| Letter Factory Letter of ReprimandReason: Dereliction of Duty; Deviation from T.O. | 
| Key Points to Writing - Remember, there the purpose for the documentation.
- Ask for HELP if you need it, otherwise you can hurt yourself, Airmen &/or unit.
- Use the right words, utilize a resource like Merriam-Webster Online.
- Use a spell checker. (F7 Word)
- Related the Reason for the Discipline to UCMJ
- Do not forget the Privacy Act of 1974 information!
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The following Example was taken from a Word document. If you have anything you would like to submit, please do so. If you have found this information useful, please let me know as each letter has taken a considerable amount of time to prepare.  
Copy Directly on to Unit Letter Head! DATE
MEMORANDUM FOR MADE A MISTAKE, AMN, FR123-45-6789
FROM: 4 XXX/CC
SUBJECT: Letter of Reprimand - Dereliction of Duty
1. On or about 6 Apr 03, you were derelict in your duties. Specifically, you failed to follow
proper technical orders while inspecting safety wiring on aircraft 65-0983. Although the safety
wiring was accomplished incorrectly, you signed off the AFTO form 781A indicating the job was
done in accordance with applicable technical orders. Your failure to follow technical data
resulted in a system failure, and could have resulted in serious damage to Air Force property or
personnel.
2. You are hereby reprimanded. You have engaged in aberrant behavior which will not be
tolerated from a member of the United States Air Force. Your past behavior has raised serious
questions about your ability to remain in the United States Air Force. Your actions are a clear
dereliction of duty, which is punishable under Uniform Code of Military Justice (UCMJ), Article
92, Failure to obey order or regulation. If any task is worth doing, it is worth doing well; as a
minimum, it is worth doing satisfactorily. By definition, you dereliction fell well below
minimum standards and was the result of conscious behavior. In addition to being despicable, it
is a crime. Henceforth, I expect you to take more pride in your job and in helping this unit
accomplishes its mission. Rest assured that I will be watching you closely, and in the event you
degrade this unit’s mission again by your dereliction, I will take swift and sure action against
you. I intend to establish an Unfavorable Information File on you, and place this Letter of
Reprimand in it. Any future incidents of this nature will bring stronger administrative or punitive
actions. 3. PRIVACY ACT. AUTHORITY: 10 U.S.C. 8013. PURPOSE: To obtain any comments
or documents you desire to submit (on a voluntary basis) for consideration concerning this
action. ROUTINE USES: Provides you an opportunity to submit comments or documents for
consideration. If provided, the comments and documents you submit become a part of the action.
DISCLOSURE: Your written acknowledgment of receipt and signature is mandatory. Any
other comment or document you provide is voluntary.
4. You will acknowledge receipt and return this letter to me within 3 workdays of your receipt.
Your signature on this document is solely for receipt purposes and is not an admission of guilt.
Any comments or documents you wish to be considered concerning this LOR must be included
with your response.
LOTS O. PATIENCE, Lt Col, USAF
Commander
DATE
1st IND, 4 XXX/ XXX (AMN MISTAKE)
TO: 4 XXX/CC
1. I acknowledge receipt and understanding on ___________. (NOTE: If member refuses to
sign, have commander write, “Member received LOR dated ____ but refused to sign
acknowledgment on ________ (date).”)
2. I understand that I have until _______ (insert date), which is no earlier than three (3)
workdays from the date of this letter to provide a response, and that I must include in my
response any comments or documents I wish to be considered concerning this letter.
MADE A. MISTAKE, Amn, USAF
FR123-45-6789
DATE
2nd IND, 4 XXX/CC (LT COL PATIENCE)
Member (did) (did not) provide written matters in response to this letter.
LOTS O. PATIENCE, Lt Col, USAF
Commander
DATE
3rd IND, 4 XXX/XX (LT COL PATIENCE)
I have considered all matters submitted for my consideration by the member. On reviewing all of
the evidence I have determined that member (engaged) (did not engage) in the conduct noted
above and that, as a consequence, have concluded a Letter of Reprimand (is) (is not) the
appropriate course of action in this case.
LOTS O. PATIENCE, Lt Col, USAF
Commander
DATE
4th IND, 4 XXX/ XXX (AMN MISTAKE)
TO: 4 XXX/CC
I acknowledge that on _________ Lt Col Patience advised me that she had considered the
matters submitted by me in response to the above LOR and informed me of her final decision
regarding same.
MADE A. MISTAKE, Amn, USAF
FR123-45-6789
Reminder: Signature lines are 5 spaces below the last line of text. Comments: All text in blue will need to be modified. |
