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HomeMy WebLinkAbout1852 , ~ U ~ 3O'1.858 ~ TNii If AN IMrO[TANT lECOt~ fAFEGUARD IT. 1. 1A51 NAME - iIAST NAYE - YIODIE M~YE 2. SEZ SOCIA~ SECUYti1 NUYOE~ ~EAR YONTM DA~ j)T'r{C~~~ `~.+.t_~;~:y _ee A' 'vl; ~1 r~r1 °nir~ nr. S. OE~ARTMFNi, COYWIIENT AMO l~AMCN OR CL~SS ia- 6~AOE. RATE Ot RANK b'GpAOE ~LIIR YOMTN' DA7 ~ T DATE Oi [ ~i~.C ~ RAMK J C (Il: ~ 1 . SEICCTIVE SfRVICE NUtlBLR 6.SElECT1YE SE~VICE LOCAI WARD MUMOER. CiTt, STATE f. MOME OF ~ECOtG AT TIYE Of ENT~t IMTO ACTIVE , AND 21~ COOE SERYICE IStrevt. RFQ Cit~, Slats and IIP Cade1 ~ Lr~.1' is ~r 1'i ~ . '.5iJG 1?V@• Fort Fic~_ = ~'T -1• C!~ ! 3~ - ~ ~'i=r~ !s- TtK Oi SEfARAT10M 6- STATqN OR INSTALLATION AT NMICM EFFEGTED Z'j` ~J ~ ,-'1 ~ d~ J.~.. Il? 't Iteleased froc. ac ~:iv~ ;~r. 1G~:~-:~s 2ci;:ariii-r C~~;C ~ ~iY~ ~'L~C ',2j31 AUiNORITf ANO REASOM d. YEAp MOMTM • DAT ~ ~ EFFEC7IVE K { . DATE r 1 1Q t. CNAfACfER OF SERYICE . ~ T~K OF CEiTIFICAiE ISSUEO 10. REENIISTYENT CODE ~ i'.D:~:'~ .:l"C'_t~]?~~ C(:.:?TiTG;.:~ 'I b ~ t~ _ ; 11. UST DUTT ASSIGNYEMi ANO MAJOR COYMAND ~ial: ?'I:11 ^'T~,~ 12, CpYYAND 10 WMICN TRANSFE~REO ' ~ „ :a ~ 1t_ ~~~:~,_;_r~.}{C~~e ~ir ) i'3I ar1.}L' V 1'': :1' 1,~:~~, 15~ ` ' ~i M'-:5 _ S '~3 i"~ g SOL='.~'L Y~ l3.TEVYIMRi DATE O~ RESERVE~ PLACE O~ ENTf~ IMTO CURRENT ACi1VE SERYICElCity. SlafeQ/!d Z/PCo~le/ ~ 15. DATE EN~EREO ACTIyE j 1lSt OBLIGAl10U _ DUTY TMtS ?EY100 ~ 1EAt YONiM OAT iEAp MONTN DAti n~ ~ 1 1 ,_'A ~ ~ i'..,; r;each ~Z 1 - 4 + ° , 34c~ 7; ~~t iSA. PYIYARt 5?fCMLTf M~YlER t. RElA1E0 CI1rIl1AN OCCUPATION AND 1~. ' ' ANO TRIE D.O.T. MUM9ER RECORD OF SERYICE TEARS MOMTMS DA~S l,~'1~ t'i.°.1.:~ tiI~ :ii~_~'.i'~" ~':7~1t~~ ~'i:X~i ~irector - ~ . _ Ia/ NET ACTIYE SERWCE TMIS tER10D `11 11~ ~ s• ~ .~~Z'.% i'.~' ~•+C~",_a ~~1,,.