Downloaded 35 times
![fAUII['N: NOT TO EE
IDENTIFICA.TIOT{ PURPI
THIS IS AI{ IMPORTANT RECORD.
SAFEGUARD IT.
ATTIY ATTERATIONS IT{ SHADED
AREAS RENOER FORM VOID
CERTIFICATE OF RELEASE OR ARGE FRoM AcrlvE DUnf+ 7 -LL4i1., NAME (Last, First, Middle)
F*{t^f'& I Fi . ii*}"}frfi ,l {Fif.J
2. OEPARTMENT, COMPONENT AT{O BRAilCH
'i:filf"!Y "
Fi*
3. SOCIAL SECURITY NO.
4s4 lrtl i.r;?{}
4.a. GRADE, RATE OR RANK
r "E!ti;
4.b. PAY GRADE
tr'ri
5. DATE OF BIRTH (YYMMDD)
*!ii I -.::t-I- i
6. RESERVE O8TIG. TERM. DATE
Year"i 7 MontFl Day {-}ii
7.a. PL,ACE OF ENTRY INTO ACTTVE DUTY
iiilr*]ufi: *i;:E " i:ii-.-
7.b. HOME OF RECORD AT TIME OF ENTRY GiA and.state, or complete
address if known)
F:'E.iiSiit*i:1...n, ri.. .i-;:rl{i;?
8.a. LA.ST DUTYASSIGNMENT AND MAJOR COMMAND
il ';* A&4'ia1 HtJ#tt fit.d irflG:**Sf.i.*f[.
8.b. STATION WHERE SEPARATED
i:'Hti$ t ]: I: L1F $iir; fj F:iit'.Ii: I *{ilr , i-r.;
9. COMMANO TO WHICH TRANSFERRED
1?:i: [ :.*iTtt *i.rE ii!^iFiF.:
4i:,& *IiT *i1'T Hr;ilii,
f, T lt j ilL
'4r",*0,
, t_'rj :Ji-,'ij.l1ri
t0. SGL! COVERAGE LJNone
Amount: S i:i;J. i-i{}i-}
lr. PRIMARY SPECIALTY (List number, title and vears irxl montk h
specialty.
-List
additional specialty numbers and titles involving
periods of one or more vears.)
:r*{- 1fiH5 i:i,.1il 1i:'fiHfi i' p;Ii;r]li{[g p+f'ril-:
r'ftr{T* giFs[i:.i {ii._ I t]' :. yr&R $tri.iili
I {i t':{.li'.j":-'#-*r .ri.{i}]. ii j ilj# rijr.i._ i:il..jf;
I2. RECORD OF SERVICE Year(s) Month(s) Day(s)
a. Date Entered AD This Period ,ei-I
I -_l
b. Separation Date This Period i..i,/
c. Net Actiye Service This Period i i"., tJr$ 1t{
d. Total Prior Active Service I ll r
e. Total Prior lnactive Service { i1 I ilf i i ti
f. Foreign Service fli {-i. I .-.
g. Sea Servi-e i-i i_} iJ t-l i->a_i
h. Effective Date of Pay Grade 1j
13. oECORATIONS, MEDALS. BADGES, CITATIONS AND CAMPAIGN RIBBONS AWAROED OR AUTHORTZED (All periods ot servicC)
{iu{Illr#irri* llii.f:r,jii-i{ }:ii*;i*;l';.,.,,'ii.,* #.if;Li ii'?rlFii..Iji,:iil!i.'.'liF;i-i'i't-.-:ii::'ii.,;:LJTi*:i,,',rfiifii-lif.Jiji
rliLi.,l.i'**
14. MILITARY EDUCATI0N (course title, number of weeks, and month and year completed)
a.a.li";Itiil' ,=U,'".i;:',-:i'i:-t E-i$lialih :.:, l,il,i:t,5 ifiili* iti-i] j ,'i.iiJ'Ti-t ; i',:rr f:i-ri-.r-{}US
15.a. MEMBER CONTRIEUTED TO POST-VIETNAM ERA
VETERANS' EDUCATIONAL ASSISTANCE PROGRAM
Yes I No I5.b. HIGH SCHOOL GMDUATE OR
EQUIVALENT
Yesl No 16. DAYS ACCRUED TEAVC PAID
,:'LJ, - ]f
17. MEMBER WAg PROVIDED COMPLETE DENTAL EXAMII{AIOil ANO ALL APPROPRIATE OCIITAT SERVICEs At{D INCATMEiTT tl,lTHII{ 9{' OAYS PRIOR TO SEPANANOil ves l.d l rvo
18. REMARKS
