HomeMy WebLinkAbout0825 TN15IS AM /MPORTMIT REOORD `~~vJ
SAFEGUARD IT.
1. LA{T NAYE -~~AST NAY[ - YIODIE NAYE Z. SERy1CC NUY~EI~ 1 SOCIAL 3[CUA1f~l NUwew ~
< RUSS 2b 2
O pErA TY[NT, COY EMr ANO /NAVCN pp CLASS S~. GNwOt, I~A~[ OR RANK • PA11 pAT~ OAt rOMiM Y[Y~
J 6RAOE
~ I~ANK
Z
~
~ 7. U. i C1~/2EN PIACE O~ OMTM (C~f/ wJS/~f~ w CawlA) DwT~ D~1t OOMtM r[M
Y
s os
r'cs O p o~wrM
~r p~. SELF~CTIVE ~~~CE NUYBER 6 SEI.ECT~VE SfNVtCE IOCAI SO1~AD MYw![N, CITY. COUNTV. STATE AND 21I GOO[ C. OATE ~NOVCT[O
HV < O~r YOMTM tLY
~
Wrt ~
J ~1 0
YM
N
1 t~. TYPE Oi TRANSiER O D~SCNMGE L STATION OR IMSTALLAT1pM AT ~MICN EFilCTEO
„ _ ,Releas@ f"~'am BCtiY6
r
" d t and trans er t a -a Sta.t P `e a Penns v'
< n
= C. pEASON AND AUTMpRITr i(~~+•^, A~. G„1o317(1)(b) Code ~i~ ~F~`,T1V OA? YOMiM ?E~N
x ~,a~~wa.~
~ 8 1 y OATE
L 4
12. LAST p~?TY ASLGNYENT ANO W10R CO~AMD ~1~. O~ARAC~EI~ Oi SCRV~CE ? TrK O~ CER7~i1G~TE ~SStlEO ~
K
~ USS F.D. R006 A ~ ~s
~ ~1. 01SrN1CT. ANEA COYY4MD OIi CORPS TO ~MICw A[SENVIST TRANSf ERRED ~f. 11EEMl~STYENT CODE
R
f y
4
TERWMAL DATE OF RESERVE% 1). CIMAEMT ACTIVE SE/~V~CE OTNEI! TNAN SY INDYCTION TERY Of DATE OF EMTR~I ~
UYT~SOBL~G~TIpN spupCE OF ENTRV: ~AVKE
OA~ rOMTN t[M (y'y~) O~Y 1qwTM ~CM ,
~ENIISTfD(FirME~6sOwwfl O[MIIST[D(PrlerS~r~ic~ ONEEML~STCO
J~ O ~OTMER - 10 JAN
PNWR REGYLAN ENIISTMENTS GAAOE. RAT[ OA RAl1K AT t1YE OF ~p, PL1~CE OF EMTI~Y IMTO CUNREMT ACTIVC 3ERVICE (Ctry d Sf~t~
. ENTRY INTO CURIIENT ACTIVE SVC
H(~3E S~.I~S Ft Pierce Florida
2~. MOYE OF RlCOND I~T TIYE OF ENTq1l INTO ACTIVE flNVICE 22 STATEr[MT pi fERV~CE rEMS YOMTMS OA~f -
` fShee+. RFD. C~ry. Caet~. St~t~ wd Z!P CedeJ
! 2~
0~ W~ p~ gx /y • 14 w[7 f[~VK[ iM~f K~qD O ~ 2
11 ~i V V cweaTwe~e
.a iow OwS~C ow1/ ~y oTMCw sCwv~C[ ~ ~
PYAPOSES
i tl•. SnEC~w~Tr NUYBER ~ T1TLE R RllATEO CIVILIAN OCGUOAT1pN I~ND ~f~ 70TIL (LM~ (Il ~4~ Lr~ ()l~ z
; ` O.O.T_ NUYSlR L~O•~A~ ~ TpTAI ACTIVE SEMViCE
~ ALiZ~ONABIIF. SERVICE ~ u
0 "Q~(~(~(~ c. iOREK.M AMO~OR SEASlRV1CE
r ~f-'vvvv
V 2l DECORATIOMS. YEOALS. BApGES. CO~[ND T~ NS. T1~TIOMS M10 C PAIGN RtBSOMS A~AI~DED OR AYTNOIIIZED Q~
~ National DeYense Service Meda1 c~ °D u'
~ Viet Nam Service Idedal m~ ~ ~ r-
Viet Naa Cam
p a
i g~ Medal ~ c z ~ c v
2S. EOLCATIOM AND TRAtNING COYVIlT[D m D ~
A N
~ X$ ~Tt ~ ~~n0
~ ~ - ' ~A ~ W ~ ~ ~1
~ ~03~ ~-t ~ CQ ~ Z~'
S,N "A" SCHGOI, USNTC GLAI~S ILL. 11 MAY o4 - 31 ~TUL 64 ~~C N 0-n
~ gg XX ° cn X% C.. rn•
~ ~ v
g7C XZ ~u Xgs ° ~ m
~ 25~. NONAAY PERtODS'T1ME 1057 (Precein/ R 0+4v5 ACCRUEO IEAV! PA1D Z1~JM513RAMCE W~ORCE A ~rOUNT OF A~~OTYEM~ MTN PlL N~
7~o Y~~ra) [NSU w USGL!) W SCOMT~wUED
<
~ TL - NONL 2~ orEi ~NO . N/A N~A
0
=V y_ yA CIMY MUMOER b. SERVtCEYEM'SGNOUP I~FE 1MSUNIIMCE COV(N11GE
~ r ~+6LQ ~ l~Ql~i
tr
> M ~i ~ f~0.000 Q f3.000 MOUC
G;
~ I0. NdMKS
~ IffGH SCHOOI.
~ ~ ITEH lla CONTINUID: E%PIHATION OF USN CONTRACT AAID CONCUR~~iT ~FER T~0
~ = NAVAL RFSERVE
~ ` I7EM 13b: NC DISCHAtt~S (~:ftTIFICAZE I3SUED AT TIME OF SEPARA~~"i0N
XR XX AC XX
~I. PE~ANEMT AODRESS fOR Y411.IM6 IYR?OS! A RAN k. fIpM11TY1lL O •E~1SOM ~UM6 T1~IWSFlMEO OA pfCNA11GlO
~ fSor~~t. RiD. C~4. Ca.w4. Spe~ ad 1IP CoM) /
e'y O '
~ ; 106 T~ucerne Roe~d Olll
u
~ . TrPE AYE, G ANO TITIE OF AYTMOIIIIIMG O~iKf11 NATY11 f/1CEA AUTNOIUS~O TO f~6M
~ r
~ J. Fta7C~ ASS ~ T PSRSOh'hI:L OFFICEft d00K 1~O PAGf v~
~ BY DIRECTIOIti OF ~IE COHI~.AI~ING OFFiCTR ~
~ DD ?a!hss 214 N •wcvawcaTaoor rwsro~r Mt o~~o.aTC. s%w-oio~-soo•~ao~ ARMED FORCESOf T11E UNITED STATES ' '
REPORT OF TRAMSFER OR WSCHARGE
- S -
~ , ~ : ~ ~
f:- ~ w.:
. ~Y4~~~ :