Article Structure
The NAVPERS 1001/3 form serves as a vital tool for the United States Navy as it assesses the readiness of individuals in the Ready Reserve. This fillable questionnaire collects essential information that helps Navy officials manage personnel effectively. The form is grounded in the directives set forth by BUPERSINST 1001.39 and complies with the Privacy Act Statement, ensuring that personal data is handled with the utmost care. The questionnaire seeks to verify qualifications and suitability for continued assignment, covering a range of topics from the status of emergency data records to potential medical issues that may impact mobilization. Respondents are required to answer a series of questions, indicating their circumstances regarding dependents, employment, and any legal matters that could affect their readiness. While the completion of this form is voluntary, it is important to understand that failing to provide requested information may have consequences, including changes to reserve status or possible separation from the Naval Reserve. Through careful attention to the information gathered, the form plays an essential role in determining an individual's mobilization readiness, thus ensuring the Navy can respond effectively to national needs.
Navpers 1001 3 Example
FILLABLE FORM
READY RESERVE SCREENING QUESTIONNAIRE
SUPPORTING DIRECTIVE BUPERSINST 1001.39
PRIVACY ACT STATEMENT
AUTHORITY AND PURPOSE: 5 U.S.C. 301, Departmental Regulations; and E.O. 9397 (SSN). Provided information is used to assist officials and employees of the Navy in the management, supervision and administration of Navy personnel (officer and enlisted) and the operations of related personnel affairs and functions.
ROUTING USES: Information will be utilized by Department of the Navy officials in verifying qualifications and suitability for continued assignment to the Ready Reserve.
DISCLOSURE: VOLUNTARY. However, failure to provide the requested information may result in an administrative change to your reserve status or separation from the Naval Reserve.
NAME: (Last, First, MI) |
SSN(LAST 4 DIGITS): |
PAYGRADE: |
|
DESIG/RATE: |
|
||
Place an “X” in the Yes or Nor box. Provide |
amplifying information as required. |
|
YES |
NO |
|||
1. |
Is your Record of Emergency Data (NAVPERS 1070/602) current? |
If not, review and |
|
|
|||
update as necessary. |
|
|
|
|
|
|
|
2. |
Do you have a dependent(s) who would prevent, restrict or delay your mobilization? |
|
|||||
If yes, explain. See note 1 BUPERSINST 1001.39 (Ch. 21). |
|
|
|
|
|
||
|
|
|
|
|
|||
3. |
Do you have a spouse who is an active or reserve service member? If yes, see |
|
|
|
|||
notes 1 and 2 in BUPERSINST 1001.39 (Ch, 21). |
|
|
|
|
|
|
|
4. |
Are you a single member with dependent(s)? |
If yes, see notes 1 and 2 in |
|
|
|
||
BUPERSINST 1001.39 (Ch. 21) |
|
|
|
|
|
|
|
5. |
Have you within the last year failed to meet, or do you believe you are now unable |
|
|||||
to meet, the physical readiness standards per OPNAVINST 6110.1? If yes, explain |
|
|
|
||||
below. See note 3 in BUPERSINST 1001.39 (Ch. 21). |
|
|
|
|
|
||
|
|
|
|
|
|||
6. |
Do you have a medical problem or physical defect, which might prevent your |
|
|
|
|||
mobilization or restrict your assignment? If yes, explain below. See note 4 in |
|
|
|
||||
BUPERSINST 1001.39 (Ch. 21). |
|
|
|
|
|
|
|
|
|
|
|||||
7. |
Are you preparing for religious ministry by attending a recognized theological or |
|
|||||
divinity school, or an equivalent, or preparing to meet religious faith group |
|
|
|
||||
requirements? If yes, identify institution course of instruction and date entered |
|
||||||
program below. See note 5 in BUPERSINST 1001.39 (Ch. 21). |
|
|
|
|
|
||
8.Are you a student, resident, or intern in any educational program, which leads to a certification as a medical doctor or dentist? If yes, describe program, credential to be awarded, date started and expected duration of course. See note 6 in BUPERSINST 1001.39 (Ch. 21).
NAVPERS 1001/3 (Rev. |
S/N: |
FOR OFFICIAL USE ONLY - PRIVACY SENSITIVE
RESET FORM
PAGE 1 OF 2
SUPPORTING DIRECTIVE BUPESINST 1001.39
|
READY RESERVE SCREENING QUESTIONNAIRE (CONTINUED) |
|
YES |
NO |
|
|
9(a). Are you currently employed? If yes, provide the information requested below. |
|
|
|
|
|
Name of Organization: |
Position Title: |
|
|
|
|
9(b). Are you considered a “key” employee? If yes, please provide the information |
|
|
|
|
|
|
|
|
||
|
listed below. See note 1 in BUPERSINST 1001.39 (Ch. 21). |
|
|
|
|
|
POC: |
Phone: |
|
|
|
10.Do you have any benefits that would prevent or restrict your service during mobilization or recall? If yes, explain below. See note 1 in BUPERSINST 1001.39 (Ch. 21).
