HomeMy WebLinkAbout1989)
THIS IS AN NIPORTANT RfCORO
IIARrI IT
'7 ~i ~~~~
1 AP
IO
N
E
AYE - FI
ST N
A
YE
- Y
O
I
E
. L
A
ST
M 2. SERVCE NVYBER TY NUY~ER
RI
1 SOCIAL CU
f R
p'
TT
~~
~T
}}
pp
~~
AA
AA
~~
~~
~/~~p1 ~~pp
~
n
~
dii~ pi/IEMLW 1lf7lil~iS~Ad Vil• O 2 ~
Q
262 VCJ 0
<
O a, D[pART MENT. COMPONENT AND BRANCH OR CI ASS Sa. GRADE. RATE OR RANK d PAY
GRADE ~- DATE OAr - rDNTN rE AR
3
<
A~ {JAS
1TRT
• .a•
O~/]
G OF
RANK ~9~
YVi! .'~/^~
W
~ 7. U. S. C1 T12EN •. PLACE OF BIRTH (Cih aad Staff or CoawtrT) !.
GATE DAr YONTN rCM
tr
c ~rES O!0 ~ PI~GRCB X71 T/V~iI~ FaAI[1a~s BIwrN ~Ci
SELECTIVE SERV KE NUMBER
10 a d SELECTIVE SERVICE IOC AI BOARD NUMBER- CITY. COUNTY. STATE ANO ZIP COOP c. GATE INDUCTED
>Y
FU< . oar YDMTN YEAR
~~~ 4 40 FT P F ~
1/a. TYPE OF TRANSFER OR DISCHARGE ~ STATION OR INSTALLATION AT YNICN EF FELTED -
p US ARMY PSRS L C~1RR OAKTAI'ID CALIFQ~iNIA
U C. REASON AND AUTN ORfTV DAr taONTN rE AR
~< EFFECTIV
6 -100 3iA 6~ oArE 2 VVi, 6
Yr
O<
12. LAST DUTY ASSIGNMENT ANO MAJOR COMMAND
I7a CHAR ALTER Oc SERVICE
d TYPE OF CERTIFICATE ISSUED
YO
SF ~ i)BARV HQNORABIT NOi~
<
Y
1- la. pISTR KT. AREA COMMAND OR CORPS TO 1RN ICM RESERVIST TRANSFERRED IS. REENLISTMENT CODE
16 TERMINAL GATE OF RESERVE 17. CURRENT ACTIVE SERVICE OTHER TN AN BY IN011CTItN/ ~ TERM Oi c. DATE Oi ENTRY
UMTA S OBLIGATIO N a SOURCE OF ENTRY: SERVICE
T
rEM
NTH rEM
M N
(Year:) Oar YON
pAr
O C
ENLISTED (Firaf Fati aeremf/ l_J ENLIST EO (Prior Serricel ` !REENLIST EO
~
_
pp~~ Q ~T~
S JUL 6
OTHER j~f1
11. PRIOR RCGU LAR ENLISTMENTS 19. GRADE. RATE OR RANK AT TIME Oi m. PLACE OF ENTRY INTO CURRENT ACTIVE SERVICE (Cih wd Sfue)
ENTRY INTO CURRENT ACTIVE SVC
2/- NOME OF RECORD AT TIME OF ENTRY INTO ACTIVE SERVICE 22 STATEMENT OF SERVICE YEARS YONTMS DAYS
(Street. RFD- CIq•. Ca.wh. Srue and 2)P Code)
Y-_ a• iN NET SERVICE TMK pERK10 1 ~ 16
~• ~~ ~~
~v~F CREDITABLE
FOR BASIC PAY I21 OT NER SERVKE
PURPOSES
27a_ SPECIALTY NUY ER !TITLE d R LAT ED CIVILIAN OC PA ION AND 1» TOTAL (Lbr (f1 /be Lbe (J)) ~•
O.O.T. NVYBER
i ~~~~ INI? Vl~u ~ d TOTAL ACTIVE SERVICE
p c• FOREK.N AND OR SEA SERVICE
V 21. DECORATIONS. MEDALS. BADGES. COY/fENDATIONS. CITATIONS AND CAMPAIGN RIBBONS AYARDEO tNt AUTNORI2ED
NATIONAL TLL~SBBS 88RVI(~ 1~SUAL; VIBITNAId SBRVICB M~I~AL; COAT INFANTRYMAN BADGE;
" SILVER STAR; VIETNAM C~GN MDL i~i~BV 60; RVA GC W~PAIi~i; 2 0~8 BARB;
1
2S. EDUCATION AND TRAINING COMPI ET EO ~/~T /~~~L
LUCIE COUNTY. Ft.A. WiA/
ST
.
li' SCH 1967 IOBC #1 (1542) RFCnr-: ~ =RIFLED
USA I
`
1825'7
7
'69 SEP 3 PM 2 :56
~ ~
26 a. NON•PAr PERIODS TIME LOST (PrecediR/ d DAYS ACCRUED LEAVE PALO 2/a.INSURANCE M FORCE ~ .MONTH AILOTYEN7
Tuo Yrara) fRSIJ or USGU) pISCtN1TINUED
K CIRCUIT COURT.
< C ER
E<
YO L~rES [-' o t 1T(1
iR
r
Z V
~ ~, VA CI AIY NUMBER b. SERVIC EYEN'S GROUP LIFE INSURANCE COVERAGE
<).
<Ar
>x
(~ ~ ~ f/0.000 ~ fS.000 ~l NONE
b. REMARKS
" CIVILSAN $D[JCATION: 1G 7~AR8 (BS) CIVIL SNGR
Y
K
BLOB GROUP: "A"
rrBM 5A: PERM 2LT Us~AR APTD 11 auN 67
71. PERMANENT ADDRESS FOR MAIL LNG PURPOSES iT R TRAM I N 72. SIGNATURE OF PERSON BEING TRANSF ERR EO OR dSCNARGEO
(StreN. RFD. CitT, CoYIh. Slate awd ZIP Code)
Z
O ~ 1
~
i ~ ~ '~ {r'~`~'~'~-L 1 i~ 1
u
Z 77. TYPED NAME. GRADE AND TITLE OF AUTNORF2ING OFFICER NATURE OFi1CER AUT NORIZEO TO 9GM
•
2
t-
J. IC; MQ{iAN 2IT ORD C A83T ADJUPANP
DD F°'B' 214 PREVIOUS EDITIONS OF I«Ii TONY aGP0:19K O-277- S
/ !Ul 0t ARE OBSOLETE [FFECTIVE 1 JAN iT.
X1179 ~Ei
w+ulca ranc~ca yr r nc vnA A w a. a.. ca
REPORT OF TRANSFER OR gSCHARGE
_~•~~:5~
i
~;