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HomeMy WebLinkAbout2114 _ . . _ ,i ` ~ ~ - k.5~. s E * _ ~ _ { ~ . - • ' ~ ' ! 1~.~ . . . i q~ _ . - ~ - ~ ~ _ ~ ' ~ ~ - . . . . . . - _ - . . _ . - . t. ' . _-.1.i. f - - . ~ . `I . .l. . ~ . . _ . - • < . ` DATE OF CORRE-CT10 - ~ ~ - - - ~ ' OEPAR7MEN?, COMPONENT - CORRECTION TO DD FORM 214~ AND BRANCH OR CLASS - REPORT dF S~PARATIt;N FROM ACTIVE DUTY - i • IOENTIFICATION DATA LAST NAME-FiRST NAME-MIDDL£ NAME - SERVICE NUMBER - EFFECTIYE DATE OF SEI.ECTIVE SERVICE LOCA ~ _ ~ piSGHARGE HOARD NUMBER (Clty, a~d . , !R!Tber) Stefe) . ~ = - ~ SOGiAL 58CURITY NUMBER • - ~ - s i HO O CORO At T1ME OF ENTRY INT6 ACTIV6 SE ~ E PERMANENT ADORE 5 FGit MAtLING GIVEN ION ORIGINAL DO FORM ~ ' (Street, RFD, Ctty, Stete and ZtP Code) ; . Zt4 - . ~ ~ ~ - " - CORZECTiONS ~ The original DD Form 2la [or the a6ov~named individual is corrected as in8icated beiow: ITEM t10. - CORREGT£D TO READ ~ - ~ t - ~ _ 1~ a3 ~ - fi ~ - ~ ~ . - . . t . ~ ~ - - . _ ` ~ ~ - ~1~i ~ ~ - _ ~ _ ~ . ~ ~ . _ - ~ ~.i~~ ~ ~ F - - (Slgnature of AuthenUceeing Officer) E - RM - PREVIOUS EDITIONS OF 7M~5 FaRM ARE OBSOLE7E. - DD , No~ 21 ~ _ - _ ~ - . _ _ ; ; _ . - - . ; y = _ - ~ ` _ . . - - - - _ z _ ~ ~ - ~ - _ _ - - p w~ Q~ QpRQ~ _ ~ : ~ b - ~ ~ - . - ~ ~~~ER-ro~~ - . CI.ERK Ct~~iNt C~ . _ - : ~ . : ~ECOR4 YERtf1E~Si~ . . . . . ~ - . ` ~ ~ ~ .~11fi~~ 3 ~i~ Pl~'~~~~~ _ ; _ " _ ' ~ , _ ~ ~ _ _ ~ ° _ - . =f ~ . ~1~~2 . . : ° f ~f _ ~ ~ - - - - ~ . a ~ _ ` - . . ~ ~ • ~ - . ~ ~_'i. : , . •`i } ? d _ - - . . . - . ~ a ~ ~ ~ . . . - - Y~ ~ - . - ' . . - ~ . . ~ _ ~ BOOK~'~V PIICf I~,J _ . ~ , ' ~ - ~ . : _ ; _ . . . . : ; - - _ _ . _ , ; - ' - : - _ F ' ' { ~ ~ -