(Last, First, MI)
Rank/Grade Date of Counseling
Organization Name and Title of Counselor
Purpose of Counseling:
(Leader states the reason for the counseling, e.g. Performance/Professional or Event-Oriented counseling, and includes
the leader's facts and observations prior to the counseling.)
Key Points of Discussion:
DEVELOPMENTAL COUNSELING FORM
For use of this form, see ATP 6-22.1; the proponent agency is TRADOC.
DATA REQUIRED BY THE PRIVACY ACT OF 1974
5 USC 301, Departmental Regulations; 10 USC 3013, Secretary of the Army.
To assist leaders in conducting and recording counseling data pertaining to subordinates.
The DoD Blanket Routine Uses set forth at the beginning of the Army's compilation of systems or records notices also
apply to this system.
Disclosure is voluntary.
PART I - ADMINISTRATIVE DATA
PART II - BACKGROUND INFORMATION
PART III - SUMMARY OF COUNSELING
Complete this section during or immediately subsequent to counseling.
This form will be destroyed upon: reassignment (other than rehabilitative transfers) , separation at ETS, or upon retirement. For separation
requirements and notification of loss of benefits/consequences see local directives and AR 635-200.
PREVIOUS EDITIONS ARE OBSOLETE.
DA FORM 4856, JUL 2014
APD LC v1.03ES
Page 1 of 2
Months from ETS: Creditable Years of Service for Retirement:
ETS Date: PEBD: Previous Extensions:
Flagged: DMOSQ: Excess:
Are you currently drawing Incentives from any previous extension or enlistment?
(AB) (EB) (REB) (SLRP)
Are you currently utilizing education benefits? (FTA) (STAP) (MGIB) (MGIBK)
Eligible for Reenlistment Incentive (Bonus, SLRP, MGIB - Kicker):
Montgomery GI Bill Benefits:
MGIB CH 33 (Transferability)
Discuss features of membership in the MIARNG:
Tricare Reserve Select
VA Home Loan
Education Benefits (DANTES/CLEP, Scholarships, Grants, Joint Service Transcripts)
Tricare for Life
Discuss factors affecting decision to extend/ETS:
Camaraderie and Esprit De Corps
Home life and Family influence
Civilian and Career Requirements/conflicts
Discuss Military Career Progression:
What are your current goals in the military?
Leadership opportunities (EPS, Change MOS, Statewide Vacancies, OCS, WOCS)
Service School Availability/Requirements (NCOES, SSD, MOSQ, ASI/SQI)