Coast Guard
Leave & Liberty
Special request chit
CG Special Request / Liberty Chit
Draft a special request for liberty, swap, or other authorization before routing it up the chain.
What this worksheet covers
Open it in the toolkit and these fields prefill from your service profile — rank, name, and unit are filled in on the spot.
Administrative data
- Name (Last, First, MI)
- Rank / rate
- Unit
Request
- Request type
- From (date/time)
- To (date/time)
- Details / justification
Draft / worksheet aid. Prepare it here, then transcribe into your official system of record. This is not an official submission — verify against the current official Special request chit before use.
Related Leave & Liberty worksheets
Fill, save & export this worksheetPrefilled from your profile · autosaves to your account · export to PDF. Free to preview, Pro to save & export.
Open in the toolkit →