FjLtji:i,l *' li'.]r:i-*IiF-E F'il'F; Ifii-i ljt-- ilii:p: thj+j;ai:j?-?r)i-r:; iji,rliiJE,lHi--:" l"L-'l rrl--lIi,rf:- r,ji'.i
Fi::ilAi-.i- rir'.it.,r,,";t,; ft"ri'rilirli- $i-RF.l=.i,.r.li!ir'.'i.ri:-i i'r-i IiI{r Fl.il_r_.t_.iu;H
4 AU6 $ge
19.a. MAILING ADDRESS AFTER SEPARATION (tnclude Zip Code)
i'I?B+ Ufirj[i?{id f':I,
fiLil';r*1Efi ilfili. i4t- --ifi;ifi.ri
19.b. NEAREST RELATIVE (Name and address- inctude Zip Code)
rJ I1- f'lH F rq$-{l-$r I tu
sr}l.jL. &S *i?ri
20. MEugtRREeuEsrscopyogEsEETTtla iil- " DtR.oFvErAFFAlRsli lve No 22. OFFICIAL AUTHORIZED TO SlGIrl (Typed.name, grade, title aN
s,gnaturfur*- l + k#^g,-r**
liiild it"T" ill-iil1-ri.:'i:'!i" .',:i-{:" ti$*. FEiqi; 5rj-}-
^i'f" Ti i,o'-*"'I.P,1.'$eS1
SPICIAL ADOIIIONAL !|{FORMAfION (For use by authorized agencies only)
23. TYPE OF STPARATIOT{
t;:f i...[:F+Si: irF:i_]f"i i:.1{* i- i !ri: ;-}i.i i .i ''I$l#,',1#."H" upgrades)(lnclude
25. STPARATION AUTHORITY
r_rfil i;:f,;r_.,ii"iii Cil&i, 4
26. SEPARAIIOiI CODE
tt'-EAl!
27. REENTRY CODE
28. iIARRATIVE REASOI{ FOR SEPARATION
ilIF' l.i;;*1-IO* r-tr' "iLftfi IiF'rlF-i.{i,;li.::ia
29. DATES OF TIME LOST DURING THIS PERIOD
tiJt 1tli t-.
30. MEMI: h f,to(,Esrs coPY 4
)+V Initrats
DD Form 214, NOV 88 Previous editions are obsolete. SERV|CE-2](https://image.slidesharecdn.com/60dcce85-a4f7-45e1-8ef5-3021d61ee599-150915200154-lva1-app6891/85/DD214-1-320.jpg)
![fAUII['N: NOT TO EE
IDENTIFICA.TIOT{ PURPI
THIS IS AI{ IMPORTANT RECORD.
SAFEGUARD IT.
ATTIY ATTERATIONS IT{ SHADED
AREAS RENOER FORM VOID
CERTIFICATE OF RELEASE OR ARGE FRoM AcrlvE DUnf+ 7 -LL4i1., NAME (Last, First, Middle)
F*{t^f'& I Fi . ii*}"}frfi ,l {Fif.J
2. OEPARTMENT, COMPONENT AT{O BRAilCH
'i:filf"!Y "
Fi*
3. SOCIAL SECURITY NO.
4s4 lrtl i.r;?{}
4.a. GRADE, RATE OR RANK
r "E!ti;
4.b. PAY GRADE
tr'ri
5. DATE OF BIRTH (YYMMDD)
*!ii I -.::t-I- i
6. RESERVE O8TIG. TERM. DATE
Year"i 7 MontFl Day {-}ii
7.a. PL,ACE OF ENTRY INTO ACTTVE DUTY
iiilr*]ufi: *i;:E " i:ii-.-
7.b. HOME OF RECORD AT TIME OF ENTRY GiA and.state, or complete
address if known)
F:'E.iiSiit*i:1...n, ri.. .i-;:rl{i;?
8.a. LA.ST DUTYASSIGNMENT AND MAJOR COMMAND
il ';* A&4'ia1 HtJ#tt fit.d irflG:**Sf.i.*f[.
8.b. STATION WHERE SEPARATED
i:'Hti$ t ]: I: L1F $iir; fj F:iit'.Ii: I *{ilr , i-r.;
9. COMMANO TO WHICH TRANSFERRED
1?:i: [ :.*iTtt *i.rE ii!^iFiF.:
4i:,& *IiT *i1'T Hr;ilii,
f, T lt j ilL
'4r",*0,
, t_'rj :Ji-,'ij.l1ri
t0. SGL! COVERAGE LJNone
Amount: S i:i;J. i-i{}i-}
lr. PRIMARY SPECIALTY (List number, title and vears irxl montk h
specialty.
-List
additional specialty numbers and titles involving
periods of one or more vears.)