~'~r Ibl ~RIOR AC71YE SENYICE !1 ~6 ~ jC; '_E~ :•.D~At i+ EL'A.T~ \U!ilER RfL11TC0 C~YI! IAN OCCUpATfON AMJ (iJ TOTAL ACTIVE SERViCE :a ~ bl {j~ i . ~ I AMD ll!:E 60.T. 9Lfr~C^. Idi PRIOR INACTIYE SEAV~CE (~~l ~ i ~ ~-i'~ ~ ICI TOTAL SERI~ICE iOR fAY /a' .~j/ . ~ ; l)G " I ° ~ne - - - - - - 5 3 ~T/ PORE.GN ANDiOR SEA SERVICE iM15 tERIOp' ^e~ i,~;_ ! 1___'__`_'_ . ` . ' . . S i~9. ~ti:~:~~!iM• C7 KOktl1 ~ikV1:E S7N~E ~LG.:51 5. 1>6i 20 NiGNEST EDUCA)IOh LEYE~. SU:LESSiULL~ COMYLE/ED f/q ~~.a~:1 . ~ ~ ~ES L-''~ NO SECONDAMT/Ml~N SCNOOL ~ f' 1RS ~ IJ2 ~ru:(rt/ COIIEGE _ tRS ~ ~p - - - - ~ - . . _ - - - - . _ - . . ~ - j . } ?1 r~+E ~t~ST ~iiu'a',i.n~ .'-..o ' 2". [F7S AC:11UE0 23 SEP.Yi'F.~E+.-S GHOUi L:FE 21. O~SAB~U?I SEVERANCE t~f 25 :~4XNNEL SECs+RIT~ ~!~VESTIGAiiON 4 p )~N l.EAYE-iA'D INSUAAhCE COYERASc ~ ~ ti~' f I 5.000 SS.000 NO TES i TTPE b. OATE COYVIETED t ~r_1i._,-'7?11~'r O L~ L7 ~ r7'{ .'r r!~ "_~~J J~J~t_ rf. .i. .T~.AL r~.~l1._Il t ~ ` j l ~r' E.~~~~`1~: QStO.000 ~ ~ONONE - ~ ~ i AYOUNT . ~ ~ ~ , ~ t6- CECORAnOtiS YEO~tS. BAOGES. COMYENOAT~ONS. CITATlOMS ANO CAMPAiGN RIBBONS AWARDED CR AUTHOR12E0 . .cT~ j:l ~n°:_. . JE'.3"; . ;:1".1 k § Z7. REMARKS ~ ~ ~ :ll~:~l .iJi.:~-.l, V l.Nlic~-L -(:I~_.C~_, - . ~ ,rJ~` - . - 3 ~ FiLEO RNC RECO ~ ~ ~ idc~ cc;+~n~ = RocE~ ~o~T~r~a ~ RF.COR~ y FC~~t COURt ~ . E i ,~p ~ 1r t~ 38 ~ 'T5 ~ z ; ' BDOK ~ Pl~f 15~~ ~ a 301.85g ' ~ ~ ~ ~ ~ 2!. MAIUNG ADDRE55 AfiER SEIARATIOM /Sbeel. RFD. (.~ty. Cuun/y. SIY!!, I/PI j~. SIGNATUNE OI ?ERSON lEIMG SEMRATED ~ ~ ~G7:^ _ ::i=. • : OT t. ~'i_a?~:.e> > G. ...i'~' . - ~ c r ~ . ~ 30. it?ED NAME. GRADE AND 11TLE Oi AUTM0R121NG OifICER )1. SIGNATU~E Of OiFICER A TMpR12E0 TO S16N ~ J~. }-l~1.1_ • ~..rj ~.i ~'y~ i . ~ _ " _ _ ~v C~ 1 ~ ~ G • ~ FOkM VNEVIOUS E01T~ON5 OF tNiS TNIS If AN IM/OfTANT tECOlD REP T OF SEPARATION ~ DD 1 NOV 7~~ ~ 1 MC FORM ARE OBSOLFT[ SAfEGUA/D IT. ~ ~ FRO ACTIVE DUTY {19Q0) INDiV - ~ S/N 0102-002-0001 ~ _ ~ ~ - - - ~ ~ ~ . . . ' _ r -x~ ..-~w."~