Loading...
HomeMy WebLinkAbout1775 _ _ _ _ - _ YIC$OFIL[ YY~[[0 _ Legibility oi writing, typins or printing tmsatisiactory in thia doct~ent ior ~oioroliledng. TNIS IS AN MIPORTAIIT RECORO , ~ 1'70512 SAFEGUARD IT. l. L,1~ST NAYE - i11KY NAYE - WOOIE NAYE " A SiNV1C! NUYOEI~ 1 fOC1A6 S[CUMT~/ NUY~E11 ; SLia J_,VIL Ci ~;ii J~.. 05 20 1 ~ DEPMTYEMT, CpYPpMENT AIiD BNANCN pR ~LASS L. GRADE. RI?~E OR R/WK R PA~/ i• pATQ O~~ YOMTN ~[Y~ J GRADE OF < _ :~i~ t~ UJ:i;~ ..^?IG 1':'P p~ RANK . ~ 7- U. S. pT12EN PIACE OF SIRTM (CIry edSfafeorCo~f~) DA1/ YOI~TM ~'[Ml OATE ~ ~rES Qao !'iut1~'ii1S 1~1~i1i.t{, 5'L~yl'i ewiN cri _l~`"? f ~r qa. SELEC7~VE SEAVtCE NuYBER p. SELECTIVE SERVICE IOCAI B011R0IiUYBER. CITY. COUMTtl. STATE AND 21P COOE c. OATE tMpYCTED MV< D~Y IIOM?M ~/[M u> r w~co - M~ 17.- 1 , ~ 1 Ti TYPE OF TRANSiER OR DISCN~INGE A STI~TION OR INSTALLATION AT OMICN EFFECTEO = b ~ u ~ r~T 1}' yl-~~(~ i'l~'i ? T ~s:.~7'r f~ • /-!r t•-,-> y~-'S1 (s,,.(~7,•-T n, t~--• , +~v~ i t4rJJ~Y~.iV 11Wi~? aaL ~ 1~J LV.L.~ :ir.~. 1~J-L.J~~ii::L: V:J 1' i . . i, = e. pERSpN ANO AUTiIORITV d. D~r ODUTN 1[Mt ~ ~ EFFEGT~Y { - ~ l f ' l ~ ' 1 ' 3s.J 1'.4~i-L,- c -t ^ • , T'.~l _ 011TE , j .xJt Jv ~ < a.~V :~i::;al~! .~.1 -1~~ ~«1 J11 . . ~Q /2. ~.AST pUTY ASSIGNYENT IWD wAJOR COfWAND 1)a CNAqACTEN OF SERVICE A. T110£ OF CE~iT1i1CATE ISSUEO } ~ i ~ L~ I~i~ 7I• 1 ~1 ' y,.!~~ I'~t C~~j'r ~i~ . T 1`~ .~17 ~ : .'i \ f ~w V~~lt! ~.LLi i•j:. _ar ~i Ja Ji7...~ I ~ ~.i~.'I i.Ui.Vit:uls.:~ : t,•_: ~ ; ~ 1~. O~S~RICT, AwEA CO~WANp pR CORPS TO ~M~CN NESERVIST TRwNSFENREO ~S. qEEw-Lt3fvENT CpDE H t T .~t / .l~>^.- ;~-~r'.r, 'r'~ n :i - ' ~~T-i.~- -W I.Jtll V Li,.YL VVi~:1_~~.'J ~._:ll~'. ` T'- , j . TE~iMMAL DATE OF RESERVE 1)_ CU~iRENT /1CTIVE SERV~CE OTMER TNAN BY I/i0UCT10N TEiW OF DATE O~ ENT11V UYT~S 08lICiATIpq 5,p~~p~E OF ENTRtl: SENVtCE O~Y tlONTM YEM (y~ri) DAr Iq~tTM •E~.M ~ ENUSTEO (FirM Eali~tsaU L} £NLISTED (Pnor Sernce) `7REEMLIS~ED U Vi1F `I~ i~OtMER G1.1L:J~ ~j •-V.s ~ T T i-l',- t T•~ •:l ~ l. / ~0_ PRfOR RCGULAFl EMLISTYENTS ~9. GRAOE. RATE OA qANK AT TIYE OF 7D. FIACE OF ENTq1/ INTp CURRENT ACTIVE SENVICE (C~f~ ~dSINe) ENTRY INTOCURRENT ACTIVESVC ' z! _ 1 ~iZ'~., ~z:1t~1:aJ i L1Ji :i , • i ' • • =-r ~ I~. MOYE OF qEC0~+0 AT TIYE OF ENTRV IMTO AC~NE SEAVICE 22 STATEYENT OF SERV~CE YEMS j YONTNS OAYS IStrret. RFD. C17. Co~varr, S~we ~nd l/P Code/ 2`717 a~t~~V1-~L _Lt/~(.)