ORD Clearance Form

ORD CLEARANCE FORM (Revised as at 12 March 2013)

Declaration by

(NRIC No.)

(Name)

(Rank)

(Appointment)

(Unit)

ORD CLEARANCE Level

Declaration I have completed my Dental and Medical FFI.

I have returned all classified documents (Confidential & Above) to unit registry/ Release/ handed over to my replacement ORD Personnel I have returned all equipment/stores, which were loaned to me, to my Unit Store IC/CQMS/RQMS/QM/Logistics personnel1. I have completed "MyORD" Quiz.

Remarks

Please Tick Accordingly YES

NOT APPLICABLE

YES

NOT APPLICABLE

YES

NOT APPLICABLE

YES

NOT APPLICABLE

To bring along FFI Certificate for verification

Applicable for ORD NSF only.

1 I understand and acknowledge that it is mandatory for me to complete my Dental and Medical FFI before release from service, and that I may be subjected to disciplinary action if I fail to do so. 2 I have paid all outstanding fines and costs of recovery from loss of stores, repaid all overpayments and returned all personal equipment and stores prior to my release from service. I acknowledge and agree that I will be liable for any payments that may be imposed on me by the Singapore Armed Forces if I have made any false declarations in this ORD clearance declaration form. 3 I have completed the necessary exit clearance as stated in Manpower Directive No. (401) 09/2007 (Administrative Requirements for ORD Clearance and Disruption from Full-Time National Service) and I understand that this ORD clearance declaration form does not serve as a Handing and Taking Over Certificate. 4 I have read and understood the notes on management of service injury claims stated in GOM 402-06-04 (Management of Injury and Death Cases in MINDEF/SAF) and acknowledge that delays in processing or difficulties in making a claim may occur if claims are submitted late. 5 I have read and understood Section 50 of the SAF Act, which sets out the offence of falsification of documents and states that: Every person subject to military law who — (a) makes, signs, or makes an entry in any report, return, pay list or certificate or other official document, being a document or entry which is to his knowledge false in a material particular; (b) alters any report, return, pay list or certificate or other official document, or alters any entry in such a document, so that the document or entry is to his knowledge false in a material particular, or suppresses, defaces, destroys or makes away with any such document or entry which it is his duty to preserve or produce; or (c) with intent to deceive, fails to make an entry or fails to reveal any material fact in any such document, shall be guilty of an offence and shall be liable on conviction by a subordinate military court to imprisonment for a term not exceeding 2 years or any less punishment authorised by this Act. I acknowledge that I will be liable for the offence of falsification of documents under section 50 of the SAF Act if I have made any false declaration in this ORD clearance declaration form. I acknowledge that the SAF may recall me to answer any charges under the SAF Act, including a charge under Section 50 of the SAF Act, pursuant to section 109(1) of the SAF Act, which states that: where an offence under this Act triable by a subordinate military court or by a disciplinary officer has been committed or is reasonably suspected of having been committed by any person while subject to military law then in relation to that offence he shall be treated for the provisions of this Act relating to arrest, keeping in custody, investigation of offences, trial and punishment by a subordinate military court or by a disciplinary officer (including review) and execution of sentences as continuing to be subject to military law notwithstanding his ceasing at any time to be subject thereto.

Date

Signature of Serviceman

Date

Signature of Witness Rank, Name & NRIC of Witness (Witness must be minimum 3WO/DX 6/7 & above and from your company/branch)

ACKNOWLEDGMENT BY UNIT CSM/QM (ONLY APPLICABLE TO STORE IC AND CQ APPOINTMENT HOLDER) I acknowledge that the above serviceman has completed his exit clearance administration.

Rank/Name/Appointment

Signature of Unit CSM/QM1 Rank, Name & NRIC of Unit CSM/QM1

ACKNOWLEDGMENT BY UNIT S1/AO I acknowledge that the above serviceman has completed his exit clearance administration.

Rank/Name/Appointment

Footnote: 1. Delete where applicable.

Signature of Unit S1/AO1 Rank, Name & NRIC of Unit S1/AO1 ORD