11.Are you a
12.Do you know of any reason why your recall to active duty would create a personal or community hardship? If yes, explain below. See note 1 in BUPERSINST 1001.39 (Ch. 21).
13.Have you been convicted of any criminal offense? If yes, identify the offense below. See note 1 in BUPERSINST 1001.39 (Ch. 21)
14.Are you currently involved in any pending civil or criminal legal matters that could delay or preclude your immediate mobilization? See note 1 in BUPERSINST 1001.39 (Ch. 21)
15.Have you ever been convicted of a domestic violence offense? See notes 1 and 8 in BUPERSINST 1001.39 (Ch. 21).
16.Is there any other reason why you would not be immediately available for recall to active duty? If yes, explain. See note 1 in BUPERSINST 1001.39 (Ch. 21).
CERTIFICATION BY PERSON COMPLETING FORM
I |
certify that the information |
I have provided is |
complete and accurate to the best of my knowledge. |
|
I |
will expeditiously notify my |
commanding officer |
of any circumstances that may develop in the future |
|
that could delay or prevent my |
immediate mobilization. |
|||
MEMBER’S SIGNATURE: |
|
|
DATE: |
|
|
|
|
|
|
COMMANDING OFFICER’S ENDORSEMENT (SELRES AND VTU ONLY)
I consider the member mobilization ready. I will notify the local Naval Reserve activity of any changes to the member’s status that may affect his/her mobilization.
I consider the member not mobilization ready. The following action has been taken:
FORWARDED TO ACTIVITY COMMANDING OFFICER FOR FURTHER REVIEW. |
DATE: |
UNIT COMMANDING OFFICER’S SIGNATURE: |
ACTIVITY COMMANDING OFFICER’S SIGNATURE:
DATE:
NAVPERS 1001/3 (Rev. |
S/N: |
PAGE 2 OF 2 |
FOR OFFICIAL USE ONLY - PRIVACY SENSITIVE
RESET FORM
Form Characteristics
| Fact Name | Description |
|---|---|
| Form Purpose | The NAVPERS 1001/3 serves as a Screening Questionnaire for members of the Ready Reserve. |
| Governing Directive | BUPERSINST 1001.39 provides guidance on the use and completion of this form. |
| Privacy Act Statement | The information collected is covered under the Privacy Act and is used for personnel management purposes. |
| Voluntary Disclosure | While providing information is voluntary, failure to do so may affect reserve status. |
| Emergency Data | Questions include the member's Record of Emergency Data and its current status. |
| Medical Considerations | Members must disclose any medical issues that could restrict mobilization or assignments. |
| Employment Status | Informing the Navy about current employment is important for determining mobilization readiness. |
| Legal Matters | Members must disclose any legal issues that could impact their mobilization capability. |
| Final Certification | Signature confirms that the provided information is accurate, and members must report changes promptly. |
Guidelines on Utilizing Navpers 1001 3
Completing the NAVPERS 1001/3 form requires careful attention to detail and accurate information. The form serves to assess your readiness for mobilization in the Navy reserve. Below are the steps to fill out this important document effectively.
- Begin with personal information:
- Enter your name in the format: Last, First, MI.
- Input your SSN (last 4 digits).
- List your pay grade.
- Specify your designator/rate.
- Respond to screening questions:
- For each question, select "Yes" or "No." Provide additional details where required.
- Employment details (if applicable):
- State if you are currently employed and provide the name of the organization and your position title.
- Indicate if you are considered a "key" employee and provide point of contact information if necessary.
- Check for any restrictions:
- Review each item carefully, noting any potential obstacles to your mobilization.
- Certification:
- Sign and date the form to certify the completeness and accuracy of your information.
- Commanding officer's endorsement (if applicable):
- Have your commanding officer review and sign the form, stating whether you are mobilization ready with a date.
Once the form is completed, it must be submitted to the designated authority for further processing. Ensure that all required signatures are in place to avoid delays in the review or potential mobilization actions.
What You Should Know About This Form
What is the purpose of the NAVPERS 1001 3 form?
The NAVPERS 1001 3 form is a Fillable Form Ready Reserve Screening Questionnaire. Its main purpose is to help Navy officials manage and assess the qualifications of personnel in the Ready Reserve. This form gathers essential information that impacts personnel administration and operational duties.
