HomeMy WebLinkAbout1058
:_aut~aN NOI 10 BE USEO FOR THIS ISAN IMPORTANT RSCORD ANY AITERAl10NS IN SHADEO
~uEn:i1FICA1lON PURPOSES SAFBG IfARD IT AREAS RENUER fOiUA VOID
OR FO[M ~1~~ PREVIOUSEDITIONSOf iHIS
1~
L 51~~~~ CERTIFICA~E OF RELEASE OR ~ISCHARGE ~
FoaM aeE oaso~tE.
~~u~ ~v FROM ACTIVE DUTY
1 NAh1E (Lpa4 firaR lnjdd/t) ]. OEVAqTMENf, COMiONENi APIO 6RANCH ~. SOCiAI SECURiIY NO. ~
AI.TMAH T?MO~iZ LSB Air Force Re~ AF 263 ( 41 ( 9207
~~- GIGDE. RniE OR RI-N1t a0. -~1r GRAOE S DAIE Of BIRTM
6. VIACE OF ENTRY Wi0 AC11VE GUiv z
St~T S~ 195? Jan O6 Coral Gables # Fl
~ IASi OUTr ASS~C,NMENi AND MAIOR COMMANO 9. S1A110N WHERE SEPARAIE~
b99~ ~ (~) Travis AF'B# Ca
o CO~ANO TO wMKN 1RANSFERRED 10 SGII COVERAGE
~A AMOUN/ f_~ 000 ^ NONE
11 DRWURY SDECIAIlY NU/MBER, t111E ANO ~EARSAND t2. YECOR~JOf SERVKE I rEAR(t) ' MON (l) ' DA~I~I
MONiMS tN SVECUl1Y /AddYiOnOI fplc~Oty numben And tit/tf
~• ~~ Err~r~d AO TAi~ D~rbd ~~y
1 6 vyy ' ~
~nvulvrn~q prrioda o/ one o- mon ymrs) A
s.vo•mw/. ooa T-u v.,ae Feb ~ ~
~0550 - Electrordc Intel]igerrce erations .
e. N~~ Acn.~ S~r•k~ TA~~ P~rbd I Oi4 I 03 I 28
Specialist (03 Years - 05 Morrth~ e. ra,~ o.b. k„.. s.,,k. I 00 I 00 I 00
~,~~ o.b. e,~,~.. ~...K. I o0 I 00 I 15
~- F~•4^ s~^~ I Oi I 03 I O~i
s- s.a s«.k. ~ ~ 1~A ~
e_ Err.n~.. o~. ~ Po, c,ae. I 1979 I Au~g I Ol
L R~Nn~ OAtq. i~.w~ pot~ ~~ IdT I
I) DECORAfbNS, MEDAlS. BADGES. GTwlIONS AND CMitDAK,N RiBBONS AwARDEDORAU~NORQEII (Allpt~iods oJsen~~ce)
AF Good ~onduct Medal (12 Oct 76 - 11 Oct 79)
AF Longe~vity Sernice ffibbon
AF Ovaraeas Service ~bbo~
~t nnn~TwRr EDUCRf~O-~ /Cuunt Ttitlr. number oeek~, ond month and ytor eomp/ettdJ
B!II'S~ 6 wks rbv 76 / Flectror~c Intelli.gence Operations Spec3.alist Ccurae~ 706 Hrs May
?7 ~ AN,/I~RS~i-Tl Oparations~ 2 i~ka Dec 78 / Airborne F,lectro:dc Intelligence Spec3,alist
Co~rse, b itks Oct ?9 / Special Siuvival Training~ 1 Wk Aug 79i ilatar Sunrival Training~
1 Nk Aug ?9 / Ha~sic Surv3val Trair~dr~g, 2 Mks Aug 79 / Phase I NCO Proiessi~onal Military
1 S MEMBER CO^~~RIBUfEO f0 POST-VIEiNAM ERA 16. HIGM SCMOOL GRA~UA/E OR EOUNALENI 17 OAYS ACCRUEC
~EiERANS' EDUCAifONAt ASSiSi~NCE MtOGRAM ~~S ~-~O ~ ~ES ~ ~.~p tEAVE P~O IS . S
~e ~.~s Iteo~ 11a Ca~tltxiedt ~duasttiou~ 18 Hre Jan ~0 ~ Pbase II USJ1F Supervisora Courae~
53 g~ 4ct 80. S~ctenaia~ o! ssrvice xas at ths rsqusst o2 aad for the ca~cvea~ancs oi
the gortetrnsnt. //////////////1////////////////Nothing Fo11oWS////////////////////////1
5~.8169
t9~i ~E~ 25 ~k i~ 41
1
~
a
~
~-~ ' ~-
I~MI~~NGQOORE~S~~fA SEYARATION
71 l7QZ /;~(
Pt Pierce, F1 33450
11. ~(',NATURE Of MEMtER ~EING SEPARATED
/ _ ~7 i7
f ~tE[' tyt ~~ CuF: t 0 L\
$1.LUCIECC!ivlY./~l,A• ~'
~L~P~ ~~~/ER REOUESTS COi1f 6 dE
I, ^~ ..,, SENt TO~ ~ wt7 Q
~~~~i 3~~ pauE ~.~9 . •~: ; ~ : ,~F~~ .E: ~
22. TYVEO NAA4E. GRApf. TITIE APW SIGNATURE Of OFFICIAI '
~fO~~l'35-9~ ~upes4iaor SeQarations U~t
EMBfR
~
~