Laserfiche WebLink
�,- :�:� rI InlIr�,AIANI K=•_� u. ANY ALTERATIONS IN SHADED <br /> ICEE'!FtC� .ON PC'R:�OS�S J SAF=GUARD iT. AREAS RENDER FORM VO <br /> ID <br /> ?a= "37- ,-ir- Middle) '. CCMPCfJEyT AND 3RANCH 7,_ ,; r 1 <br /> .� �-i =� :' 'i., 1 'mom 1 91 <br /> R,.27E OR RANK 4.b. PAY GRADE 1, S. DAT° OF BIRTH (YYMMDD) 5. RESERVE OSUG.TERM. DATE <br /> EA 4A1. <br /> +i <br /> rear M71 <br /> =N-R" INTO AC71VE DUTY i 7.C. --CVic 3: 3ECORD 4T TIME OF EVT; (Ci,y a d a=. or complete i <br /> address i;known) ' <br /> -� ii.LL3ti 7 r - I �� <br /> =,VD bt:.OR. COMMAND —S. =--,-G`; <br /> I z, <br /> ��-^t l:"-;i, =• TO WHICH TRANSFERRED 10--- ! <br /> ' SGLI COVER=.z r: Verse <br /> _ :mour-: S <br /> SPECIALTY (List number, title and years and months in 12. RECORD CF SERVICE 'zar(s; <br /> g specialty. List additional specialty numbers and titles involving , oerl <br /> i �preriods o one ormore years.} a. Daz, _ _ 1D T�s ca d _ <br /> �iF7�7 'ca" b Seoara-.c- Daze Tn15 Derod <br /> _,_7 ,F Sz,,,jCe ThIS Per,CC <br /> e. .Cai 0•iar racz:ve Scrvic2 <br /> v <br /> -- y. Sea Ser-iice <br /> _`ec:;ve Daze o* =ay Grade z Y=_? -0 <br /> � .NO, <br /> �;51�. G P O A' TH <br /> N :' RIBBONS A'.dA�QFL 7 �J QRI�E_ <br /> 7 �t <br /> `i= to-!.tom` �.:= i�j nrn anG year completed) <br /> a :.,- : r <br /> x x -- <br /> - X x <br /> l _ __ a <br /> ,_.:ra CorJTt1BUTEo'0 2C:7 ilE_J h v 9 _ 11 15._ :c-c- ici ACCRUE-- I_=_,AVE ?A r 1 <br /> ,0 <br /> ._ c,,:PoS'47UGTIQNaI=iSiS'^.wC_ QRCGK,:%� <br /> 1 .1E:A5Ft ..A5 PROVIDED COFAP=- CENTAL _.....vi1C.-'rh' -f!C ?iRCP Z-NTAi. 3"c". _-- a`- ,i_.• ? o _ - 700 - i'_ __ ti..' F:,TFiIR J.! RICR 7C .-E,=. :: .� <br /> 3 RE 3 <br /> w <br /> ! x <br /> i x X S <br /> x7t IT <br /> i -.r r <br /> IFTCR <br /> - _,.-.2- A- r ---- - -- —_ - -__ -_--- -- - - <br /> -;, .A .�iiiE�•SER ?EiNv'- --- - - -'- _ _ =rC <br /> RIE- <br /> 3 <br /> :: .fa-== of T:�iE .!_'R,?aG TH1� -.Rto -- �---s- _— ,�;.NI_NtBeti R_ ;rs-= coPY s <br /> TL� <br /> 00 Form 214, ')O%i g2 ='0 Previous edirions are obsolete. <br />