Is completing the NAVPERS 1001 3 form mandatory?
While providing information on this form is voluntary, it is highly recommended. Not submitting the required information could result in changes to your reserve status or even separation from the Naval Reserve. It is best to complete this form thoroughly to avoid any administrative issues.
What types of questions are included on the form?
The form includes a variety of questions aimed at assessing your current situation. These questions cover topics such as your emergency data record, dependents, physical readiness, employment status, and any legal matters that may affect your ability to mobilize. It ensures that all aspects of your readiness are considered.
What happens if I do not answer a question on the form?
Failure to answer a question may lead to delays or complications regarding your status in the Ready Reserve. Other unanswered questions may prompt the need for further clarification, which can delay necessary administrative processes related to your service obligations.
Who reviews the completed NAVPERS 1001 3 form?
Your commanding officer reviews the completed form. They will assess your readiness for mobilization and notify relevant naval activities about any changes that may affect your status. The review process helps ensure that all personnel are properly accounted for and ready for duty.
What should I do if my circumstances change after submitting the form?
If any circumstances arise that may prevent or delay your mobilization, you must inform your commanding officer as soon as possible. This notification is essential for maintaining accurate records and ensuring that the command can make necessary arrangements for personnel readiness.
Common mistakes
Completing the NAVPERS 1001/3 form can be straightforward with careful attention to detail. However, common mistakes often lead to setbacks in the process. One of the frequent errors is failing to update the Record of Emergency Data (NAVPERS 1070/602). If this record is outdated, it can cause complications in mobilization and other related processes. Ensuring this data is current is essential to avoid delays.
Another mistake involves not providing complete information about dependents. If a service member has dependents that could impede mobilization, failing to disclose this can have significant repercussions. The form requires specific explanations, and a lack of clarity may result in administrative changes to reserve status.
Many individuals also forget to check the “Yes” or “No” boxes accurately. This seemingly minor detail is crucial for processing. Omitting or marking incorrectly can lead to follow-up questions that could have been easily avoided. Additionally, when answering physical readiness questions, individuals often provide vague explanations without enough detail, which can raise concerns regarding their capacity to meet standards.
Another area where people go wrong is in the medical disclosure section. It’s essential to detail any medical problems or defects that may restrict a service member’s assignment. Leaving this blank or providing insufficient explanations leads to delays in evaluations and approvals.
The employment section of the form also sees numerous errors. When individuals do not specify if they are a “key” employee, it can create complications for command sources evaluating their readiness for mobilization. Providing accurate information about job titles and organization is vital.
Moreover, ignoring notes and instructions provided in the form can result in incomplete submissions. Each question references specific notes in BUPERSINST 1001.39. Not reviewing these notes risks overlooking important details that affect one’s readiness status.
Lastly, failing to sign and date the form before submission is a critical oversight. The certification by the member is a legal acknowledgment of the information's accuracy. Without this signature, the form may be deemed incomplete, leading to further administrative delays.
Documents used along the form
The NAVPERS 1001/3 form, known as the Ready Reserve Screening Questionnaire, plays a crucial role in assessing the qualifications and suitability of Navy personnel for continued assignment. When filling out this form, there are several other documents that often accompany it. These additional forms provide further detail and support the information provided, ensuring a comprehensive evaluation of a service member's readiness for mobilization.
- NAVPERS 1070/602: This form is the Record of Emergency Data. It contains essential information about a service member's emergency contacts, dependents, and personal information. Keeping this record up to date is vital for ensuring that communication and support are available in case of emergencies.
- OPNAVINST 6110.1: This instruction outlines the physical readiness standards that Navy personnel must meet. It includes guidelines on physical fitness assessments and readiness for mobilization. Service members can refer to this document to understand the standards they need to achieve.
- BUPERSINST 1001.39: This instruction provides detailed guidance regarding the management of Ready Reserve personnel. It outlines the procedures and regulations that govern the screening process, including specifics about mobilization and readiness requirements.
- DD Form 1966: This form serves as an application for enlistment in the Navy. It gathers personal data that helps assess an applicant's eligibility and suitability for military service. Although primarily used for enlistment, it aids in the overall understanding of a reserve's background and readiness.
Understanding these accompanying documents enhances a service member's preparation and promotes clarity during the review process. By ensuring that all forms are accurate and complete, personnel can navigate their obligations more effectively and contribute to the readiness of the Navy.
Similar forms
The Navpers 1001 3 form, which assesses the readiness of Navy personnel for mobilization, shares similarities with several other military and government forms. Below are nine documents that are comparable to the Navpers 1001 3 form:
- NAVPERS 1070/602 (Record of Emergency Data): This form collects essential personal data to ensure the Navy can make quick decisions regarding personnel in emergencies.
