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HOSTILE FIRE PAY CERTIFICATION AND MPO

MILITARY PAY ORDER NUMBER HOSTILE fire PAY CERTIFICATION AND MPO RULE NO. UNDER WHICH QUALI- FIED MONTHSQUALIFIED NAME ORGANIZATION GRADE SSN (Last, first, MI) (From, To) DODPM) (See DATE TIME INCIDENT OCCURRED (location) DESCRIBE THE CIRCUMSTANCES SURROUNDING THE INCIDENT I certify that the above named members qualified for Special Pay for Duty Subject to HOSTILE fire under the provisions ofDepartment of Defense Military Pay and Allowances Entitlements Manual (DODPM). If member was aboard an aircraft, I further certify that the individual's primary purpose aboard the aircraft was as a directed participant in the operationand his primary purpose aboard the aircraft was not for transportation from one point to another, SIGNATURE TYPED OR PRINTED NAME AND GRADE OF AIRCRAFT OR UNITCOMMANDER (AFO use only) DATE ORGANIZATION AND STATION (AFO use only) TYPED OR PRINTED NAME AND GRADE OF SIGNATURE SYMBOL NO.

military pay order number hostile fire pay certification and mpo rule no. under which quali- fied months qualified name ssn grade organization

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  Fire, Certifications, Hostile, Hostile fire pay certification and

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Transcription of HOSTILE FIRE PAY CERTIFICATION AND MPO

1 MILITARY PAY ORDER NUMBER HOSTILE fire PAY CERTIFICATION AND MPO RULE NO. UNDER WHICH QUALI- FIED MONTHSQUALIFIED NAME ORGANIZATION GRADE SSN (Last, first, MI) (From, To) DODPM) (See DATE TIME INCIDENT OCCURRED (location) DESCRIBE THE CIRCUMSTANCES SURROUNDING THE INCIDENT I certify that the above named members qualified for Special Pay for Duty Subject to HOSTILE fire under the provisions ofDepartment of Defense Military Pay and Allowances Entitlements Manual (DODPM). If member was aboard an aircraft, I further certify that the individual's primary purpose aboard the aircraft was as a directed participant in the operationand his primary purpose aboard the aircraft was not for transportation from one point to another, SIGNATURE TYPED OR PRINTED NAME AND GRADE OF AIRCRAFT OR UNITCOMMANDER (AFO use only) DATE ORGANIZATION AND STATION (AFO use only) TYPED OR PRINTED NAME AND GRADE OF SIGNATURE SYMBOL NO.

2 (AFO use) CERTIFYING OFFICER AF IMT 1881, 19740109, V1


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