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Home My WebLink About2397 , - TMIS IS AN WPORTANT RECORD 189540 i SAFEGUAROIT. 1. LASS N~YE • fIRST w~f1E - WOD•.E Nu,E S. SENVKE NVYBER SO:.~AL SECURI~Y NVHBER ~ < : i F : 0 OE~AR~Y IiT. COY~ ~NO B4AMCN JR CI~SS S.r. c'sRAOE. NArE OR R~NK I~. PAY 6. DA• M7MTM •EM ; ~ J GR1~OE ~~~E _ < ~ Z ~ 1 RAMK ~ ~ ~ • ~ U.S CI~~Z£N {e oLACEOFd~ATH~C'.ry-adS~q~~arCwwrrf) O?v ~qwTw vEu pwrf - r ; ` il---~ ri S ~~0 1 B RrM i ~r U~. SELECTWE SE~ivCE Yu~aEN C. SELECT+vE ixRV~CE ~OCwt 9p~RD MUYSER, C1r'v, COUNTY STATE AND 21C COOE D~TE ~aOU~TEO ; ~.V< O~? ~UNTM~YE~ V > t rr~ w~ w Jr0 ~ ~ ~ 1!~, TrVE ps TR~NSFER OR D~SCnAfii:! 6. STATIpM OR INSTALLAT~ON w7 tYMiCN EFFECtEO ~ i ,N~[fi~~ ~ {iiY. ~~iV ~s~i~V ~ ~iAR i@~i~I . V qERSOM ANO wuTtiOR~T~' d- O~? YOtiTn rE~N M . EFFECTtV ' ~F ~ V ~W QiR LMi ~ owtE ~ i , OO ~j_ LAST OUTY ASSN:NYEM~ U1D V~JOA COHY4ND ' CNARAC~Ep OF SERVICE O. TYaE O~ CER~tr~CATE ~SSUED r ~ M S~?!8 f~l~ 00 TifiL ~Ii~AS1.E ~ < D~STRtCT. .\PEA GOMM4MD Oi1 CORVS TO ~'CM RESERY~ST ~pA45FE1iA~D . ~S. REEN~,ISTYEN7 [a1DE - I ~ i ~ ~ Y i a ~ q. r TEr•Y1NAL DI1TE Of RESERYE 17. Cl'RREMT wCT1VE SENV~CE OTNEN rH~W BV INDUC~~OM d TERN O~ a. UATE Oi EN~RY _ UYT650BlIGAT10M SpURCEO~ENTRV: SENV~CE DAY tiJNfX ?EAR (~'.'xs} OAV 1YOI~~N VE~A ~ ENL.S:ED{FustFsli~tr.n11 _tEN~.15TE0(PnmSe`sx.e) ~NEEN~~STEO ` ` ~ i O!HER ~ ~i ~ ~ ~ ; 10. pR~OR f1CGULAV Enl ~STrENiS ~9 ~GQAOE RAT~ pR RI~I~1( AT T111~ O~ IO. OL~CE OF ENTNV INTO CURNEN" ~1C~e:•E SERVtC! lC~ry~ .anJ S(~re; . ~ £MTRt ~NTO CURAENT ACi~yE SYC _ ~ tv~c cotuti a?nsua s~t~tz~a ~ . i~. MOrE O~ RECOWU itf~E Oi Ey7fl'~' rKiO ACT:yE SEAVICE 22. ST~TEMENT O~ SEpY~CE •EARS YJNTnS DAYS r5...-.~. RFO. Gq. Cou~tv. Statr asd ZIP Co.le) ~ ~ _ f~~ A~• 1~A ~ V!~ ~'f7M/~ i. 11{ MCT S£RVKE TMIS ~E9qp as ~ ivwi si.~~w+~.o` CAED~TABLE A FOA d~S~C PA~ ~h OTn[11 SE~'~KE ',I A 7 , a wrvws.~• PuRPO5E5 2]a.SoEC~A{,TYI+UMBE4STIT~E aREIATEOC~V~~tANO:LUPI~~tpNANO ~)1 TOTIL(tfne!!)~l~tLM~())1 ~ A O ' D O. T. NJ1iBE~! • i • F ~~'7 ~ TO~AL AC11VE SEAr1CE 3 O ~P 0 c FORE~aa AND Oil SEI~ SERV~CE ~ ~ ~ U 2~. OECO~iAT10NS YEOA~S. BAOGES CO~rENO~T~ONS. G~t~/!QMS AMO CArPA1GN A~BBDNS AM~ROEOOR ~VTNORIZED ; ~ ~ UItTi04~A3. DBTI~i~B SS~l13Cit 3~. FILEO AND RECORDEO~ ~ ~Q ~L ST. LUCIE COUNTY. FLA. ~ t:ECt~RfI YERIr1EC ts. eouc~rwN ~wo ~ww~«+wc corv~e*eo ~ : =~a FEa 9 PM 3: 09 ~u~ Efi6t ~ i tA~ti ~!lCIALIlz ~ ~;0 ~Ei< i•0{TRAS - Cl.ERK CIRCUiT COURT: - ; ( M.~. NOY-PA~ PEAiOM T1ME LOST /Pih'vbnt h ORt~S 4CCNVEO LEAVE PAID 27~- ~NSUNI.M~E M~ fORCE 6. AVOUYT OF wL~,OTYENT . YOYTN ALLOTYENT - Tno Y. ~iu lNSll or USGLII - D~SCOar~!~UEO - t ~ ?P =O ~ '__.vES ~ O S t r o ' ~ Z; b VA ~~niM NU~BER ?9 S£RVIGEYEti'S GROVP 1.~FE IMSURwMCE COVERAGE < S ~ ~t/{t!'~ ~StO 000 ~ ~ 35 GOO , NONE ~VRi 30. HE~wprtS 1 w WAIfiY iii0i ~ = ~ ; ~ ~ ~ ' ~ r r ~ PE~~tiENT ADDRESS iOP VA~~iNG PURPOSES A~TE TRANSF R OR O~ HARG ' ~2 4N~TURE OF GERSOM BE~NG ~RANS~ERFED OR O~Y_Ni1FGE0 ~Strr.r. RFD. Rrr. iwnrs. Sratr mA2IP Codei 2 ~ O , ~ t~~i . ~ ! ~ _ TTPED NAME. GR~OE AN(2 TITLE Oi ~1Utr~ppiZ~MG O«~CE~i fGNl~1YNE O~ OFFICEN AUTMOR12Ef;T0 S~GM _ ' . . , ..r ~ ' _ ~ i Ci ~ Z~ i / . ' . -L..r~i, ~ : - ~ DD Fo~r ,Z' 4 P"E~~o~s EO~T~OM o~ .».s ~oaM ARMED FORCES'OF TNE 11NITE0 STATES - y AAE OBSOLEtE E~FECr~vE ~ l~N i7 O~~ ~ ~'66 O- 21]-115 ~ t 60~ ~v~ r1iCE~~~T oF rn~+sF~ oR asa~acE _ _ - - - - - . . . . - - . . _ .