PEB Letterhead
Office Symbol
(Date)__
SUBJECT: Proceedings of Formal Physical Evaluation Board
TO: (Name, grade, and address of member)
1. Enclosed is a copy of the proceedings of the recent hearing in your case. The copy is
forwarded for your information and retention. You are requested to reply within 3 working
days after you receive this letter. Check one of the comments in the attached letter, enter
the date and sign in the space provided, and return the copy in the self-addressed
envelope provided.
2. You may not agree with the recommended findings of the board. If not, you may prepare
a letter of rebuttal, stating your reasons for disagreement. This letter must be prepared in
two copies. Address it to the Army Physical Evaluation Board. Mail the letter to this office
within 3 working days. Should you need more time for valid reasons, you may request a
reasonable extension in the reply below. The counsel who represented you at the hearing
may assist you in this matter.
3. If, within the 3 working days allowed, you do not submit a rebuttal, or request an
extension of time, it will be assumed that you agree with the recommendation of the Board.
Your case will be forwarded to Headquarters, Department of the Army, for review and
action.
FOR THE PRESIDENT OF THE PHYSICAL EVALUATION BOARD:
3 Encl
1. PEB proceedings
2. Reply form letter
3. Self-addressed envelope
Figure 5-11. Notice to member advising results of formal
PEB action.
MD0755
5-43