MILITARY DISCHARGE UPGRADE PETITION

PETITION TYPE

☐ Discharge Review Board (DRB) Application - DD Form 293
- For discharges within 15 years
- Cannot review General Court-Martial discharges

☐ Board for Correction of Military Records (BCMR) Application - DD Form 149
- For discharges over 15 years old
- For General Court-Martial discharges
- For medical separation/retirement issues

SECTION I: APPLICANT INFORMATION

Full Legal Name: [________________________________]

Former Name(s) (if applicable): [________________________________]

Social Security Number: [________________________________]

Date of Birth: [__/__/____]

Current Address:
[________________________________]
[________________________________]
[________________________________]

Phone Number: [________________________________]

Email Address: [________________________________]

SECTION II: MILITARY SERVICE INFORMATION

Branch of Service: ☐ Army ☐ Navy ☐ Air Force ☐ Marine Corps ☐ Coast Guard

Component: ☐ Active Duty ☐ Reserve ☐ National Guard

Service Number (if different from SSN): [________________________________]

Date of Entry: [__/__/____]

Date of Discharge: [__/__/____]

Length of Service: [____] Years [____] Months [____] Days

Highest Rank/Grade Achieved: [________________________________]

Rank/Grade at Discharge: [________________________________]

Primary MOS/Rating/AFSC: [________________________________]

Last Unit of Assignment: [________________________________]

Last Duty Station: [________________________________]

SECTION III: CURRENT DISCHARGE CHARACTERIZATION

Current Character of Service:
☐ Honorable
☐ General (Under Honorable Conditions)
☐ Other Than Honorable (OTH)
☐ Bad Conduct Discharge (BCD)
☐ Dishonorable Discharge
☐ Entry Level Separation/Uncharacterized

Separation Authority: [________________________________]

Narrative Reason for Separation: [________________________________]

Separation Program Designator (SPD) Code: [________________________________]

Reenlistment Eligibility (RE) Code: [________________________________]

SECTION IV: REQUESTED RELIEF

A. Discharge Characterization Change

Current Characterization: [________________________________]

Requested Characterization: [________________________________]

B. Narrative Reason Change

Current Reason: [________________________________]

Requested Reason: [________________________________]

C. Other Requested Changes

☐ Change SPD Code from [____] to [____]
☐ Change RE Code from [____] to [____]
☐ Other: [________________________________]

SECTION V: HEARING REQUEST

☐ I request a PERSONAL APPEARANCE before the board
- Preferred location: ☐ Washington, D.C. ☐ Other: [________________________________]

☐ I request a RECORDS REVIEW ONLY (no personal appearance)

Note: Personal appearance hearings for DRB are held in Washington, D.C. Travel is at the applicant's expense.

SECTION VI: REPRESENTATION

☐ I will represent myself
☐ I am represented by a Veterans Service Organization (VSO):
- Organization: [________________________________]
- Representative Name: [________________________________]
- Contact: [________________________________]

☐ I am represented by private counsel:
- Attorney Name: [________________________________]
- Bar Number: [________________________________]
- Address: [________________________________]
- Phone: [________________________________]
- Email: [________________________________]

SECTION VII: BASIS FOR UPGRADE REQUEST

A. Legal Standard

I contend that my discharge was:

☐ IMPROPER - The discharge was not in accordance with applicable laws, regulations, and policies in effect at the time of discharge

☐ INEQUITABLE - The discharge was inconsistent with the policies and traditions of military service, considering all circumstances

B. Specific Grounds for Upgrade

(Check all that apply and provide explanation)

☐ Post-Traumatic Stress Disorder (PTSD)
Explain connection to misconduct leading to discharge:
[________________________________]
[________________________________]
[________________________________]

☐ Traumatic Brain Injury (TBI)
Explain connection to misconduct leading to discharge:
[________________________________]
[________________________________]
[________________________________]

☐ Military Sexual Trauma (MST)
Explain connection to misconduct leading to discharge:
[________________________________]
[________________________________]
[________________________________]

☐ Mental Health Condition
Diagnosis: [________________________________]
Explain connection to misconduct:
[________________________________]
[________________________________]

☐ Discrimination Based on Sexual Orientation (Pre-2011 DADT discharges)
Explain circumstances:
[________________________________]
[________________________________]

☐ Procedural Errors in Discharge Processing
Describe errors:
[________________________________]
[________________________________]

☐ New Evidence Not Available at Time of Discharge
Describe new evidence:
[________________________________]
[________________________________]

☐ Exemplary Post-Service Conduct
Describe achievements since discharge:
[________________________________]
[________________________________]

☐ Punishment Was Disproportionate to Offense
Explain:
[________________________________]
[________________________________]

☐ Command Climate Issues/Unlawful Command Influence
Explain:
[________________________________]
[________________________________]

☐ Other Grounds:
[________________________________]
[________________________________]

SECTION VIII: DETAILED STATEMENT OF CASE

A. Circumstances Leading to Discharge

Provide a detailed narrative of the events and circumstances that led to your discharge. Include dates, locations, individuals involved, and any relevant context.