:r*{- 1fiH5 i:i,.1il 1i:'fiHfi i' p;Ii;r]li{[g p+f'ril-:
r'ftr{T* giFs[i:.i {ii._ I t]' :. yr&R $tri.iili
I {i t':{.li'.j":-'#-*r .ri.{i}]. ii j ilj# rijr.i._ i:il..jf;
I2. RECORD OF SERVICE Year(s) Month(s) Day(s)
a. Date Entered AD This Period ,ei-I
I -_l
b. Separation Date This Period i..i,/
c. Net Actiye Service This Period i i"., tJr$ 1t{
d. Total Prior Active Service I ll r
e. Total Prior lnactive Service { i1 I ilf i i ti
f. Foreign Service fli {-i. I .-.
g. Sea Servi-e i-i i_} iJ t-l i->a_i
h. Effective Date of Pay Grade 1j
13. oECORATIONS, MEDALS. BADGES, CITATIONS AND CAMPAIGN RIBBONS AWAROED OR AUTHORTZED (All periods ot servicC)
{iu{Illr#irri* llii.f:r,jii-i{ }:ii*;i*;l';.,.,,'ii.,* #.if;Li ii'?rlFii..Iji,:iil!i.'.'liF;i-i'i't-.-:ii::'ii.,;:LJTi*:i,,',rfiifii-lif.Jiji
rliLi.,l.i'**
14. MILITARY EDUCATI0N (course title, number of weeks, and month and year completed)
a.a.li";Itiil' ,=U,'".i;:',-:i'i:-t E-i$lialih :.:, l,il,i:t,5 ifiili* iti-i] j ,'i.iiJ'Ti-t ; i',:rr f:i-ri-.r-{}US
15.a. MEMBER CONTRIEUTED TO POST-VIETNAM ERA
VETERANS' EDUCATIONAL ASSISTANCE PROGRAM
Yes I No I5.b. HIGH SCHOOL GMDUATE OR
EQUIVALENT
Yesl No 16. DAYS ACCRUED TEAVC PAID
,:'LJ, - ]f
17. MEMBER WAg PROVIDED COMPLETE DENTAL EXAMII{AIOil ANO ALL APPROPRIATE OCIITAT SERVICEs At{D INCATMEiTT tl,lTHII{ 9{' OAYS PRIOR TO SEPANANOil ves l.d l rvo
18. REMARKS
FjLtji:i,l *' li'.]r:i-*IiF-E F'il'F; Ifii-i ljt-- ilii:p: thj+j;ai:j?-?r)i-r:; iji,rliiJE,lHi--:" l"L-'l rrl--lIi,rf:- r,ji'.i
Fi::ilAi-.i- rir'.it.,r,,";t,; ft"ri'rilirli- $i-RF.l=.i,.r.li!ir'.'i.ri:-i i'r-i IiI{r Fl.il_r_.t_.iu;H
4 AU6 $ge
19.a. MAILING ADDRESS AFTER SEPARATION (tnclude Zip Code)
i'I?B+ Ufirj[i?{id f':I,
fiLil';r*1Efi ilfili. i4t- --ifi;ifi.ri
19.b. NEAREST RELATIVE (Name and address- inctude Zip Code)
rJ I1- f'lH F rq$-{l-$r I tu
sr}l.jL. &S *i?ri
20. MEugtRREeuEsrscopyogEsEETTtla iil- " DtR.oFvErAFFAlRsli lve No 22. OFFICIAL AUTHORIZED TO SlGIrl (Typed.name, grade, title aN
s,gnaturfur*- l + k#^g,-r**
liiild it"T" ill-iil1-ri.:'i:'!i" .',:i-{:" ti$*. FEiqi; 5rj-}-
^i'f" Ti i,o'-*"'I.P,1.'$eS1
SPICIAL ADOIIIONAL !|{FORMAfION (For use by authorized agencies only)
23. TYPE OF STPARATIOT{
t;:f i...[:F+Si: irF:i_]f"i i:.1{* i- i !ri: ;-}i.i i .i ''I$l#,',1#."H" upgrades)(lnclude
25. STPARATION AUTHORITY
r_rfil i;:f,;r_.,ii"iii Cil&i, 4
26. SEPARAIIOiI CODE
tt'-EAl!
27. REENTRY CODE
28. iIARRATIVE REASOI{ FOR SEPARATION
ilIF' l.i;;*1-IO* r-tr' "iLftfi IiF'rlF-i.{i,;li.::ia
29. DATES OF TIME LOST DURING THIS PERIOD
tiJt 1tli t-.
