OFFICE
SYMBOL (MARKS NUMBER)                                              DATE

THRU Chief of Staff

FOR Commanding General

SUBJECT:

     1. FOR: Decision

     2. PURPOSE: (Briefly state the issue or problem being addressed.)

     3. RECOMMENDATION: (What decision is wanted or required? Quantify dollars, manpower, and equipment, if involved. Clearly state desired decision.)

     4. ASSUMPTIONS:

          a. (State assumptions, i.e., it is assumed that current funding levels will remain constant.)

          b. (If there are no assumptions, state, "none.")

     5. FACTS:

          a. Background. (Provide a brief background of the issue or problem.)

          b. Facts. (Provide a brief description of the current status of the issue or problem.)

     6. RATIONALE FOR RECOMMENDATION: (The assumptions, if any, and facts should support the recommendation in paragraph 2 .)

     7. IMPACT OF SUCCESS OR FAILURE: (State the results of putting and not putting the recommendation into action.)

     8. COORDINATION: (If coordination is not required, state, "not required.") (Draw a line through "concur" or "nonconcur", date and write the name of the person with whom coordination was made.)

          ACofS, G3:     Concur     Nonconcur     Name and Date:

          ACofS, G4:     Concur     Nonconcur     Name and Date:

     9. APPROVED ___ DISAPPROVED ___ SEE ME ___

          DRAFTED BY: Typed name/Position Title/Telephone

          RELEASED BY: Typed name/Position Title/Telephone