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Home My WebLink About1457 2'78054 t4 v iNiS IS AN IM/ORTANT RECORD fAFECUARD IT. - 1. LAST NAME - i1lST NAME - MIDDIE NAME 2. SE~ 3. SOG~AL SECUNITT NUMlER YEAf YONTM OAf OATE Oi COLVILIE Jeff~e Keith t~ 2 R8 (1~J sinrN ~ tr/ S. OE/ARTMEMT, COMPOt1ENt AMD ~RIIKCM ON CLASS ia. GRADE, RATE Oi RANK b•GRADE DATE pF rEA~ YONTN DAT VJP)v ~1~DiLT ~1 RAMR 1 ^1 ~d SELECTIYE~ SEYY:~E NUYBER 6. SELECTIVE SERVICE LOCA~ WARD MUMlER, CIT~, STAfE ~RYI E` (Slrt~ oRFQ~Cirr Srars a,ad ZIP C~ I ANO ZI~ COOE n,p, Box 42? ~ 8 4~ 5~ 352 L`~ #4C~, Pierce, ?~'I.. 3345~ Jenson ~each, F'I.. 33457 ~ 9A. Tl?E OF SE~A~AT~ON b• STAi1011 OR INSTALLATION AT MfMKN EFFECTED ?~etirertent ~ARAKS NAVR pNTLA PUC: 532~~ "°TM°"T• "E"S°"Transferred to the Fetired List bv reason of d~ .~R YONTN o~. EiD TEYE 7µ 1~ Perm~anent ~ ~sical L~isabi?it t- CMARIICTER OF SERVICE J. TY~E OF CERTIFICATE ISSUEC 10. REENLISTMENT COOE ~HONUPABLE - RF^~' I1. lAST DUTf ASStGNYENT AXD MAIOR C011MAND 12- COYYAND TO WMtCM TYANSFERRED i '^BS, I~F, AUA2*!'~ VA. 22134 ~ ~'~A 3 13. TERMINAL O~TE OF RESERVE/ ~uCE OF ENTRT INTO CYRAENT ACTIYE SENYICE lCity. Sta[e and ZIP Codel 1S. OATE EM7EiEO ACTIVE MSS OlL16ATION . DUTY TMIS ?ERIOD tEA~ YlOMTM DAT ~EAq YONTM DAY ~ ~S ~*~nF.~, ~UAP*!', ~?A. zz~ 34 7z ~ 2. ~ 5 fi0. ?RIYARY SPECIAITT NU~1lER 6. REIATED CIVILIAN OCCUtAT10N AND lECORD OF SERYICE ~EARS ~10MTX5 DAtS i ANO TITtE 0-O.T. NUYlER ~ 19~~~f`7 (O/ MET ACTiYE SENYILE TMIS PERIOD . m ' Fi'A~1'~tT C- ~0~1 Technician /b? PRIOR AC7iVE SENYICE ~~L 21 ~ ~i • 170. SECONDAR~ SPEUALTI NUYOER 6. REIATED CfV1UAN OCCU?At10N AND (el TOTAL ACi~VE SENVICE (a t b) v' <5 ~i AMD TITLE D.O-T. NUYBER ~~j~ pR10R :NACT~YE SERVICE ~ 11 ~ ~ TO1Al SERYICE iOR PM lC td/ Q1 1~ f 1/ € None ~ NOT1E fORE~GN AMD/OR SEA SERVKE 7NI5 1ERtOD ~ ~ 3 --l------- - - - - 19. INDOCNINl1 OR KOREA SERYICE SIMCE AUGUST 5. 196~ 20- NIGXES~ EDUCATION LEVEL SIiCCE55FUllT COYKETEO /IR YeO/sI ~ rE5 ~ NO SECQNDART/MIGM SCMOOL _ TNS ~1-I? gradel! COLLEGE n~+ rR5 z1. TtME LOST IPI¢fr~ltrs~ Tn~O 22- DA~S ACCNUED 27. SERYtCEYEY S GROUP LIFE ~ 2~. C:SABIl1T7 SfYERANCE PAf 25. ?ERSCNNE~ SECURiT1 IYYESTIGATION C }rs~ LEAVE PAIO IMSURANCE COYERAGE a. 7T~E b. DATE COYPlETEO { ~ ~ 515,000 Cj SS.000 ~ NO Q 1~E5 *?one I 23 Days ps~o.ooo QNONE AMOUNT ri A '~AC 72~"725 26. DECORATIUNS. ME011L5. BAOGES. C011lIENDA~~ONS. CITATIOMS AND CAlIPA1GN YIBBONS AWANOED OR AUTMORIZED 'Vational Defense Seririce 2~!edal q !~~rksman Shootin€ Radge - F.ifle ~ "~rksman Shootin~ °ad~e - Pisto2 27. REYARKS F~, '~B~ ^t'Aiv'~' ~ VA. - 'I'he °asic School - .?_6 ~;eeks - 1Q73 ~ f~~~UC,:~~:G+~9T~ fLA. ~ \J ~O~c~ • ~~TRA: GtE?iK ~,~.L'J~T COUR1 ~ 1!f~!!P,^ yFL:'vi'~~~~ ~ ~ ~t~ II13AH~7a } ~ ~ ~ ~ ~ 2'~SU~4 ~ ~ ~ 2!. ItA1L1NG ADONESS AFTEN SEFARATIOM !S/ietl, RFD. Cil). COtrwlJ. SlafC. ZIP/ 29. SIGMATURE OF ?ERSOl1 BEIN SEPANATE~ ~ ~ v _ ~ ~ See Item f?C • ~ 70. Tf?EO MAME, 6NADE lUID TITtE OF JIUTNONIZING OFiICER 31. SIG A YRE OiFICER AYTNORI O t0 SK.N ~ ~ O~ 2"~.E. D(?11~UF~ C'.~'C~-3 ~ US;~~ ~ °ers0 - FORM CREVIOUS EDiT10N5 OF THIS THIS IS AN IWORiANT RKOtD REPORT OF SEPARATION ~ DD ~ ~+ov -zZ ~ 4 MC soaw ~tE oeso~¢rE. SAFEGUARD IT. FROM ACTIVE DUTY ( i 9G0) Ir;r;i.V' _ : S/N 0102-002-0001 ~ - ~ T . > . _ ~'i ,~a E ' ~ R.'., 3 ;~z` I ~ ~ ;3