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<br />C.AUTIO"': NeT TO Bt' USlD'FOR <br />IDENTIFICATION PURPOSES. <br /> <br />THIS IS MHMPGRT ANT RECDRD. <br />SAFEGUARD IT. <br /> <br /> <br />w: /Jr;l1V,/~, '- ., 'Ll , <br />~-l./t/, .,~:....:!..... -,'../..J <br />, ANY ALT RATIONS IN SHADED <br />ARlAS RENDER FORM VOID <br /> <br /> <br />c::ERTIFICATE OF RELEASE OR DISCHARGE FROM ACTIVE DUTY <br />2. DEPARTMENT, COMPONENT AND BRANCH <br />OSMC-ll <br /> <br />6. R SERVE OBLI . ERM. 0 T <br />Yea Man Cay <br />7.b. HOME OF RECORD AT TIME OF ENTRY (Citi: and state or compiete <br />add,ess if known) 1556 AME S APT D ' <br />T PAUL, MN 55106 <br /> <br />B.b. STATION WHERE SEPARATED <br />HQBN lMARDIV CAMPEN CA 92055RUCl1001 <br /> <br />12. RECORD OF SERVICE <br />a. Date Entered AD This Period <br />b. Separation Dat~ This Period <br />c Net Active Service This Period <br />d_ Total Prior Active 5ervrce <br />e. Total Prior Inacti....e Service <br />f. Foreign Service <br />g. Sea Service <br />h. Effective Date oT Pay Grade <br />13. DECORATIONS. MEDAlS, BADGES, CITATIONS AND CAMPAIGN RIBBONS AWARDED OR AUTHORIZED (All pe,iods of service) <br />GOOD CONDUCT MEDAL (W/3 STARS). NATIONAL DEFENSE SERVICE MEDAL. LETTER <br />APPRECIATION. MERITORIOUS MAST, CERTIFICATE OF COMMENDATION (2). <br />MERITORIOUS UNIT COMMENDATION. SEA SERVICE DEPLOYMENT RIBBON <br /> <br />S. DATE OF BIRTH (YYMMDD) <br />600Hll <br /> <br />MEPS MINNEAPOLIS, MN <br />8... LAST DUTY ASSIGNMENT AND MAJOR COMMAND <br />HQBN IMARDIV CAMPEN CA 92055RUC11001 <br />9. COMMAND TO WHICH TRANSFERRED <br />N/A <br />11. PRIMARY SPECIALTY (List number, title and years and months in <br />specialty. List additional specialty numbers and titles involving <br />periods of one or morey:ears.) <br />0231-INTELLIG~NCE SPECIALIST <br />(05 YEARS, 03 MONTHS) <br />3531-MOTOR VEHICLE OPERATOR <br />(02 YEARS, 06 MONTHS) <br /> <br /> <br />OF <br /> <br />1ti~NJ~Rv~gra~ (6'15'fR}{lfot'&~c\'6l:1~s, nY5"'W1!'t~~e"fif~ey! INTELLIGENCE SPECIALIST <br />(08 WEEKS, 03/88), SERGEANTS COURSE (05 WEEKS. 11/94), MOTOR TRANSPORT <br />OPERATIONS NCO COURSE (04 WEEKS, 07/97). BASIC AIRBORNE COURSE (03 WEEKS. <br />03/91), INTER TRANS COURSE (04 WEEKS. 09/90) <br /> <br />lS.a. MEMBER CQNTRI9UTEO TO POST.VIETNA.M EllA <br />VETERANS. EDUCATIONAL ASSISTANCE PROGRAM <br /> <br />-Yes No lS.b. HIGH SCHOOL GRADUATE OR <br />EQUIVALENT <br /> <br />V" No 16. DAYS ACCRUED LEAVE PAID <br />DUE <br /> <br /> <br />17. MEM8EA WAS PROVIDED COMPlnE DENTAl:.- EXAMfNA.TlON AND. ALL APPROPRIATE DENTAL SERVICES ANO TREATMENT WITHIN. gO DAYS PRIOR TO SEPARATION <br /> <br />k_~..~, <br />