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RECOMMENDED APPROVAL YES DATE RANK/RATE/TITLE SIGNATURE NO APPROVED 22. REASON FOR DISAPPROVAL NAVPERS 1336/3 Rev. 10-2011 FOR OFFICIAL USE ONLY - PRIVACY SENSITIVE. SPECIAL REQUEST/AUTHORIZATION PRIVACY ACT STATEMENT THE AUTHORITY TO REQUEST THIS INFORMATION IS CONTAINED IN 5 USC 301. THE PRINCIPLE PURPOSE OF THE INFORMATION IS TO ENABLE YOU TO MAKE KNOWN YOUR DESIRE FOR ITEMS LISTED OR FOR SOME OTHER SPECIAL CONSIDERATION OR AUTHORIZATION* THE INFORMATION WILL BE USED TO ASSIST OFFICIALS...

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DISAPPROVAL OF YOUR REQUEST. OF DAYS REQUESTED FROM DATE AND TIME DISTANCE MILES MODE OF TRAVEL COMMUTED RATIONS OTHER BELOW CAR AIR TRAIN LEAVE ADDRESS BUS TELEPHONE NUMBER REASON FOR REQUEST SIGNATURE OF APPLICANT I AM ELIGIBLE AND OBLIGATE MYSELF TO PERFORM ALL DUTIES OF PERSON MAKING APPLICATION SIGNATURE OF STANDBY DUTY STATION RECOMMENDED APPROVAL YES SIGNATURE AND RANK/RATE/TITLE/DATE NO SIGNATURE APPROVED REASON FOR DISAPPROVAL NAVPERS 1336/3 Rev. 01-2011 FOR OFFICIAL USE ONLY PRIVACY...

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NAVPERS Form 1336/3 "Special Request/Authorization Form"

What Is a Navy Special Request Chit?

NAVPERS Form 1336/3 Special Request/Authorization Form, is a legal document used to communicate the desire for items listed in the form (leave, special liberty, commuted rations, etc.) or some other special authorization or consideration.

Alternate Name:

  • Navy Special Request Chit.

The information on the NAVPERS 1336/3 Form is used to assist the commanding officer or some other employee in the department of the Navy to determine the applicant's eligibility for the authorization or consideration being requested. Certain requests are only approved in the case of special occasions or circumstances - for instance, individuals who worked unusually long hours or need to attend a funeral of a family member may be granted special liberty.

This form was released by the Navy Personnel Command on February 1, 2011, with all previous editions obsolete. You can download a Navy Special Request Chit fillable version through the link below.

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