~. 1:~J~~J, ME7fERVICETMISPf~1qD 1 lC CqED1TABLE ~ ~ ~ ,I .i ~ + - ~]v T^" , iOR BwSIC aJ~V ib OTwEw SEAVKE ~ 1 i `'Y.: . ; : , PUQPOSES ! 2~~. SPECULTY NWIBER ~ TITIE b. RElATEO CIVIUAN OCCUPI~T~ON AND Iy TpiAL (Lh.111 ~1~~ L~ O1) 3 p ~ O.O.T. NU~BEQ (J~ < O~l'' ~ h TOTAL ACTIVE SERYICE 3 l+ ~ < / 1 ~ Vt,i 1~=Jt{ ~~t .1. c. iCRE1GN AND'OR SEA SERVKE ~ ~ J ~ ~ r V 2~- DECORwT10NS. YEDALS. B~OGES. COrYENOAT10N5. C~TATIONS AND G~PAIGN RIBBONS AAAqDED OR AUTNORIZED ~ ~ > } ~ 1 , ` ~.1 ~ i'' . • 1' ( 1 . t ~ _ 1' ~ r T~ ' " ~ ( ' i" -rT ~ T f'. • ' . .i ' . N 1~ L1Z~f~i ar~ L::?~_~~i+J;.i .~.J_IYlUJ •~~-~L/' Y'.J111.L'? JuJ1t~IlI.•J ~.L.Jt~j.~. ~.J i.i1.1~~(1. _:~:fU:a.L~ 2 ' 1 1 1' "..t 1 ~f l - t < " \ _:1.C ~...~IJ_~.i,~ t .u~_.v~tli ~ 1.:-~f.tJ:i;_i~ :;i..~ L1v.~:{J.~.. ~ :~_.Li;~ - : s 2S. EDUCATION AND TRAIMING COYPIETED ~ - . ~ .:J_aJ.JJJ ~CJ:7 ~i'.! l~.u~:J - . . . ~i- - : ~ `i t .~rr, , j,- • 1 = J j = ~..rJJ ~ ; ~.~J ,~J1i, ~a~7 ~.~)t.i.i.~ u. . ~ _ Y~ _ ~ ~ ~ ( F V ~ ~w 1/~ . ; . .-'i ~e-I ~ 2i~. Nplt-PAY PERIODS TIYE IOST (P~eraHaj 6. OAV$ ACCRUEO IEAVE PAlO Z7~.INSUAANCE 1N iORGE b. AYOUNT OF /1LlOTM[NT TN LOiYENT Tw Yersl (NSU or USG[JI dSCON j M1'!O < ~ ` . ~p : (t I~rES ~JNO S y" r s. Vl ...J ~ O `V b. VA CINY MUMBER M- SERVICEtiEN'S G~iOUP LIFE IMSURANCE GOVENAGE > ' ~.ri~ G tW.000 l~ tS.OQO ~ j NONE l0. AEYARKS M r -„-.r - , : , - , . ~ ~ ~ - ~ ~ . ~ ',il~e~- 1 ,s: .~i.~,v a_1~.~..: ~.t ~-~J ~~w .J .....si ~ J{..a a. _ ~ . r ' ' Z. 5-a: :~iv 1 7..~ tL 7~ '.vvl~ JJ PERMwNENT ADORESS FOR YAILING PUNVOSES FTEN T AN MA 32 SiG ATURE O ER £~NG 7R ERAE pSCMARG _ (Stnet. RFD. Ciry. Caw4. ~~tr ~nd IlP Code) • ~ O ~ < Y :..i Zi.:i ~ a ~ 77. TYPEO NAYE. GRAOE ANO TITI.E O~ AUTNpi~~ZING OFFICER Y~. 51GNI~TU1! O E ZED TO S1GN Z r z ~ ~ , a. i..::,.r~:! 1' ~~~:~i yJ ?ow~ na or tM~s soar AR/IEp FQRCES OF THE UNITED STATES ~ ry~ M E F CTIV E 1!AM 67- • GPO : 1lf~ O- 27~-1ZS D Z""~~~,'I~ ~°L~~ REPORT OF TRANSFER OR DISQiARGE 7 VlJ ~P~E .d.,~ _ _ - _ _