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HomeMy WebLinkAbout2765 ~ ~ Y ~'T1F1S !S AN IlfPOR~'i~Jl7T JfSCORD ~ - ~ J~ ~ SAFEGtJA IT. ~ ~ ~ASr u~~C•s~RSi NAME•y~DDlE~1wy•. . - . 't. i[RV~C[_NY ~ Sotut SECU~~rv vU~9_a ~ F ~ ~ 1 _t . ~ . OI\ - ~ i~I 0 i O[~AMTYENT, COY?ONtMT hN0 ~R~1MG~+ uw t;lA3i F SQG~IADt. ¦4Tt O• •a~K 6. a+-r 0. O1~v ~stOHTM YEA11 GA~D[ D4lE i s O i ~ 2 •Al~R ~ u V I ~ U. S. CIT12[N r~AC( O~ ~~R7M~Ctn QAd S~~! Or CUf/Q~~ O. O~• . YUNTH YEAO _ ~ y DATE ~ ~ a ~ pr ( M~ r[s Ko ~ --v' - 1j4 Vi~ •-ar IOa fEIECTWE SEAYIC[ NUY~E• b_ S[LECT~V[ ttWIC[ lOt~l ~OA110 NUV~ER. C~TV. CO M7r, f*/~TE ~ND Z~/ COOE . ~ ~ O~TE 1NpuC~[O ~ ~ 4l ~ ~ • ~ prr ~YON7N ?EAR ) ~ ~ 1 ' `ao ~ ~ 4 4V ~ ~ 1 ~~j } a.~; ~J'~~{`• ~ ~ ~ ~ " ~ ~ Y• • I Ia,TYPE O~ TRANS~ER Ow O~SC~tARG~ b. 'iTAT ON Oli ~NAS~Ll~1~0~+ •T r~M~C~e~~[sFEC7E0 _ ' ~ ~ j r_~~ i < ~ ' iii~~t M~ ~ - - ~ G~EASON AND AUTHORITY ~ d AY YONTN 1'EAR EsvEC'~v[ O~ ~ i ; - ~ ~ 6tal~. L li~~t~'IYI~ i~0 i~tl 2 E , .2 t~Q CHA111~CTER OF S[RVtCE b. TvVE O~ CENTifIC E ISSUGO ~ ~ ~ t 01STRICT. Aw[A CpYYAlrO O! C0//S TO ~MNICH IIES[RVIST TRANSfEA~EO ~ ~ 9. AEEYI~STYE/iT CODF = 1 W.~a~.~ w •w~~...~av a~..~iY [~a~trv. la~raa ~!v_ ~ats~'~ ~ I VML AYV~Ui~. ~i ~~w ~ws~w .~.R ~a ~ ~s TEAYIMAL OATE OF IIElEI~VE/ ~~/_CVRIIENT AtTWE SEIIVitE OtH[R 7MAN eY ~NOUC7~ON 6. TEwv f. DitE O~ ENiRv - ~ UYTaSO~IIGATION Q, SOURCEOi EN~NV: Uc ~ DAV YONTM 7EAR - SEA.iCE DA? VOA7H TEAA ! , ~ ENL~STED (First Enlutmrnt) ~ E~aIiS~ED ~P1i0I .SCr1JLtY~ ~yeQRJ - ~ ~ ' ~ OTNE• . Q ME[MItSTED s ~ ~ ~ ~ ts- •RIOA'1EOUlA! ENl13TYENT3 tY.OR40E. RATE OR RANK AT TIYE Oi 20. PI~CE O~ ENTRV 1MT0 CU~111EN? ACTIYE SERN~CE ~Cl~~ Q1:(I S~Il~ ENTR~ INTO CURRENT AC~~vE SvC ~ ' ~ ~ ~ ~ ~ 2~. HOYL OF RECORO 47 TIY[ OF EN7RY ~NTO ACTWE SENV~CE zt~ 5T11TEYENT Of SEIIYICE ~E~RS V.