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                                      DEVELOPMENTAL COUNSELING FORM
                                                                        For use this form see FM 22-100
                                                       DATA REQUIRED BY THE PRIVACY ACT OF 1974
AUTHORITY: 5 USC 301, Departmental Regulations; 10 USC 3013, Secretary of the Army and E.O. 9397 (SSN)
PRINCIPAL PURPOSE: To assist leaders in conducting and recording counseling data pertaining to subordinates
ROUTINE USES: For subordinate leader development IAW FM 22-100 leaders should use this form as necessary
DISCLOSURE: Disclosure is voluntary  
                                                                 PART I - ADMINISTRATIVE DATA
Name (Last, First, MI)
Rank/Grade
Social Security No.
Date of Counseling
Organization
Name and Title of Counselor
                                                          PART II - BACKGROUND INFORMATION
Purpose of Counseling: (Leader states the reason for the counseling, e.g. Performance/Professional or Event-Oriented counseling and includes the leaders facts
and observations prior to the counseling)

Event-Oriented: Violation of article 86 (Absent without leave AWOL) of the Uniform Code Of Military Justice in that on or about (date) at (location)
you failed to report to your appointed place of duty,(building # or Location) at the appointed time.
                                                                 PART III - SUMMARY OF COUNSELING
                                      Complete this section during or immediately subsequent to the counseling

Key Points of Discussion:

In the United States Military, Failure to report is a crime and it is unacceptable behavior that will not be tolerated. If found
guilty of this offense, the maximum punishment is ______________________. This unit cannot function properly when it's
members become undependable and place undue hardship on the rest of the unit members. In committing such
misconduct you have brought discredit upon The United States Army, this Unit, and Yourself. (I am recommending that the
commander impose nonjudicial punishment for your misconduct) OR (You will receive corrective training as outlined in the
plan of action).


You are here by notified that if this type of conduct continues, actions may be initiated under the Uniform Code of Military
Justice to separate you from the Army prior to your scheduled ETS Date IAW AR 635-200.  If you are involuntary
separated, you could receive an Honorable Discharge, a General (Under Honorable Conditions) Discharge, or a Under
Other Than Honorable Conditions Discharge. If you receive a discharge Under Other Than Honorable Conditions, you will
be ineligible for reenlistment and for most benefits, including payments of accrued leave, transitional benefits, the
Montgomery GI Bill, VA benefits, and You may also face difficulty in obtaining civilian employment.   
                                                                                  OTHER INSTRUCTIONS
This form will be destroyed upon reassignment (other than rehabilitative transfers), separations at ETS, or upon retirement. For separation requirements
and                                                                                       notification of loss of benefits/consequenses see local directives and AR 635-200
Download and make changes to DA Form 4856, Counseling for violation of Article 86
Absent without leave AWOL of the UCMJ. Requires Pure edge viewer
Army Counseling, Article 86 Absent without leave AWOL: Any member of the armed forces who, without authority fails to report to his/her
appointed place of duty at the prescribed time; leaves his/her appointed place of duty prior to being released from duty or absents his/herself
from his/her unit, organization or place of duty, may be punished under article 86.
Sergeant's Time Training, AWOL
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ime
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Use this Counseling Example when your Soldier is late for duty or misses formation. As a supervisor you are responsible for the accountability
of your Soldiers and should take immediate action by counseling the Soldier on the first minor offence. You may recommend punishment under
the UCMJ depending on the severity of the offence or if your Soldier is Absent Without Leave AWOL for an unreasonable length of time either
way you must report up the Chain of Command.
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