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HomeMy WebLinkAbout0099 E . _ _ ~ THIS li AN WPORTANT RECORO 1,~~Q SAFEGUARDIT. IAST N1WE - i1RSt MAYE - WpOLE NAYE 2. SERVIC! NUYSER 7. SpC1Al SECVR1TV IfUYOER [ < " xA 12 695 874 129 36 5482 ~ 0 OEPJ~RTYEM~. CCYPpNENT I1ND SNANCM pq CL4j5 S~. GqAOE. A~TE OR RAMK • OA? pATE DA• YpMT~: ~[Ul ~ GRApE ~ s_4 ZS J~1 65 R t/. S. C171ZEN PL ACE OF BIwTM 1C~ry rw/ S~xr w Counfrl) f. O~r rOMtl~ M r OAT[ ~ ~rES w 1 p0 BRTN 1 Jlll ~i5 ~r 70a. SE~EGTwE SERViCE NU~KEN ? SlLIECTWE SERVICE IOCAL BOwqD Nu~9EN. GTr. CpUe~TV. S~AfE AND 21P COOE OATE IMpUCTEO FV< w~< o~v rorrr v[ue i' ~ro ~N i M ~ 1 ta_ ~vPE O~ TRAMSFER pq O~SCMMGE ST~1T10N Oq INSTA~L4T~ON AT ~11/CM EiFECTEO ~ E r 1 u ~ < - ort Br Aorth Carolina , ~ c. sa~ w urMOa~Tv d C~r IlowiM rEM ! E«EC i W f rac~ - ewre ~ I 67 ~ ~0 It_ LAS~ OUTr A551GNYEt~t ANb ~AWR COwYAND qa d1~RACTER OF SERYICf A T~IPE O~ ~ERTIFlG~ITE ~SSUED r r N 2d 1 t Bda DSATC TOSA HQIOI~ABLE ~ona ~ ~ DiSTi11CT. ARE1~ COYYAND Oi1 CORPS TO M~ICN RESER~'IST TRwNSiERIRED 1S. NEENLIS~MENT COOE t t DSMC St Louia liiss i 8E-4A TEFMNAL OATE Oi RESERVE 17. CL~tWENT ACT~yE SERNCE OTMEp 1H1W SY ~MpyL'TION A TERY OF OATE OF~ ~M1pv ~ia5 OBL~GwTC N ~~qCE Oc ENTNY: SERV/CE OAV YpUTN ?E~ (Y ,in1 O~r YpqiN vEYI ' ^ ENl15TE0 (Fir+t Enihramf) ~3EtrL~S~EO (Phar Service) REEML~STED ~ t 69 ~-~TNER J 15 Ap 64 ta. PRqR R[GUL4R ENLISTYEMTS 19.•GNApE RATE OR RANK AT TIYE OF 7D, PLACE OF ENTqY INTO CURAENT ACT~yE SEAVICE (Crlr apdSJa~e) ENTRY IuTO GUARENT ACT~VE SYC Privata 8-2 Fozt Diz, Nav Jersa 2/- MOYE Oi hECORO AT TIYE OF ENTNY 1NT0 ACtIVE SERV~CE 22. STATEYENT Oi SERVICE YEARS ~lONTMS OAVS ~ fS~.~er. RFD. C~er. Cw.rr. ~Ke wd 2lPCat'1 374 S7th Street ~ rE75C~Y~CETNISKRqO , cwea r we~.e ; Y rk 11209 ~OR 9ASIC PA~I ~h OTMEI~ SERVKE ! PuAPOSES 37s• SPEC:/1LrY NUrBER a TITLE b. REIATED C!VIIi~N OCCUPAT~ON AMD ~p tpTAL (Lh~ ()1 ~hr~ Lb~ ~7y ~ ' D.O.T. NYMBER . . . ~ g4g2p ~ TOTAL ACTIVE SERVICE ~ k ~ FOREKrN AMD ON SEA SERV/CE 1J~ ~ r V 2~. OECORAT/ONS YEO~lS BnDGES Cp4YENOAT10N5. C~T~TIpiS ~ND CAYV~IGH qIB90MS A~I.pDED OR AUTNORIZED > ~ ~ tlational Defenae Service M~edal - i U3~A0~3n r~~i'~ C~~ii=~ .Y ~ t'.'JO:~ ~.>~t;.: 2S. EOUCATIOM ~ND TRAINING GOYVLETED - • ~ - ~ High School Htry Gm High School Equivalent -Cook~ Conrae ! ' ' ~ ~"c 1s ~ ~ j u~ ~ ~ _ s ' ~ ~ ! , • ti ~ Q~da of Conduct GB~ Training ~ilitary.~~t-~ ~ I , ~ ' _ . ~ I 26y NON-P/~r PERIODS tiYE 105~ Ip~eaedms A O~rs wCCAUEO LEwvE viu0 ~a. ~YSURAMCE IM FORCE ` A A~bLNT OF ALIOTYENT . YpNTN AI.LOTIIEMT Tro Y~+r~1 (1y$U w(lSGIJI D~SCONTINUED i < ~ ~i ~ o~ ~ioae 53 _,•ES ~=N° s ~tA NA m. VA CLA~Y NU~F• = i9. SERVICEYEN'SGRWP L~iE ~MSUAANCE COVERAGE tt ~ • G ~ r ~ s,o.oao ; ~ ss.ooo ' '..o..e . . 70- NE~tARKS ~ . . ~ ~ ll~A~ GZO~Tt • O ~ ; ~ ~ i ~ f ` ~ ` ~1. r(qyAMEN/ ApMESS Fpq YMLtNfi ?UII~p~ AF7 AM ~2. S~GMI~TYNE Oi pERfpM K~r~6 T EAREO OR dSC +~qGED ~ (S~mf. RFD. Clt~. Cowtr. ~~fe rW ZIP C«N) 374-87th Btrtat x Bodn~ • ~ ~ arookl a lfev 2ork 11209 ~f/ Y }t. T77I0 M11rQ. OI~ApE ANp TITLC OF A1/TNpR/ZWQ OI/ICER K. 51GNAT O«'ICl11 AU IEO TO LOM ~ a~ a~~ u.T ~c a~~e~ssT ec : ~ L• ?:tA`; ?t . ~ . ~ iORY PwEV~OUS [OtTWrS O?~W~1+`/V I/Nit ~ . ~D Z~~ ~Re osso~ert ersecT ~ c~: ~~l~a_~~~ ARMED FORCESOF 7HE UNITED STATES ~ REPORT OF TR/WSFER OR DISCHARGE Yea:- ..-.r~..~. _ ~~~~'~'~aaa~'a""~`~+e~'} '4`~~y'~° . ' - ' ~.y ' & .