Failure to Report - DA Form 4856 Example

PART II - BACKGROUND INFORMATION
Purpose of Counseling Failure to Report - Violation of UCMJ Article 86
PART III - SUMMARY OF COUNSELING Complete this section during or immediately subsequent to counseling.
Specialist Smith, At 0600, on 14 April 11, you failed to be at your appointed place of duty, our morning formation in front of Bldg 11. At 0900, you called me and stated that you overslept and would be in as soon as possible. You arrived at 1010. Specialist Smith, you have had numerous verbal counselings and 5 written counselings on violation of Article 86 of the UCMJ in the past 11 months. You are demonstrating a serious pattern of misconduct. If you had been my Soldier, you wouldn't still be in the Army. I recommended you for immediate discharge to the First Segeant but he wants to give you one more chance. However, he stated that if you are late for duty one more time, he will accept my recommendation. As emphasized in previous counselings, accountability and responsibility are indispensable traits of a Soldier! There is no exception to this requirement and no room for interpretation. I am formally informing you that, as of now, you will report to each formation at least 15 minutes prior to its scheduled time. If, for some reason, you cannot make these formations on time, you will explain to me and me only, the reason and clear it 24 hours beforehand. Reporting for duty on time is one of the most fundamental requirements of being a Soldier. If you cannot report for duty on time, I have serious reservations as to whether you are capable of military service. In my opinion, a Soldier without the self-discipline OR enough respect for authority to show up on time is not a useful Soldier and may even be a detriment to the safety of his unit. If you are late one more time while you are my responsibility, I will make it my priority to make sure you are not allowed to reenlist. This counseling statement has been furnished to you, not as a punitive measure under the provisions of article 15, UCMJ, but as an administrative measure to stress that continued behavior of the same or a similar nature may result in initiation of action separating you from the U.S. Army under the provisions of Chapter (5) (8) (11) (13) (14) , AR 635-200. Such action may result in either an Honorable Discharge, General Discharge, or an Other Than Honorable (OTH) Discharge. If you receive a General or an OTH Discharge, this could result in the possible loss of some or all Veterans Benefits and substantial prejudice in obtaining civilian employment. In addition, if you have contributed money to the Montgomery G.I. Bill and you are released from active duty with a less than Honorable Discharge, you will not be eligible to receive money for educational purposes and any money already contributed for educational purposes is nonrefundable and may be forfeited.
OTHER INSTRUCTIONS 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.

DA FORM 4856-E, JUN 99 EDITION OF JUN 85 IS OBSOLETE
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Plan of Action: Due to your inability to be at the appointed place of duty at the appointed time, the following corrective action will be taken: Starting now, 13 May 11, until I say otherwise, you will report for daily morning formation at 0545 in the uniform of the day. During this period, your actions will be evaluated and failure to show, as directed, to future formations, will result in UCMJ action in accordance with Article 86. In addition, I will make every effort to ensure you are barred from reenlistment.
Session Closing: (The leader summarizes the key points of the session and checks to ensure the subordinate understands the plan of action. The subordinate agrees/disagrees and provides remarks if appropriate) SPC Smith will report to every formation 15 minutes ahead of time. This is not to be considered to be 15 minutes early. It is SPC Smith's actual reporting time. I will be present at every formation and if you are not present at the required time, I will take immediate administrative action. SPC Smith is aware of the consequences of any future failures to report as ordered. Individual counseled: I agree / disagree with the information above Individual counseled remarks: space space Signature of Individual Counseled: ____________________________________ Date: ___13 May 2011__
Leader Responsibilities: : (Leader’s responsibilities in implementing the plan of action) I will ensure that our leadership is aware of this counseling and will provide guidance and assistance if requested. space Signature of Counselor: ____________________________________ Date: ___13 May 2011__
PART IV - ASSESSMENT OF THE PLAN OF ACTION
Assessment: (Did the plan of action achieve the desired results? This section is completed by both the leader and the individual counseled and provides useful information for follow-up counseling) SPC Smith was only 10 minutes early to formation on one occasion and did not have a valid excuse. I did submit additional counseling but our current leadership did not want to accept it. However it is on file and will be resubmitted in the event of any future failures. I still have reservations as to SPC Smith's suitability for military service and continue to evaluate his performance. Counselor: ______________________ Individual Counseled: ____________________ Date of Assessment:_________________
Note: Both the counselor and the individual counseled should retain a record of the counseling.

DA FORM 4856-E (Reverse)
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