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1. WT MAYE-i~RST NAYt•MIDDLE NAYE I. SERVICE NUY~ER EOCtAL 3ECUR~TY NUY~[11
~ PAGAN i1II.L7.~!?I AB~UR AF44005756 264 42 1852
0 1. OE~MTYENT, CO~t/ONENT ANO 1l1AMCM OA CLASS S` GRADE. RATE Olt IUNK A. ~A1/ O. DAY YONTN YE.U1
GIUDE OATE
AI~ FORCB Re AF t B6 ~°NK Ol Dec 67 ;
7. U. S. CITIZEN S. KACE OF /111TN (~r ~A/ $ppk pi Cpwp~r) OATE OAY YONTM YEA71 ~ .
•ES ~ No Ft Pierce, Fla trRTN 21 Nay 26
W~ 104 SELECTIVE SERVICE NUM~E11 b. SELECTIVE SEllV~C[LOCAI WARD NUYBER, CITV. COUNTt, STATE A.VO 21P GODE DATE ~wOUCTEO
~Y~ DAY M'JNTN YEJ111
~l~~ NA NA
Tf~E OF TRANSf ER OR 015CMAR(' E S. STATION OR INSTA~UTION AT W//1Cr1 EFFECTEp
W
`~~S~jj Retirement C~RSiffi.L AFB, FT i~AR1S, ~BAS
v ~ REASON AND AUTMOR~T1f
d OAY YONTM YEAR
~ t ACCL75'~~ C~~Z30, Voluntary Rltirement EF~ EvE 31 Jan 7Z ;
O O ~ST DV7v ASS~GNYENT AND YUOR COYYAND d CMM4CTEN OF SERVIGE A. TY~E OF CE11TtFIC~TE ~SSUfO ~
~ 7C9GP (SAC) HONDRABLE DD 363 AF
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Z 1~. OISTRICT. AitEA COYYANO ON CO~IPS TO YIM~GM IIESERY15T TRANSfERREO IS. REEN~~STYENT COCE
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~ D SAFR 2
1e TERYIMAL OATE OF 11E5[ME/ 17. CURI~EHT ACTIVE SERY~CE OTMER THAt/ BY INDUCTIOH D.TERY O~ G DATE Of ENTPY `
YTAS O~UGA~10N }
pAY YONTM YE~ a 5'~UIlCE OF ENTM: SERV~CE ,
Q ( ~y OENL~STED(pjprSsr~lt~ ~,]NEENLiSTED OA1/ 1rONTM rEAp {
EMLtSTED Fj~t ~
~ Q OTMER 3 26 Jul 67
1~. MtlO11 IIEGULAR ENLISTYENTS li. G11ADE. RATE OR IIANR AT TIYE OF 20. ?LACE OF ENTRY INTO WRRENT A[TNE SEItVICE (Cij owd $tpq~) t
~ ENTItY INTO CURRENT AGTryE SVC
4 four S t Arnold AF Stn, ~enn :
21. N~YE OF .IECORO AT TIYE OF ENT11Y INTO ACTIVE SERV~CE I2. STATEYENT OF SERV!CE YEApS uONTMS OAYS
(s...r. ~er~, ab. co..ti. s~ a,~a ztr coa~) ' 04 06 OS
62O ~rIIaII~ S~• n' <<~ NET SEAYICE THIS PER{00
CREOiTAS~E
FOR ~AS~C VA1r ~2~ OTNEl1 SERVICE _
2~Q 3?EWI.TY NUV~ER TIT~E A. RELATEO C1YRtAN OCGII?ATION AND PUIIVOSES ~
O.O.T. HUY~ER 70TAL (I~e (I) pSu Lf6f (2II
: ~ 61270 Meat Proc ~at Dresser
~ ~ b. TOTAi AC7rvE tE~MCE
! ~ v ~ C FO~IE~GN AND/OII S[A.SE1K~Cf 03 00 ~
~ W
~ ; 2~. O[CORwT10HS. YEOAlS. O.~OGES, COMYENOAr10N5, QTATOf{SANO CAM/AlGN IM~WNf A1NAJtD[D OR /WTHOpZED
~ `i Ai V4Cl wf~lYV
~ y flE0 AMO RECO
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ROCER P011R~! ~1~
S 23. EDUCAt~ON AND TM~q~NG COwYIETED ~
11EC~RD VEaiF~E~
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~ ~t for eF s„p~ $ci o006 1967 j9 41~ PM'?1
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° =en yor+•vwr PEW~OOSTtYE LOST
t (r/~iry( b. OAYiACGRUEDLEAVEPAID ZTa1NSURANCE IN FORCE A, i.iOUNT OF ALLOTMEN? G VJATr+~;~CTYEh•
, ~o Z'le~ff /~SLI or USGLIJ !:t$~O`+7~yUE0
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~Y 2e. VAGU11f NUY~ER 29. SERV~CEYEN'S GROUP Li:E ~NSURANCE COVEIIAGE
~ ~ ~ s~s.ooo O s~o.ooo ~ ts.ooo [7 woHc
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.
ao. ~uuwrts
~ HS Grad ~947
~ Blood Cp: B Poe .
AQS: N05 A55 G55 825 ~
~ ~~~V'~l FRCE
~ ~bC : 25 l~ar 59 4D0 SI e~CuK ~
~ -
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3~ _ PEAflANENT ApOAESS FOR YMIING ~U~POSES AFT(R TMNSFEp OR DISCr~AAGE D2_ S•3NATUNE OF VEI~SON ~E~HG TA/1NSfE1lAEO Oil D~SCNAAGED
(3swt IlR QO'. GrM'.1awr ~ I/~ CoirJ
~ P0. ~O]C 486 Ft Pierce, Fla 33450
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J~- TYTCO NAY[. GRADE ~ND TT~E Of AVTMOMZ~HG OiFICER S lU K AUT MZEQ TO S
~ ~ 8UG'BI~ C~ ~WN, JR, gI9GT, USAF ' ~ .
_ ~ C IYC
} DD F~~ ~I~IY~OUS EDiTpN Oi TNIf FOIW IS 70 ~F 45ED. pR~Ei Of iME VMREO STAtES 1
T~ 1 JVL 7C
~ RE?O!i Of ~~ANSfER 9~ OKCHARG:
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