/ENLISTMENT PROGRAM ENLISTEE c. DATE SIGNED (YYYYMMDD)

G. APPROVAL AND ACCEPTANCE BY SERVICE REPRESENTATIVE

21. SERVICE REPRESENTATIVE CERTIFICATION

a. This enlistee is discharged from the Reserve Component shown in item 8 and is accepted for enlistment in the Regular

Component of the United States (list branch of service) in pay grade

b. NAME (Last, First, Middle) c. PAY GRADE d. UNIT/COMMAND NAME

e. SIGNATURE f. DATE SIGNED (YYYYMMDD) g. UNIT/COMMAND ADDRESS (City, State, ZIP Code)

H. CONFIRMATION OF ENLISTMENT OR REENLISTMENT

22a. IN A REGULAR COMPONENT OF THE ARMED FORCES:

I, , do solemnly swear (or affirm) that I will support and defend

the Constitution of the United States against all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; and that I will obey the

orders of the President of the United States and the orders of the officers appointed over me, according to regulations and the Uniform Code of Military Justice.

So help me God.

b. SIGNATURE OF ENLISTEE/REENLISTEE c. DATE SIGNED (YYYYMMDD)

23. ENLISTMENT OFFICER CERTIFICATION

a. The above oath was administered, subscribed, and duly sworn to (or affirmed) before me this date.

b. NAME (Last, First, Middle) c. PAY GRADE d. UNIT/COMMAND NAME

e. SIGNATURE f. DATE SIGNED (YYYYMMDD) g. UNIT/COMMAND ADDRESS (City, State, ZIP Code)

(Initials of Enlistee/Reenlistee)

DD FORM 4, MAY 2020 CUI (when filled in) Page 4 of 4

PREVIOUS EDITION IS OBSOLETE.