REQUEST AND AUTHORITY FOR LEAVE

                                STANDARD FORM DA-31 / NAVPERS 1070/613 • SECNAVINST 1050.4
                            

                            SCAN TO VERIFY
                        

CONTROL / TRACKING NUMBER

                            ML-2026-55104                        

CLEARANCE STATUS

Under Command Review

SECURITY CLASSIFICATION

                            UNCLASSIFIED // FOUO
                        

PART I — SERVICE PERSONNEL DOSSIER

1. Full Legal Name (Last, First, Middle)

Lieutenant Sarah Jenkins

2. Service / Roster Number

USN-4819-0023

3. Service Branch & Grade/Rank

United States Navy — Lieutenant (O-3)

4. Station of Record / Base Command

Naval Base San Diego, CA

5. Active Duty Status

Active Duty

6. Clearance Cost Package & Fee

Standard Clearance • $0.00 USD

PART II — LEAVE SPECIFICATIONS & TRANSIT ROUTE

7. Type of Leave Requested

Ordinary / Annual Leave (ORD-ANN)

8. Total Authorized Days

15 Calendar Days

9. Effective Departure Date

September 20, 2026

10. Mandatory Return / Check-In Date

October 05, 2026 (23:59 hrs)

11. Primary Physical Destination Address During Leave

120 Ocean Breeze Blvd, Miami, FL 33139, Miami, FL, United States

12. Emergency Contact / Next of Kin

David Jenkins (Father)

13. Emergency Contact Email

d.jenkins@email.com

PART III — COMMAND AUTHORIZATION & AUTHENTICATION

COMMANDING OFFICER / APPROVING AUTHORITY

Cmdr. Harrison Miller

Defense Personnel Records Command • Clearance Authenticated

                                Date Cleared: Sep 14, 2026 01:31                            

*ML-2026-55104*

This document constitutes an official military travel & leave pass under 10 U.S.C. Chapter 40. Alteration or unauthorized use is punishable under Article 134, Uniform Code of Military Justice (UCMJ).