Navmc 10132 Form – Fill Out and Use This PDF

1. OFFENSES (To include specific circumstances and the date and place of commission of the offense.)

2.I have been advised of and understand my rights under Article 31, UCMJ. I also have been advised of and understand my right to demand trial by court martial in lieu of non-judicial punishment. I (do) (do not) demand trial and (will) (will not) accept non-judicial punishment subject to my right of appeal. I further certify that I (have) (have not) been given the opportunity to consult with a military lawyer, provided at no expense to me, prior to my decision to accept non-judicial punishment.

(DATE)	(Signature of accused)

3. The accused has been afforded these rights under Article 31, UCMJ, and the right to demand trial by court-martial in lieu of non-judicial punishment.

(DATE)	(Signature of immediate CO of accused)

4.BOOKER STATEMENT: I have been given the opportunity to consult with a lawyer, provided by the Government at no cost to me, in regard to a pending NJP for violation of Article(S) of the UCMJ. I understand I have the right to refuse that NJP; I (do) (do not) choose to exercise that right. I further

understand that acceptance of NJP does not preclude my command from taking other adverse administrative action aganist me.

(DATE)

(Signature)

5.UNAUTHORIZED ABSENCES (in excess of 24 hours) AND MARKS OF DESERTION

6.FINAL DISPOSITION TAKEN AND DATE

7.SUSPENSION OF EXECUTION OF PUNISHMENT, IF ANY.

8.FINAL DISPOSITION TAKEN BY (Name, grade, title)

9.

Upon consideration of the facts and circumstances surrounding (this offense) (these offenses) and upon further

10. DATE OF

consideration of the needs of military discipline in this command, I have determined the offense (s) involved herein to be minor

NOTICE TO ACCUSED OF

and properly punishable under Article 15, UCMJ, such punishment to be that indicated.

FINAL DISPOSITION TAKEN.

(Signature of CO w ho took final disposition in 6)

11.

The accused has been advised of the right of appeal.

12. Having been advised of and understanding my right of

13. DATE OF APPEAL, IF

appeal, at this time I (intend) (do not intend) to file an appeal.

ANY.

(DATE)

(Signature of CO who took final action in 9)

(DATE)

(Signature of accused)

14. DECISION ON APPEAL (IF APPEAL IS MADE), DATE THEREOF, AND SIGNATURE OF CO WHO MADE DECISION.

15. DATE OF NOTICE TO

ACCUSED

OF DECISION ON

APPEAL.

(DATE)

(Signature of CO making decision on appeal))

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Designed using FormFlow 2.22, HQMC/ARDE, Apr 2002