~JYTHS O~YS ' ~ /Strnt RfD. City. Co~nty. Stau and Z/P Cod y _ ~ Q. 1~~ HET SE~ViCE iM15 oENiOD ~ ' ~ CP.EDItA~IE ~=1 OTHER SERYICE ~ ~ 03 FOR BAS~C PAY PUAVOSES~ ~j II 23Q SIECIAITV MUY~E¦ a rtTlE b •[LAT£D C~VIl1/~M OCCUTAT~ON ~ND ~a~7~pTAL (Line (I) plus Line (2) ~ j+ 03 . ' 0^.0.7. NUYBER ~ t1E11 b. *orwt ACTIVE SENYICE ~ ~ ~ . t ' V )i~ J ~y' ! i islr~ E~GM •NO/O¦ SEA 5[RVICE ~/y ~ ~ ~]ii ZI, DEC011ATIONS. VEDALS. ~ADGE3. GOVYEMOATIONS. C17ATIONS ~NO CAM?111GN A1Y~ON5 AMAROED O• ~1UTMORIZED ' ~ ~~~pr„L ~ ~C~ ~3. v~Ilt'i0i~ a~~. C~! M~l iRiT ; ! L Ca~ss let~ao ai~ ri•~ C.¦~al,~a M~aal ~r/danriar ; 9rw?st SVar lMdial y/"Y' ~ 23. EDUUTION ANO i11AINING COYIILTEG ~ ~ ' Yt~Y ~chool - k- 19G1 - A.~a~la f f ~Ea ny: KEC~KUE~ t~ s~. ~ue~L ~~tlNTY FL . ~tC.r,E =£~I~RAS ' - ClE~1~. i.~.;,:1:7 COURT ~ acr,:lR~ v~ ~'r~F'.' ~ ~ S~ ~y 3 ~ PK'~ - ~ 26QNON-IAV ![RIODS/tIYE LOST b, owrs ACGRUED tEAVf rA1D 77QINSUR~NCE IN fOACE b.AYOUNT Oi AILOfMEMT C VONTN 4LL0'VEMT ~ ~RIClYl11lB T}00 Y~O/f~ (NSLI or USGLIJ DISCONi~NVED 4 /y~ / ~O Q~/ES aN0 S ~ ~ j A ~ i < ~ 20. VA ClA1Y MUY~ER 29. SEIIVICiYEN'S GlOUP l1fE ~NfURANCE COVERAGE ¢ ~ > ~ ~ /~A L~ s~o.~ . ~ p s,.~ ~ NONE ~ ]O. ~EM~RwS _ dOOQ ~:a1t~liQtr Mldtl l~tY'~id E.`~tiM t ~j ; ~ ~ ~ ~ i i ~ } 3~. ~E~YANENT ~DOpE55 ~ON ~AI~ING IUAPOSES ~fTER iPAMSFE¦ O• 015CNAAGE )2. S~GN~TUIIE Oi vE~SON ~E~MG iNwn5~ER11ED O~ C:SCH~RGEO ' ~ ~ z (StncR RFD, City. County. S~ote and Z!P Codt) { ~ : ~'i~0 !~t'• Q~~'1'l ~iwiti~ Q~aal~l Ds.i~ta~'y < ~ ~ ~ 2 . RAO ~ O UTM Ri2~NG Ofs1CEN 3~. 51GN4TU~E O~ Of/1:Ew AUtHOR~1E0 TO f1GN ~ e L j z • ~ORY ..E,,,;,,: ~o~T~o~. o. A~~ ~ORCEf OI THE UMITED STAT£S s/N-otOt-t~o.~301 MARINE CORPS OIST&1i.T-1 ou tt4 rc n~ TNIS ipRY o.,o~~t ~ RL?OIIT OF Ti1ANf~E!! OR OIKHARGE eoo+c z~3 FACf ~765 ~ - A ' ~ r'.--_~ N'~ _ ~