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Home My WebLink About1205 • 25~855 - ~s ~ ~ ~+TU~r ~co~o ~ v SAfE6UARD R. , ~AST NAME-F~RST NAYE-WOD~E NAYE 2. SEINIGE NUVSER SOCUIL SECURITI/ NUY/ER ~ F~D38 jiD~LD SDC3~R ,Ft 2835302 266 a4 1690 ~ 4. OVARTYENT, GOYWNENT ANO ~~NM OR CIAS$ S0. G~AOE. RArE 011 RANK A. PAY 6. OAY YONTM yEpp . ~ GRwOE OATE diLL ~AIYa ~ MNK 01 ~ ~ . 7. U. 5. qTZEN ~I.ACE Oi NIITN (~fjr a~d $(Wt or Corwbp) . 9. OAY YONTM YEA1t - OATE OF 1.~ ~res Q Mo Cai~'O> ~ s~rtrH ~ ~ ~i~7 1Y~ IOt SELECTIVE SERVICE NUWEII b. SE~ECT~VE SFJh'ICE IOCAL SOARD NUYSER, CITY. COUNTY, STATE AHD 21P CODE ~ OATE INOUGTED ~F OAY YONTN YEAR ° o ~0 49 025 ~a ~o ps~os (st~. ~e) ~ 33450 ~ 1 0. TYVE OF TRANSFER OR OISGInRGE b. STATION OR 1NSTA~tAT10N AT WHICN EFFEREO r ~ R~]~ass lYaa aati~ c~utty Haisstsa~d aF'~, FL 33030 C pEASON AND AUTHORITY d o~v YpNTN YEAR AF~I 39-10 oh 3 No ?(SD~T 203) ~ratioa4 Tsra O~t Sea~ios Ei~CTEVE 09 ~Pr 73 ~ Q 1 t. LAST DUTY ALS~GNYEM AND ~AJOR COYI.~wND ~ 3 4 CHAI~ACTER Of SERVICE 6- T/PE OF CERTIi1tATE ISSYED ~ 31 do~ganisat~iaa~al I~tainb Sq (T~C) HoNOR~~ffi.B Ns ~ 1~. dSTNICT, MEA COMYAND ON CO~S TO VIM~CN R£SEAVIST TRANSFERRED 1 S. REENUSTYENT CODE _ ~ ~ ~S TEIM~~NAL OATE Of RESEME! f7. CUNRENT ACTIVE SERVKE OTHER TNAN Bv ~NDUCT~OM 6.TERY OF C DATE OF ENiRY UVTAS WLWATIOH SE4v1CE OAY YONTM ~ YlAp 4 SOURGE OF ENTqY: pqV YOHTH YE.Ut REENI~STEO ~Y~n~ 0~ ~ ~ O ~EHL~STED (F ~SIII~OIfOQ Q ~LISTEO (f~jOr Sf/V{L1~) Q ~ ~ ~ . Q TTT 'O OTMEA {~j.Lj ~0. MGO~ REGUUR ENUSTY[NTS 19- GRADE. RATE OR ItAMK AT TIME OF 20. PUICE OF ENTRV INTO WRRENT ACT7YE SERYKE (GTj Owd $lule) ~ ~ ENTIlY 1l1T0 CURRENT ACTIVE SVC ~M~ ~ A~ ~ ~ 21. MOYE Or RECORD AT T1YE O~ ENTRY INTO ACTNE SERVICE 22. STATFJrENT O~ SERViCE ~EARS uONTMS DAYS ~ JtFA G-1Qy` Co a~d I/l Codt) ' O a. 1 t ~ NET SEllt/tCE ~M15 VERIOD ~ ~ - ~ v~f~Y~.~+r CRECIIAYLE I ~ ~ iOR 6A51C PAY ~2~ OTNER SERVICE ~ 23LL S~ECaALT1/ NU10ER R T1TLE A REU17E0 CtVLLWi OCCU~ATION AND PURPOSES ~ fa? TOTAL (Lint (JI Pku Lint (!II O O~ O D.O.T. NUwSER ~ < ~1 ~Q b. TOTAL ACTIYE SERVKE O ~ ~ IV ~y~ ~ ~ 6G, 281 C F011E1GN AND/ON SEA SERV~CE ~ ~ y~/ Y 2~. OECORATtONf. YEDALS. BADGES. COYYEf~OAT~ONS. C1TATl0l/i/WD CAMPAIGN RIHONS AWAROEO OR AUTt~O1tlZED ~ ~ pD~~/~~P~pW//~ (10~ps'b9•~91p~72) AFLS? (10~Pac69"'r9~T3) ~!i 900~•3 ; 25. EODUTON AHp f1U1NiNG COYOIETED Lp(~NiY FL • ST. LUC : ~ ~AS Bas1c KLlitat'y ~aining Covrss ~~+D0010 001~'L 1969 RoCER ~t. ~CS`t. 1& 2$l~~tl WMPT+ 19~ CIERK. C1Kr +!t ~ COURT T~ RFC(;r~~F~ 1-D 252856 ~ I~ 4 2~ Pi~'~~ 26G NO•~•PAY PER~O'JS TIYE ~OST (~~&t~ b. OAYS ACCqUED Lf~VE PA70 Z7a~N5UR4NCE IN FORCE h AMOUNT OF ALLOTMEHT G MOt+`H /.L.OTMENT T~p Ymp) (NSLI or USCL/) . D~SCO'~.rWED t v~ AO li~ J/Y~ Y Q YES ~ NO ~ i~ ~ <Y 28 VAGl~f1~R NUrBER 29- SERY~GEMEH'S GROUP uFE ~NSURANCE COVENAGE I ~ ~ ~~W/I ~~73.000 O f10.000 O:5.000 Q NONE ~ ~ ~ 30. REYARKS - ~ sQ~L00~'~'i~li4tr~~ ~.OOd ~f j p~• ~~i ~~'~17~ ~FB~ ~T~~ ~i• ~ ~ ~ ~35 $80 ~pr69. D~IFSth 43151 c. Ind~oohina.iTofvi~t8a~•iio;Yor~a-iio. I bavr b~eai oo~• ~ ~ a~lsd as to oondi~iao~ !or ~ s~ntr~ into t~r ~ir Foa~o~ a~?d I that ~ lai~ ~tr ~ba~~os a¦i¦b~r ~nvt ~t t~a sw~tlie~t st~dards ia slY~at ~ at ttr~ tis oi hia app] iaat.i.on. ~ 7~. PERYANENT ADDAESS FOR u~1~~N4 oURPOSES AiTFF TMNSFER OM DISCHAAGE 32. 51GN 7UAE Oi PERSON BEiHG TRANSFERRED OR DiSCrrARGED ~a ~ (~t RID. Cih'. CouNy. S:ntr and Z/P Codrj ~ ~ ~ s... it~.. z~ ~ )3. TYPEp:/WE, GRA ~ A_NQ i~~~ OF~/I~R~Z~NG OFCICEI~ - 31. S~GNAtUNE Of O~ ~CEN AVTNORi2E0 TO S~GN ~~D Hw~i ~~i ~wi~ Ci~i u ~r F ?~[vrovs [o~Twa or tw~s sollr ~i To ~E us[O. AYME~ ~OtGES OF TME UNRED StAtES 1 DD ~~u~ ~o Z~~ tE~ORi OF ifANSFER O! DIiCM~4GE ~ ~ _ ~ z:.__~: