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HomeMy WebLinkAbout1151 252819 THIS IS I1N IMPORTANT RECORD SAfEGUARD IT. l. lAST NAME~FIRST NAYE-Ni00LE NAME 2 SERVICE NUMBER 7- SOCIAL SECVR~TY NUMBER ~ LARSON, MICHAEL CAR~~ ~ • DEPARTMENT. COYPONENT AND OR C1A55 Sa GRADE. RATE OR RANK PA~w~ R~TE QAV MWVTN VEAR ~ NAVY - USN 01 NOV 7 ~ 7. U. S GT~ZEN • PLACE OF BYfiM IQO ~+I !w M Q~w~f) 9 pATE W?~I NOP~TM VE/~R ~~s ~NO DULUTH, MN 6~RTH y W lOa SEIEGTrvE SERV~CE NUMBER ~~~CTtvE SERVKE LOCAI BOAFtO NUMBER, GtV. COl/NTY. STATE wND 2iP COOE . GATE WOllC TED ~V< V~` DAV J MONTM YEAp 21 1~9 51 10 109, DULUTH, 11N ~ r"~ °F T""'''s~ER ax""`~c~ R E L E A S E F R 0 M A C STATION OR WSTALLATION AT NRYGN EFFECTED < TIVE DUTY AND TRANSFER TO NAVRES NAVAL STATI N, H N °'~"S°^'""°""T"°"'TMBUPERSNAN 3850220, NAVOP 12 AND CODE ~E~~ M°"T" Y~" Q~ 27~G - REDUCTION IN AUTHORIZED STRENGTH ~TE. Op 12- l/~ST OVTY A551GNNENT AND MAlOR COMMAND 13a CFIARACTER OF SERViCE 1, TYPE OF CERT~F6ATE ~SSUED ~ „ USS FIDELITY {1150 443} HONORAB 1~. OtST(LCT, /IREA COMMAND OR CORPS TO MM1OCN RESERV45T TRANSFERRED ~ lS REENL~STMENT GOOE K ~ NAVAL R S RV M - 16 Rtd~~+Al DA E OF RESERYEi 17. CVRRENT ACTIVE SERVIGE OTHER THAN 9Y WOlICT10N TERiN OF e ~ pATE OF ENTRV UMi65 OBUGA7qN a SOVNCE OF ENTRV: y~~E V MONTH YEAR DAY MONTN YE/1R . ~ ENLtSTEOIh~t ~~4rwA ~ ENUSTED llfer Sn~iee) ~ REENIISTEO ~ _ ~ OTNER B. PRqR REGt1LAR ENUSTI.tENT 19. GRADE. RATE OR R/1NK AT TIME OF 20. PIACE OF ENTRV INTO CURRE?R ACTtVE SERVICE {pp r[ S~Yr? ENTRY MO CtJRREM ACTIVE SVC ~ NONE SR • • 21. MOME OF RECORO AT TIME OF ENTRY NTO ACTIVE SERVICE ?j. STATEMENT Of SERVICE VEARS MONTHS UAY$ ' (8sa+~ SJD, 00. CMb. !~U MI W Ceil ~ii ~ p) NET SEItV~CE THt3 PERIOD ~ ~ CREO(TABLE i ~ ~ OR BwS~C PAY OTHER SERViCE 23a SPECULLTY NUMBER 6 T1TLE t REUTEO CMIMN OCCWATION AND ~~~Eg ( D.O.T. MIYBEA (31 TOTAL UMr Iq ~{ti ~ _ 223, STOCK CLERKS ~`T~T~~T~~~E ~ W S K~ 2~ O O ~ FOREttiN AND/OR SEA SERVICE V 21. OECORATIONS, MEOALS, BADf'ES, C01Y1ME?~lW?TIONS. CITATIONS MID CAMPAIC'.N iOB90N~' AIMAROEO OR AVTNORIZEO - W NATIONAL DEFENSE SERVICE MEDAL {FIRST AWARD} ~ h VIETNAf1 SERVICE MEDAL W/01 BRONZE STAR ~~~'~t~~E VIETNAM CAMPAIGN MEDAL 8 RIBBON Ra~~P g EI FAIC elu 25. EOUCATIONANOTRAMiP1UCOMPlETEO X ~FCQRO vERif~E \ „ ECC FOR Bf1R, SN ~W XX Xx ~~I~~ ~~VJ x x ~5 ~ x 81 ~ x X X X X X ~ 26o N0~1~PAY PERIOOS T1ME 105T IRra~i~ i. OAtlS ACCRVEO LEAVE PA1D 27a INSURANCE W FOqGE AINOIMT OF AILOTMENT t. MONTH ILLIOTMEt~i 7Le Ywrl INSI! VSCIf) 015COf1TYiUEO ~ W~ Tl - 10-Z2NOV69 03 4~"° NA NA ~ Z V 2 4- 26A UG 70 VA CIAMA NUMBER 29. SERVICEMEt~t'S GROVP lFE IHSllta4NCE COVER/?GE y 24-26MAY71 ~:~s.ooo p:,a.ooo p:d.ooo Q NONE ~ ~ NONE ~ 30 REMARKS HIOH SCHOOL - 4 ~ Y LARSON SEPARATED DUE TO DECREASED PERSONNEL STRENGTH ~ ~ X X ~ ° X X . X X . 3l. PERMn?NEN7 AODRE55 FOR MAiINVG PURPOSES AFfER TRANSFER OR pSClWiCE 32. SX'ahATVRE OF PERSON BE~ SfEftRED OR QSCMARt.EO 2 lSOrtt RfO. Cw~. Cwrp. SYM ~w/ 2!r C~r/ ~ 1408 BELL AVENUE 33450 ~ • ~ ~ Z 33 TVPEO NAME. 4RAOE ANO TITIE OF AUTMORIZItKi OFFICER 3t. HE Oi FICER A T ~ V. POSS, PNCf1, USN ~ TRANSPERSOFF BY DIR CO ~ONV v~c~rious [DtT10N O/ TIIS ro~.~ ~s To ~c usco. AR FORCES OF TME UNITEO STATES ~ ? ~u?T ~0 214N Q R~~~ ~ REPORT OF TRANSiER OR qSCFUIRGE f,:~. , aooK P~~ 150 _ _ ~.Y _ _ ~ ~ ~ .