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CAUTIO,H lu,T TO BE USED FOR THIS 15 AN IMPORTANT RECORD. ANY ALTERATIONS IN SHADED <br /> iDENTIFiCAT!ON PURw OSES SAFEGUARD IT. i <br /> i^ � - �-_ ,{ - _ AkFA� RENDER FORM VOID <br /> L CERTIFICATE D,- RELEASE- OR DISCHARGE FROM ACT11VE DUTY <br /> i NA.YiS irSt. bfiddle) 2 D-PARTLiENT. CCN,4PO <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> INS i 1i1 i i i i A LOUFNa ^�LFAl ii-�X t"�+,i 3' ar c0mpreted) <br /> x .t x x <br /> x x <br /> SS.a. MEMBER CDN `=4 YYesVr, ii o -IG- `uC :B.:uU ]4 j 16. '.C ^L��� E LEAVE PAID I <br /> 7ETERAN1 7UC :: t. .. <br /> ". MEMBER WAS PROVIDED COMPLETE DENTAL =:A�a i:`:.-`GN .AND AL! APPROPRIATE DENTAL. '-ERVIC— AND TREA'MENT 9d17HIN M DA tS PRIOR <br /> 18. REMARKS <br /> a <br /> x x x <br /> a x <br /> g x <br /> x <br /> x x <br /> x h x <br /> x x <br /> x x _ <br /> �'j�+� ,f! PTER SE?IaRA-'_`: '!neLde i5_ -�C_ I <br /> �71 — .i i VTt� �7 I DOF,0$W .i'rl[_:+'t+'*'•37 ` iilMrVf*� I <br /> CWESTEA, PA 169C13 OaAWARD ii GESTV, RA 19W <br /> I <br /> _J. `.cm3:R 2EGUE5-5 COPY 53ExNT.TD��-�� DIR.DF - IVc'�--_ - D j;;=,i� /C �� ��aR!e. grace, .'I t;: dnd <br /> ". SiGNATURE OF MEMBER BEING SEPARATE <br /> - SPECIAL uCI :Cf!t, iP)FCRMAT'CP' =or e by a,'?ori_ed agencies <br /> 23. Tvoc CP SEPARATiG;J -- - -74. CHARACTER OF SERVICE (lntr C'E .cgrade., <br /> inomma <br /> HONORMLE <br /> 2S. SEA- .AT!ON .AUTHORITY _ 26. SEPARATION COCE �m '27. REENTRY COrE <br /> 123. NARR, TiV= RE.AS :,i F,-eR SEPARA T!ON - - — <br /> EXPIRATION 8f TM 4F ENLISTMW <br /> 29. DATES OF <br /> T;iVIE LOST DURING THIS PERIOD 30.MEMBER REQUESTS CCPY 4 u <br /> L: t'iV1'ai� !r.-.a <br /> ©O Form 214, NOV 88 S/.N 0102-LF-006-6E00 Previous editions are obsolete. <br />