June 2, 2020 | 3:47 pm Information on Novel Coronavirus
Coronavirus is still spreading in New York. New Yorkers are required to wear a mask and maintain 6 feet distance in public.
New York State Division of Military and Naval AffairsNew York State Division of Military and Naval AffairsNYANG Airman
Governor Andrew Cuomo | Major General Raymond F. Shields Jr.

New York Naval Militia Forms, Instructions and Notices

NYNM on Facebook NYNM on Twitter

NYNM March NYNM March NYNM March

Composed by:
CPT Douglas Hedwig, NYG

Save Download

The following Naval Militia forms are available for the convenience of our on-line visitors.

Title Document Date
 

Application and Service Forms
DD Form 2536 Request for Participation in Public
Events		 01 Dec, 2016
NYNM FORM 088 Report of Medical Examination 13 Aug, 2011
NYNM FORM 093 Report of Medical History 17 Aug, 2011
NYNM FORM 100C ENLISTED APPLICATION - CURRENT DRILLING
RESERVES		 08 Mar, 2019
NYNM FORM 101C OFFICER APPLICATION - CURRENT DRILLING
RESERVES		 16 Nov, 2018
NYNM FORM 102C ENLISTED APPLICATION - PRIOR SERVICE -
NON-DRILLING		 16 Nov, 2018
NYNM FORM 103C OFFICER APPLICATION - PRIOR SERVICE -
NON-DRILLING		 16 Nov, 2018
NYNM FORM 1040 Notice of Administrative Action 28 Apr, 2010
NYNM FORM 1041 Retention in the New York Naval Militia 25 Oct, 2012
NYNM FORM 1070 Civilian-Military Skills Questionnaire 03 Feb, 2010
NYNM FORM 1121 How to Join the New York Naval Militia 16 Nov, 2018
NYNM FORM 1140 NYNM Information Brochure 25 May, 2018
NYNM FORM 1155 MEBS Enrollment Application 20 Sep, 2016
NYNM FORM 1160 State Active Duty (In-pay) Request 26 Jun, 2017
NYNM FORM 1420 Promotion Board Checklist 29 Jan, 2020
NYNM FORM 1571 State Active Duty (Non-Pay)
Authorization		 26 Jun, 2017
NYNM FORM 1611 Officer Performance Report 29 Apr, 2020
NYNM FORM 1616 Enlisted Performance Report 29 Apr, 2020
NYNM FORM 1620 Report of Counseling 25 Aug, 2009
NYNM FORM 1650 Awards and Decorations Ribbons and
Device Guide		 24 Dec, 2012
NYNM FORM 1900 Request for Separation or Retirement 19 Nov, 2009
NYNM FORM 3058 Boat Operations Risk Calculation
Worksheet		 23 Aug, 2018
NYNM FORM 3061 Mobilization Screening 04 Jan, 2012
NYNM FORM 3120 MEBS Pre-Operational Checklist 31 Aug, 2016
NYNM FORM 3123 Float Plan 20 Oct, 2011
NYNM FORM 4027 Boat Fuel Log 12 Jul, 2017
NYNM FORM 4082 ELST Regional Readiness Summary 22 May, 2013
NYNM FORM 4440 Expeditionary Logistics Support
Team Inventory Report		 22 Aug, 2014
NYNM FORM 4620 Crew and Passenger Manifest 04 Oct, 2011
NYNM FORM 4790 MEBS Maintenance Tracker 08 Apr, 2015
NYNM FORM 5892 Risk Advisement and Release of Liability 19 Feb, 2014
NYNM FORM 9079 Sea Trial Acceptance Checklist 08 Jun, 2018
NYS DMNA FORM 03a Daily Attendance Register (single) 31 Jan, 2016
NYS DMNA FORM 04 SAD Leave Request Form 04 Aug, 2017
NYS DMNA FORM 1200R DMNA TAG 9 & TBTA TICKETS ISSUE CONTROL
LOG		 15 May, 1992
NYS DMNA FORM 2875 Information System Access Request (ISAR) 15 Jun, 2017
NYS DMNA FORM 40-400 STATE ACTIVE DUTY PRE/POST DEPLOYMENT
MEDICAL SCREEN		 10 Sep, 2013
NYS DMNA FORM 96-1 Recruitment Incentive and Retention
Program (RIRP) Application		 05 Jul, 2019
NYS DMNA FORM 96-1
NYNM RIRP
ACKNOWLEDGEMENT		 RIRP TUITION ASSISTANCE ACKNOWLEDGEMENT
FORM		 05 Jul, 2019
NYS DMNA FORM 96-1
NYNM RIRP Checklist		 RIRP TUITION ASSISTANCE CHECKLIST FOR
RIRP APPLICATION		 05 Jul, 2019
NYS DMNA FORM R-1 Receiving Notice 28 Aug, 2019
NYS FORM AC 2772 Direct Deposit Form for NYS Employees 31 Oct, 2011
NYS FORM AC 3237 SUBSTITUTE FORM W-9: REQUEST FOR
TAXPAYER IDENTIFICATION NUMBER &
CERTIFICATION		 06 Dec, 2009
NYS FORM AC 3257-S Claim for Travel Reimbursement by a
Non-employee		 15 Jun, 2017
NYS FORM MV 412 Application for Military and Veteran
Custom Plates		 31 Mar, 2013
NYS FORM ST-129 Exemption Certificate for tax occupancy
of hotel rooms		 01 May, 2012
US DD FORM 2973 Food Operation Inspection Report 04 Apr, 2018
US MN FORM 1998-E Personnel Security Investigation Report 31 Oct, 2011
 

