DEPARTMENT OF THE ARMY
OPERATIONS COMPANY
DIVISION HEADQUARTERS & HEADQUARTERS BATTALION
1
ST
INFANTRY DIVISION
FORT RILEY, KS 66442
AFZN-HQ-O 13 March 2012
FOR COMMANDER, OPS COMPANY, DHHB, 1
st
INFANTRY DIVISION, FORT RILEY, KS 66442
SUBJECT: Loco Parentis for NAME
1. I, NAME loco parentis is my grandmother Jane Punisher, who raised me since I was four years old. I
was in her custody from Jan 1995 to Jan 2012.
2. The definition of immediate family includes family members of either the Soldier or the
Soldier’s spouse to include parents, step parents, spouse, children, step children, sisters, stepsisters,
brothers, stepbrothers, only living blood relative, and a person in loco parentis.
3. Loco parentis is defined as one who stood in place of a parent to the Soldier or the Soldier’s spouse for
24 hours a day for at least a five-year period before the Soldier or the Soldier’s spouse became 21 one
years of age. This includes providing a home, food, clothing, medical care, and other necessities as well
as furnished moral and disciplinary guidance and affection.
4. The point of contact for this memorandum is PVT NAME at (000) 000-0000.
NAME
PVT, USA
XXX-XX-9876
NAME
CPT, AD
Commanding
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