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Home My WebLink About1528 f S • LEGENO: bsM N/.1'agei.~~iiMo rilel~nrf~T~Ir~ie 14 9 • ' 1. W7 IMt.~-FIRlT INME-MIDOIE NAME 2. 8E1IV1GE M~~O! ~t. IMi'E 01t MIM( 1. OATE OF MIMC(O~ryr. Mwt1r 1 Ye~l ~ ~ .~Mr ~uo ~uMCa. s. w.~ca os siRn+tcur••+sr.ee «c..«~sr a~ r MowrN ve~ut o ~ ~ - ' o El7t e. OOLpt COLAR lYES 1~Ni1R I. ~~T 0. u.3. CIT12E11 9. w1RITl1~ sT t~ 3 i ~ ~ ~ p,p Me~rried # 101. NIWIEST CMLIAN EDUCATIpI LEVEL . 4MJOR • i ATTAl1ED . ' s 114 TY}[ OF OR OIiGltAMiE i. STATION Oll INiTAtJ.ATlpl AT MHlpi EFR6GTED I i ~ ` C . ~a e. I~ASqI Alb AUilIONITr MY MONTH Y[M ; ~s - ae,t - - arm ~ a ~ ~ ~ usT outv nss~T w~o w~~ae ooe~ - t+se,oF serv~ a. T,rvE aF co~nF~u?~ ° a a ~ aa. - - - - m ~a~c z ~ ar~n. ~e. d?rc ~MOUCrEo ts. saeeTrvE senv~ i~+4 _ ~eSF y~, - t_..._. - 7 JI~ ~ ' S ~ ~ ~ r» 7. D18TRiGT OR ~ i ISt . ) . ~ • _ : • ~ ~ - " ' , , ~ ' p' ? ; i`'' . - . < ~ . 1 li ~ ; i ~`.l i 1. TERMIIIAL SE1l~ICE IE1t SY~ !Oy 1lM~~ ~ 011TE OF EMTRY 6 ~ ! ~ I..l01AIGE OF EM7RY ~ t i . ~ Y , aJ~T~ (Fssf ~~alisb~U~' EIR.I~TED/~ir s~1Mc~)~IST~ R~/d MONTN YEAII_ ~ - a ~ ~ r f' ° : ; ~ ~t ' f ~ ' 20. PRI t. iRAO[• fAiE d! T T , OFj IIY 1 CI~IEN~ 01 SYtd ~ j _ } j nrt..1~rQ aah~"""'ca? ~ ? . ~ i F_'~ A`~ ~ - ~ ~ `'l i 2a. ,oF' ~ ~ nw+t oF aner rrro ~cr sEnvice~sa~.r. ~n ta. ~ro~rr`os sav rw~~ ~n~s wrs . 4. . - ~ t. (Il MET SENVICE Tu~s lo~ 1 _ ~ ` * CKDIT ~ O?MEJt SEIMQ f f. ~ , ANDT IIELAIlR CIYILIAM _ ATIOII AID P (8) ~~A~. ~~.iN ~~~'t Ila~ _ t - ? 0~. O. r. MuMBER i f ' T A~: ACTIVE sEJ~1t1~ ~ , ~ G FOI~CIa1 AI~/OR SEA SEIIVICE - Y V 26. T~pNfy . BADGES, COMyEl011TIOMS~ G~TATIQIS AID NWMMIqI 81 ANANOED OR AUTHORI ~ ~ y . . . :`_3 . M C ' , AS ULT OF ACT~OM WITH E)IQAY FDIICt{ /P~~.d/~h. ~1~~ - :y ' - ? ~ - Ol . dfM1~iE Ul1lAif' COlMSlS N~DIOt /06T-0MOW~ ~ gIC~SRR?f COIYlf1E0 S- 2Y. SEINICE TRAINING fpqp• QI1T[S fP?O/•~~-;y • . MAIOR GOI~ - SUGCF.SSFIR.LY t . _ ~ ~ ` y I - - -3 ~ ~ . ~ f t. ~ . . _ ~T/ - . ~ft ~ ~ ` ' . . .~~~~y' 1l'y ~ ~9 - . ~.1 f '~Y~ ~ G011FRN.EIR LIFE µ ~ , . ~ ^ b ~ ~T~~ c• DISODN~IMUED~~T . : t . ~ , . ~ ~ ~ , ~ ~ _ L , ~ 310. VA BEIEFITS iIEV IOUSLY + /f~~Y ~e) = , a ~ i. VA CIAIM Ml+IBEA Y i ~ ~ ~ ~ ~ t MaM - ~~Q.IS , ; i~ we ~qwt ri~ teae 3~I~s ~ ` ~ ~l~~i+ea Heara ~ o !l~ai i~ ~ ~d~i~s ~ei s~alr~ ~~b~ ~ ~,st~e~ 1lii ti 11~tfLn. ~ ~l i : ; j} 3~~ , ~i~ u ~K ~ ~ ~ ~'1N - _ ~ ~~+w~~ ~ ~Ma ~ : ; : ~ : ~ - , ~ 33. PE1tMANE/R AOOIIESS FOR MAlL11Ki PUlPOSES AFTfR TiW15FER OR''- ' 34: S ~~RSOM lEIIIG TRANSFEAIEO at DI ! ~ DISCNARGE fSe,rer. RFO. Guy. Ce..er d Sarel ~ { ; ~ . - ; ~y : . 3 ~ T Os TYPED NA6l, 6RAOE AMO TITLE OF AUTHdi121NG OiFIGER . s ' O• ~IU ZLt It~ ~N~ 1~ # DD ~ rF+ov~s5 ~ as oe~D~i ~ ~~~u~ ARMED FORCES OF THE UNITED STATES gQOK REPORT OF TRANSFER OR CISCHARGE ~ _ ~ _ - x~.: _ y ~~w 'S~_-~ A~~. .