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1. Request that SFC _______________ be awarded the Combat _______ Badge for personally being engaged by the enemy.
2. The following information is provided:
a. Date of Engagement:
c. Soldier (example) was within XX meter(s) from impact of (circle one) Small Arms Fire, Sniper Fire, IED, VBIED, or Artillery. Soldier performed medical duties while under fire.
3. Situation: While providing security at the New Baghdad Police Station during the Iraqi's Free Elections, SFC ________ came under direct fire. Additional information is provided in the narrative and eyewitness statements.
1-DA Form 4187
2-DD Form 214
5-ORB/ERB/DA Form 2-1
6-Eyewitness Statements (Minimum 2, other than the recommended recipient)