Loading...
HomeMy WebLinkAbout0004 , • . :s ~ n, _ _ ~ . TMIS iS M IIIPORTAMT RECORO ~ SAFEGUIIRO IT_ ~ l+~S* N~.ME • FiNS~ NAYE - r~DOIE NAYE 2. SlNV~CE NuYBER 1 SOC~AI, SlCIlIqlYi~tlYOER • ~ MARTDT JAI~IIH'.g EDWARD i O ~ p£PaA~YENT COVPONENT AtiD Y4ANCM OA CIAK Sa GRAOE. pATE 071 N~.MK ~ PA'~ DATE Oa1f YOMTM ' ~[M ~ J GRADE • = MAMK ` e~rnr a~ ~a sp s z a i ~ 7 V. S. CIT~ZeN S. PIACE OF B~QiHlC~t~' aeJStsfewCwntrf) O~~ YOMTM ~ tl~R - ~ r OATE ~ ~r_j Q\) 1 SiA115i\ 1~i/ ~ 1V~lA BRTN ~ Y~I ' i)) ~o +Q,.. ~ELrCTIVE SERVKE NV~BER ? SELECTIYE SERVICE IOC~~ BO~ND ~~tJrBEN. GITY COUNTr STATE AND Z1P COOE a-_ OaTE ~MqlCtEO ~ ~ U>F _w D~1 rOwTn 11EAflY . ~ ~ ^ ~ ~ ~ ~ . ~ I68 $TIT~ I,S~LLND RIC~01iD 1TBN 2~O~R1C 0 00 N ~ ~ 7~. ivof OF TAI.NSiEq OR DISCM~RGE A STATION OR IMSTAtlAT10!'~ AT ~MtCN EFFECTED i r li\/lL1V ~ W~41 ~~A - W{I~LJ.A DA~i AlO_ ~ ~ll~ ~ 1~iW < u AEaSJM ~ND PU~HORITY O!~ rO~Tw - ~pp~ ~yp~~~p EFFEC T I V v~ ~ F IiAR ; A[~ v W S~ G~~fi ~1itiAi1~ i~iYi ~JIC ~7~lLtiV1 o~rE t1~~n 6 - ~O 22. LA:T .^~'viY ASSKsMYENT ~D ti~JON CO~AlaO 1)~. CNAA~TER Oi SfAVICC d T~PE Of CEA71FIt~TE ISSUED ~ ~ ~ ~ ~ ~ ~ < D~STRI~~. ~REA COHYANOOR COpPS ~O ~M~CM RESERy15T TA4NSFEpRED U. wtt~u~Ye~+T CODE ~ ~f - ~t ~ ~ i ~6'EGw"~+~L OATE O~ RESENVE 77. CURRENT ACTIVE SERY:CE OtMER TMAN 8~' INDUC~~OM - 8. TEpYpi OATEOC EN~AY ~ ~YZeS OBL~G~TION a, SpURCE Of EN~RY: SEAY~GE 1 pa~ YOM~M ?EAA ly~w» D~~ YOwTM YCM j ~ ENLISTED (Fus~ F~h.!r.mN ~I E~tL~S7ED ~Prw Sern: e~ ~AEENL~S~EO ~ ~~g + ,:~ER ys 6 ; ~tOp pCGULAR £N115~YENTS U~iADE RATE Op NANK I~T T1Y[ OF IO. nL~CE Oc ENTn~ ~MTO CU(tNENT ~C~~V£ SEpY1CE !C~fS" Sf~fe) ( E~+TRr ~hTO CURREVT 11CT~vE SVC i ~ ~ ~ 2t. wpYE OF qECONO A~ TIYE O~ ENTR~ ~NTO ACT!VE SERYICE 27. STAT(YENT OF SE~7V~CE YEARS YO~iTMS OAYS . :Srren. RFD. Cetr. Ca.rh'. St~re ~nd IIP Cadel ~v.v` ~~j~1 ~~i yEt fEwvKE TMK?EwqD ~ ~ ~ Ma ~anv~ CpEO~TABLE ~ O fOp BAStC PAV •z~ O~MEA SCI~JKE ~ puAGOSES 27~. SpEC~AI~r NUYSEr+ S T~TLE 2 RELATE~7 C~V~lUt1 OCCUPAT~pN wp0 1b Tot~t ~L~.. tt) ~A.• Lr.. ~SU 0.0.7. MUYBEP ~ Al~M YTTT~~D~ ~T(~$(~V 6. TOTIILACTIVESERVICE i 7JDf.\I 171i~1 AR avaira. ~ ~/R TAQ~LIli 2 c. ~ONE~GN ANO OR SEA SERVICE O 0 O ~ r~~~ivsrruu~ V 2t. DECORAT1pNS rE011LS. H11CGE5 COrtiENO~T10N5. G~TAT/pN5 AMD C~MPAIGN RIBBO~.S ~*AwDEO OR AU~NON~ZED :~(x-~ ~.a) ~ s~sHOO~ t45 ~sTa~.) ss~s n~v~s a~nc~ tist ~,rean) NATIO~i/1L ffiFII~tSB S~RVICS MS~ (Lt Ai~tARD) GOOD CONDIICT I~D~L (lst A~TASD) " 25 EDUCATION YiD TRAtK1t~IG CpYPIETED l ~ ~ . ~ T'tl~33 ~LIra~t7 PoLIC~ - ~ ~ N ' _ ~o ~ ; C ' n~ ~ ~AD ~ ~,y ~ t*1 ~ 26a. MpN-PAV PE~~OOS T~ME LOST ~Pre. cdm~ d DA`~S ~CCRJEO IEAVE ~AID 2'~a. ~~+SURAMCE M iOpCE S. ~MOUN7 OF AL KNT YONT ENT Tso Y~rsY . ~xSU or USGLI.~ (r Q ` DtSCOfIT ~ ~ ' < ii m ' ~O ~ ~ ;YES =_NO f ~ ~ i; 1 m VA CLAlY MUY9ER A. SERwGEYEN'S GROUO UiE ~NSURPNGE C E f ' C • • j t jM SMO00 SSO00 r~OMZI O C~ Nl ~ 'i ~ c p ~ 30.wE~~pRS ~ ` ~ rr~[ 3~ ~+c s-3 ~x apta: 5~tov65 - _ i ; eor,oon a~on~ •a~ ; I.1?ST PAID o!t vooCHBR ~ 1235 ; l~. PE~~rEyT AD S~M YA~L~~+6 ~~-RPOSES ~~TEN • N OR D~ s? r,~GN~~VpE O~ pERSON BE~V~- TP~tt«lRREOOR dSCMARGED ~ Z !Sf~~H. RFD. GfI. C~~II. SfNe ~1d J1i~ ~'..d~) Q ~ L4 71 ~ . ~ _ T~vEO MAYl. GRAOE AMO T~rIE Of AUT11p/1t2wG OiiKEA . S~ Y E Oi FK[p A11 NO /ZE TO = B.E• ~.I.A~~ CPT. ~3C ~ LSSt. ~D.ttl?~i? • • ,~,~j~~C.~ so~tr owcv~ous Rar~ons oc T»~s rrn+r _ AR11Ep FORCES QF THE UNITED STATES ~ D D ~ i ca ~ ~R[ OSSOItTE EiiECTIVE ~/11N 67 o GIn r 14{R (1 - I~.1 12S ' ~ ar ~I~~. _L~Ii:C ..1 REPORt OF-IBAMSFER OR DISCHARG~ , ,~y; - " - ~ ~44 _ Ii+~:M+-