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Use to authorize or refuse the implementation of specific rules of engagement. Reference: FM 101-5.

LINE 1 — DATE AND TIME______________________________(DTG)

LINE 2 — UNIT________________________________________(Unit Making Report)

LINE 3 — ROE APPROVED ______________________________(Approved Rules of Engagement and Any Applicable Constraints)

LINE 4 — ROE DENIED _________________________________(Rules of Engagement Being Denied)

LINE 5 — POLITICAL GUIDANCE________________________(Political Guidance Code for ROE Authorized)

LINE 6 — NARRATIVE__________________________________(Free Text for Additional Information Required for Clarification of Report

LINE 7 — AUTHENTICATION____________________________(Report Authentication)