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Get and Sign Navy Leave Chit Form
LEAVE USED THIS FY
SEE PAGE 2 FOR
PRIVACY ACT
STATEMENT
9. DUTY PHONE
12. MODE OF TRAVEL
11a. Leaving Area of PERMDUTYSTA
YES
NO
11b. Taking Leave INCONUS
YES
NO
15. TO (Hour, Date) (YYMMDD)
AIR
BUS
CAR
TRAIN
16. NORMAL WORKING HOURS
DAY OF DEPARTURE:
TO:
FROM:
19. LEAVE PHONE
DAY OF RETURN:
DAYS AS OF
TO:
FROM:
20. LEAVE ADDRESS
21. RATION STATUS (Enlisted)
COMMUTED RATIONS (COMRATS)
Meal Pass No.
Entitled to EDF meals except
during periods of leave
I CERTIFY THAT I HAVE...
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