- OPNAVINST 6110.1 (Physical Readiness Program): This instruction outlines the standards and procedures for assessing physical readiness, similar to how the Navpers 1001 3 evaluates physical readiness status.
- BUPERSINST 1001.39 (Policy for Navy Reserve Personnel): This directive provides guidelines for managing Navy Reserve personnel, including aspects of reserve status and mobilization, akin to the Navpers 1001 3 form.
- NAVPERS 1070/605 (Dependents' Report): This document gathers information related to dependents, crucial for understanding personnel obligations during mobilization.
- DD Form 214 (Certificate of Release or Discharge from Active Duty): This form provides a record of service, highlighting the readiness status upon discharge, similar in purpose to what the Navpers 1001 3 assesses.
- ENLISTMENT/AFFILIATION FORM: Used for initial enlistment or re-affiliation, this form also captures information about service members' qualifications and readiness for duty.
- DA Form 4856 (Developmental Counseling Form): This form facilitates discussions and documentation about a service member’s performance and potential barriers to mobilization, paralleling aspects addressed in the Navpers 1001 3.
- SF 86 (Questionnaire for National Security Positions): This document collects sensitive information for security clearances, ensuring that personnel are suitable for assignments, much like the qualification checks in the Navpers 1001 3.
- NAVMC 5580 (Reserve Status Worksheet): This form helps assess the status and readiness of Marine Corps reservists, echoing the readiness evaluation detailed in the Navpers 1001 3.
Dos and Don'ts
When filling out the Navpers 1001 3 form, certain practices can help ensure a smooth process. Here is a list of what to do and what to avoid.
- Double-check your personal information. Make sure your name, SSN, pay grade, and designation are accurate.
- Use clear and concise language when providing explanations. Avoid vagueness.
- Indicate “Yes” or “No” completely and accurately for each question. Do not skip any questions.
- Review your Record of Emergency Data before filling out the form to ensure it is current.
- Notify your commanding officer of any changes in your circumstances that could affect your mobilization.
- Do not leave any questions unanswered unless instructed otherwise.
- Avoid providing incomplete explanations, especially for questions that require additional details.
- Do not submit the form without reviewing it for clarity and completeness.
- Never withhold information that may impact your qualifications or suitability for assignment.
- Avoid using informal language or abbreviations that could lead to misunderstandings.
Taking these steps will help you submit an effective form and avoid potential complications with your reserve status.
Misconceptions
Misconceptions about the NAVPERS 1001/3 form can lead to confusion among service members. Here are five common misunderstandings:
- This form is mandatory for all Navy personnel. While it is required for those in the Ready Reserve, other personnel may not need to complete it.
- Providing information is optional. Although the form states that disclosure is voluntary, failing to provide requested information can lead to administrative changes in reserve status.
- The NAVPERS 1001/3 only concerns medical issues. This form addresses various aspects, including employment status and personal circumstances that may affect mobilization, not solely health-related matters.
- Completion of this form guarantees mobilization readiness. While it is one component of assessing readiness, it does not assure that a member will be mobilized or retained in the Ready Reserve.
- Submitting false information has no consequences. Providing inaccurate or misleading information can have serious ramifications, including potential legal issues and impact on military standing.
Understanding these misconceptions is crucial for service members to navigate their responsibilities accurately within the Navy.
Key takeaways
Completing and utilizing the Navpers 1001 3 form effectively is crucial for personnel in the Navy's Ready Reserve. Here are some key takeaways regarding its use:
- Understanding the Purpose: The Navpers 1001 3 form serves as a screening questionnaire aimed at assessing qualifications for continued assignment to the Ready Reserve. It gathers essential information to support management and administrative functions.
- Voluntary Disclosure: While providing information on this form is voluntary, failing to do so may lead to changes in reserve status or separation from the Naval Reserve.
- Accuracy is Essential: Completing the form accurately is vital. Participants must certify the truthfulness of the information they provide, and it is their responsibility to notify their commanding officer of any future circumstances that might affect mobilization.
- Dependents and Employment: Questions related to dependents and current employment are significant. Respondents should be prepared to explain how these factors could affect their mobilization capabilities.
- Legal Matters: Participants should be aware that their involvement in any pending legal issues or prior convictions may impact their eligibility for immediate mobilization and should respond to relevant questions thoroughly.
Browse Other Templates
10-1 Areas of Parallelograms and Triangles Worksheet Answers - Parallelograms can often be divided into triangles for easier area computation.
If I Get Fired From My Job Can I Collect Unemployment - The importance of accuracy cannot be overstated when filling out the UC-253.