[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]

B. Why the Discharge Was Improper or Inequitable

Explain specifically why you believe your discharge should be upgraded:

[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]

C. Impact of Current Discharge

Describe how your current discharge characterization has affected your life:

☐ Employment difficulties: [________________________________]
☐ Educational benefits denied: [________________________________]
☐ VA healthcare access denied: [________________________________]
☐ Housing assistance denied: [________________________________]
☐ Other benefits denied: [________________________________]
☐ Social stigma: [________________________________]
☐ Mental health impact: [________________________________]
☐ Other: [________________________________]

SECTION IX: MILITARY SERVICE RECORD

A. Positive Service Factors

Awards and Decorations:
☐ [________________________________]
☐ [________________________________]
☐ [________________________________]
☐ [________________________________]

Combat Service:
☐ None
☐ Yes - Locations and dates: [________________________________]

Deployments:

Performance Evaluations Summary:
[________________________________]
[________________________________]

Special Duties/Qualifications:
[________________________________]
[________________________________]

B. Prior Disciplinary Record

SECTION X: POST-SERVICE CONDUCT

A. Education

B. Employment History

C. Community Involvement

[________________________________]
[________________________________]
[________________________________]

D. Criminal History Since Discharge

☐ No criminal history since discharge
☐ Criminal history (explain circumstances and rehabilitation):
[________________________________]
[________________________________]

E. Medical/Mental Health Treatment

☐ Currently receiving treatment for PTSD/TBI/Mental Health
- Provider: [________________________________]
- Diagnosis: [________________________________]

☐ VA disability rating: [____]%
- Conditions rated: [________________________________]

SECTION XI: SUPPORTING DOCUMENTATION CHECKLIST

☐ DD-214 (Member Copy 4)
☐ Service Personnel Records (obtained from National Personnel Records Center)
☐ Service Medical Records
☐ VA Medical Records
☐ Private Medical Records/Mental Health Records
☐ PTSD/TBI/MST Diagnosis Documentation
☐ Character Reference Letters (attached as Exhibit [____])
☐ Employment Verification Letters
☐ Educational Transcripts/Certificates
☐ Community Service Documentation
☐ Court Records (if applicable)
☐ Prior DRB/BCMR Decisions (if applicable)
☐ Personal Statement
☐ Witness Statements
☐ Other: [________________________________]

SECTION XII: LIBERAL CONSIDERATION STATEMENT

(For applications involving PTSD, TBI, MST, or other mental health conditions)

Pursuant to the Hagel Memo (2014), Kurta Memo (2017), Wilkie Memo (2018), and current DoD policy, I request liberal consideration of my application based on:

☐ PTSD that was not recognized or properly diagnosed during service
☐ TBI that was not recognized or properly diagnosed during service
☐ Military Sexual Trauma that contributed to my misconduct
☐ Other mental health condition: [________________________________]

Connection to Misconduct:
[________________________________]
[________________________________]
[________________________________]
[________________________________]

SECTION XIII: CHARACTER REFERENCE LETTERS

SECTION XIV: PRIOR APPLICATIONS

☐ I have NOT previously applied to the DRB or BCMR for this discharge

☐ I have previously applied:

Reason for Reapplication:
[________________________________]
[________________________________]

SECTION XV: CERTIFICATION AND SIGNATURE

I certify under penalty of perjury that the information provided in this application is true and accurate to the best of my knowledge. I understand that providing false information may result in denial of my application and potential legal consequences.

I authorize the release of my military service records, medical records, and any other relevant documents to the reviewing board.

Applicant Signature: [________________________________]

Date: [__/__/____]

SECTION XVI: REPRESENTATIVE CERTIFICATION (if applicable)

I certify that I am authorized to represent the above-named applicant and have reviewed this application.

Representative Signature: [________________________________]

Printed Name: [________________________________]

Organization/Title: [________________________________]

Date: [__/__/____]

SUBMISSION INSTRUCTIONS

For Discharge Review Board (DD Form 293):

Army: Army Review Boards Agency, 251 18th Street South, Suite 385, Arlington, VA 22202-3531

Navy/Marine Corps: Secretary of the Navy Council of Review Boards, 720 Kennon Street SE, Suite 309, Washington Navy Yard, DC 20374-5023

Air Force/Space Force: SAF/MRBR, 3351 Celmers Lane, Joint Base Andrews, MD 20762-6435

Coast Guard: Commandant (CG-133), ATTN: Office of Military Personnel, U.S. Coast Guard, 2703 Martin Luther King Jr Ave SE, Washington, DC 20593-7907

For Board for Correction of Military Records (DD Form 149):

Army: Army Review Boards Agency, 251 18th Street South, Suite 385, Arlington, VA 22202-3531

Navy/Marine Corps: Board for Correction of Naval Records, 701 S. Courthouse Road, Suite 1001, Arlington, VA 22204-2490

Air Force/Space Force: SAF/MRBR, 3351 Celmers Lane, Joint Base Andrews, MD 20762-6435

Coast Guard: DHS Office of the General Counsel, Mail Stop 0485, 2707 Martin Luther King Jr. Ave SE, Washington, DC 20528

SOURCES AND REFERENCES

• DD Form 293 - Application for Review of Discharge
• DD Form 149 - Application for Correction of Military Record
• Swords to Plowshares - Discharge Upgrade Guide
• Yale Law School Veterans Discharge Upgrade Manual

This template is provided for educational and informational purposes. Veterans are strongly encouraged to seek assistance from Veterans Service Organizations (VSOs) or qualified attorneys who specialize in military discharge upgrades.