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NA Form 9B (Revised 2004)

Our Ref……………………………. Serial No…………………………….

DISCHARGES/PENSION AND GRATUITY ASSESSMENT SOLDIERS

(Delete which ever is not applicable)

Part 1

1. a. Regt No……………………………..............b. Rank on Discharge……………………..........................

2. Surname & Initial………………………….......................................................................................................…..
3. a. Present Unit. ………………………............ b. Trade Classification.…………………............................
4. a. Date of Birth……………………..................b. Date of Last Promotion……………………...................
5. Reason(s) for discharge…………………………….…………………………….….……………..............................
6. Permanent Postal Address………………………….…………………………........................................................
….….……………....……………….…………………………….….…………….......................................................
7. Residential Address….….……………....……………….……………………………......................
Town………………………...............LGA …………………….............. State ……………………………..............
8. Address of Nearest Sub-Treasury Street….……………....……………….…………………………
Town………………………..............LGA ……………………................State ……………………………..............
9. Banker’s Address………………………….………………………….......................................................................
….….……………....……………….…………………………….….…………….......................................................
10. Bank Account No………………………….………………………….......................................................................
11. I………………………................... the CO certify that the particulars contained in para 1-9 are correct
Date….….…………….................. CO Signature…….….…………….....
Name…….….….....…………..............
Rank…….….……………....................

Part 2

(to be completed by CO RO)

12. Details Of Service

a. Previous service from........................ To...........................Years................days..................................
b. Previous Unit…….….……………..................….….……………..................….….……………...............
c. Date of Enlistment/Re-Enlistment/Mobilization….….……………..................….….…………...............
d. Present Service from….….…………….............................to….….…………….....................................
e. Previous Service Civil Or Military….….…………….................TOTAL….….……………......................
f. Total service including previous service...........................Years................days..................................
g. Nigerian Civil War Bonus (Period of War Service up to 15 Jan 70 incl)
.....................................................Years.................................days......................................................
h. Total service including Nigerian Civil War Bonus (11e & f)
.....................................................Years.................................days......................................................
i. Non-reckonable service...........................Years.............................days.....................................................
j. Reason(s) for forfeit of service....................................................................................................................
.....................................................................................................................................................................
k. Total reckonable military service (11g & h) .........................Years....................days.................................
l.
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13. a. Any disability................................................. (State if any) ...................................................

b. Nature of disability.................................................
c. Degree of disability.................................................
14. Total reckonable service for pension and/or gratuity (11j & 13a..................................days
15. I................................................. .............................................the CO of RO certify that the particulars of
service contained in para 10 to 13 are correct
Date................................................. ...............................................
Signature of CO RO............
Name ....................................
Rank .....................................
16. Approved By Comd
Date…......................................... ...............................................
Signature of Comd, HQ CAR
Name ..................................
Rank ...................................

Part 3
(to be completed by COMD, CPO)
17. Details of debts to the Federal Government Of Nigeria
A. Vehicle /M/Cycle/Bicycle Loan (N)…....................................................................................................
B. Federal Staff House Scheme Army (N) .................................................................................................…
C. Balance of Post Housing Scheme Army (N) …...................................................................................
D. Balance of Car Refurbishing Loan (N) …..................................................................................................
E. Balance of any other indebtedness (N) ….................................................................................................

18. Last pay per annum (N) ….................................................................................................................................

19. Grant of advance gratuity if any (N)…............................................................................................................
20. Total of (17 & 19) (N) ….....................................................................................................................................
21. 1 ............................................the Comd CPO certify that the information provided in paras 17-20 are correct.

Date…......................................... ...............................................
Signature of Comd, HQ CAR
Name ....................................
Rank .....................................

Action Recommended
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