CAUTION: NOT To BE USED FOR “THIS 1S AN IMPORTANT RECORD. [TERATIONS IN SHADED AREAS
IDENTIFICATION PURPOSES. SAFEGUARD IT__ iis mt on
CERTIFICATE OF RELEASE OR DISCHARGE FROM ACTIVE DUTY
[E: BEPARTHENT, COMPONENT AND BRANCH 3. SOCIAL SECURITY NOMGER.
USMCR-KM, oss | | 07
Js GRADE, ATE ORTOOR PAY Ge OATES HES ERENT ATONE TRATION ORTE
cr a sor formas apn
ERCECRRGERTERRROSO™™” | RTRGETEgyP Tor eT o9 owen. amen Fay
roe ea Basses
CASON SENT OTROS SHER SEATED
at 0h he NE od dN abn Harr PARE
Sou Wr TRATERTED ia a eR — TE
Tu iy hair ar, PRUE HER oun a
11. PRIMARY SPECIALTY (list number tila and yaare and montheln | 49 RECORD OF SERVICE ‘Yeanis) | monTias) | sane]
Seay toda techy nanbors and os erg TERED pms PERO | 2008 [OT |
0311, Rifleman, 9 mont wan nares penn | 200 | os [17 |
a
igunonenane [o-]ae
es a
os sets
Smee | «0 | 00
___ | Rrcene oncarearanae |-son-]—e—1—a
[RRR RT em | Mnapennon casa ars amare ar
eens amare | Man
a het ere x Seemed un sr Ene Um 09
ik mi to oes ee
Fowl
_Jres[_ XT x0
z S Eoue ATO NSTANGE POON
"HIER GE OTTR EL TuN mAVTERNS evATOW FateP Ts
"TE. DAYS ACCRUED LEAVE ] 17, MEMBER WAS PROVIDED COMPLETE DENTAL EXAMINATION AND ALL APPROPRIATE | YES
PAID RLB 0.5 SLB 00 DENTAL SERVICES ANO TREATMENT WITHIN S0 DAYS PRIOR TO SEPARATION Pst
EAE Screed TAME Benes expire on (11/1209) dette fallowing uiing eter: Member’ sere component was called
Seen re Be FOnaras gt Eta OME tm 07728208 to 05172009
‘Retr sewed os esa Teme: ang Poy ae Fon 307 AAA
‘Sova cage ns eammleones TRUE Copy
Ser: 81269-2009.0056 Euan soley
eon enna sn em gen rato eft. cee in
Ln a ist
Fae ois Apress FTER SEPARATION cls OP Gxt) [p REAREST LAINE Nos a oda0s POPE CO)
es ean er SEARLE
1469'S Mountain Rd
Dillsburs PA 17019
PA _DIRECTOR OF VETERANS AFFAIRS hes] Tne
[22 OFFICIAL AUTHORIZED TO SIGN [Typo nara, grado, fe ond signature)
PANEL bone”
1 Ww Crosers Set Admin
‘SPECIAL ADDITIONAL INFORMATION [For use by authored aponcies on
ES TYPE OF SEPARATION ac cHAOAETER OF SERVICE (ra pom
Released From Active Duty
[25 SEPARATION AUTHORTTY "26. SEPARATION CODE 27, REENTRY CODE
MARCORSEPMAN PAR 1005 MBKS Ia,
i, NARRATIVE REASON FOR SEPARATION
Completion of Required Active Service Z
[a8: BATES OF TIME LOST DURING THIS PERIOD (YY YHOO) 20, MEMBER REQUESTS COPY 4)
[None eis) Ju
PREVIOUS EDITION 15 OBSOLETE. SERVICE -2
DD FORM 214, FEB 2000