Instructions
DMNA REG 10-1 New York Naval Militia Regulations 15 Oct, 2010
NYNM INST 1001.1B Administration Manual 03 Mar, 2017
NYNM INST 1020.1D Uniform Regulations 07 Dec, 2018
NYNM INST 1410.1C Promotion Policies and Procedures 12 Feb, 2019
NYNM INST 1410.2B Promotion to Officer Ranks 12 Feb, 2019
NYNM INST 1550.1B Military Emergency Boat Service Training
Manual (MEBS TRAMAN)		 09 Mar, 2017
NYNM INST 1650.1 Josephthal Trophy 08 Feb, 2010
NYNM INST 3051.2 Mission Essential Task List (METL) 02 Aug, 2010
NYNM INST 3061.1A Mobilization Plan 19 Jul, 2013
NYNM INST 3120.1C MEBS Standard Operating Procedures 28 Jun, 2017
NYNM INST 3120.2 MEBS Seamanship Manual 26 Jan, 2018
NYNM INST 3501.1 Readiness and Metrics 01 Nov, 2013
NYNM INST 3501.2 MEBS Craftmaster Personnel Qualification
Standards		 30 Mar, 2016
NYNM INST 3501.3 Boat Coxswain Qualification 09 Mar, 2017
NYNM INST 3502.1 w/
Ch 1		 Training and Exercise Management 03 Mar, 2017
NYNM INST 3502.2A In the Service of the State 03 Feb, 2017
NYNM INST 4650.1 Travel Policy 11 Aug, 2016
NYNM INST 5210.1 Regional Command Turnover Files 26 Jan, 2011
NYNM INST 5320.1A Manpower and Authorized Billet Structure 09 May, 2012
NYNM INST 5401.1B MEBS Organizational Guidance 20 Sep, 2016
NYNM INST 5401.2 New York Naval Militia Regional Commands 15 Oct, 2010
NYNM INST 5401.3 Organization of Expeditionary Logistics
Support Teams		 24 Jun, 2013
NYNM INST 5725.1 Reserve Activity/Unit Liaison Duty 26 Jan, 2011
NYNM INST 6110.1B Physical and Medical Requirements 17 Apr, 2015
NYNM INST 9510.1 Hazardous Material and Waste Management
Plan		 09 Dec, 2015
 

Notices
NRMARCCNORVA-NYNM
MOA		 Relationship, Collaboration and
Potential Support between Navy
Operational Support Centers Assigned to
RMARCC Norfolk and the New York Naval
Militia		 24 Aug, 2017
NYNM NOTE 5210 List of Current Instructions, Forms, and
Notices		 02 May, 2020
NYS DMNA TBTA MEMO Cashless Toll Credit and Reimbursement
for Metropolitan Transportation
Authority (MTA) Bridges and Tunnels for
State Organized Militia Personnel
Operating Their Personally Owned
Vehicles (POV)		 28 Aug, 2017
USCG-NYNM MOU Memorandum of Understanding Between the
United States Coast Guard and the New
York State Naval Militia		 14 May, 1997
USMC-NYNM MOU Memorandum of Understanding Between the
United States Marine Corps and the New
York State Naval Militia		 22 Mar, 1996
 
Additional DMNA and New York State forms can be found on the DMNA Forms page.
Personal Identifying Information (PII) should be transmitted only by encrypted email or through the U.S. Postal Service. NYS Division of Military and Naval Affairs and the NY Naval Militia are not responsible for pre-delivery loss, disclosure or compromise of PII sent by unencrypted email, non-secure media, or document delivery services other than the U.S. Postal Service.
© NYS DMNA: NY Naval Militia: Forms, Instructions and Notices
URL: https://dmna.ny.gov/nynm/?id=forms
Page Last Modified: 12 Jan 17