30. MEMI: h f,to(,Esrs coPY 4
)+V Initrats
DD Form 214, NOV 88 Previous editions are obsolete. SERV|CE-2](https://image.slidesharecdn.com/60dcce85-a4f7-45e1-8ef5-3021d61ee599-150915200154-lva1-app6891/75/DD214-1-2048.jpg)
DD214
- 1. fAUII['N: NOT TOEE IDENTIFICA.TIOT{ PURPI THIS IS AI{ IMPORTANT RECORD. SAFEGUARD IT. ATTIY ATTERATIONS IT{ SHADED AREAS RENOER FORM VOID CERTIFICATE OF RELEASE OR ARGE FRoM AcrlvE DUnf+ 7 -LL4i1., NAME (Last, First, Middle) F*{t^f'& I Fi . ii*}"}frfi ,l {Fif.J 2. OEPARTMENT, COMPONENT AT{O BRAilCH 'i:filf"!Y " Fi* 3. SOCIAL SECURITY NO. 4s4 lrtl i.r;?{} 4.a. GRADE, RATE OR RANK r "E!ti; 4.b. PAY GRADE tr'ri 5. DATE OF BIRTH (YYMMDD) *!ii I -.::t-I- i 6. RESERVE O8TIG. TERM. DATE Year"i 7 MontFl Day {-}ii 7.a. PL,ACE OF ENTRY INTO ACTTVE DUTY iiilr*]ufi: *i;:E " i:ii-.- 7.b. HOME OF RECORD AT TIME OF ENTRY GiA and.state, or complete address if known) F:'E.iiSiit*i:1...n, ri.. .i-;:rl{i;? 8.a. LA.ST DUTYASSIGNMENT AND MAJOR COMMAND il ';* A&4'ia1 HtJ#tt fit.d irflG:**Sf.i.*f[. 8.b. STATION WHERE SEPARATED i:'Hti$ t ]: I: L1F $iir; fj F:iit'.Ii: I *{ilr , i-r.; 9. COMMANO TO WHICH TRANSFERRED 1?:i: [ :.*iTtt *i.rE ii!^iFiF.: 4i:,& *IiT *i1'T Hr;ilii, f, T lt j ilL '4r",*0, , t_'rj :Ji-,'ij.l1ri t0. SGL! COVERAGE LJNone Amount: S i:i;J. i-i{}i-} lr. PRIMARY SPECIALTY (List number, title and vears irxl montk h specialty. -List additional specialty numbers and titles involving periods of one or more vears.) :r*{- 1fiH5 i:i,.1il 1i:'fiHfi i' p;Ii;r]li{[g p+f'ril-: r'ftr{T* giFs[i:.i {ii._ I t]' :. yr&R $tri.iili I {i t':{.li'.j":-'#-*r .ri.{i}]. ii j ilj# rijr.i._ i:il..jf; I2. RECORD OF SERVICE Year(s) Month(s) Day(s) a. Date Entered AD This Period ,ei-I I -_l b. Separation Date This Period i..i,/ c. Net Actiye Service This Period i i"., tJr$ 1t{ d. Total Prior Active Service I ll r e. Total Prior lnactive Service { i1 I ilf i i ti f. Foreign Service fli {-i. I .-. g. Sea Servi-e i-i i_} iJ t-l i->a_i h. Effective Date of Pay Grade 1j 13. oECORATIONS, MEDALS. BADGES, CITATIONS AND CAMPAIGN RIBBONS AWAROED OR AUTHORTZED (All periods ot servicC) {iu{Illr#irri* llii.f:r,jii-i{ }:ii*;i*;l';.,.,,'ii.,* #.if;Li ii'?rlFii..Iji,:iil!i.'.'liF;i-i'i't-.-:ii::'ii.,;:LJTi*:i,,',rfiifii-lif.Jiji rliLi.,l.i'** 14. MILITARY EDUCATI0N (course title, number of weeks, and month and year completed) a.a.li";Itiil' ,=U,'".i;:',-:i'i:-t E-i$lialih :.:, l,il,i:t,5 ifiili* iti-i] j ,'i.iiJ'Ti-t ; i',:rr f:i-ri-.r-{}US 15.a. MEMBER CONTRIEUTED TO POST-VIETNAM ERA VETERANS' EDUCATIONAL ASSISTANCE PROGRAM Yes I No I5.b. HIGH SCHOOL GMDUATE OR EQUIVALENT Yesl No 16. DAYS ACCRUED TEAVC PAID ,:'LJ, - ]f 17. MEMBER WAg PROVIDED COMPLETE DENTAL EXAMII{AIOil ANO ALL APPROPRIATE OCIITAT SERVICEs At{D INCATMEiTT tl,lTHII{ 9{' OAYS PRIOR TO SEPANANOil ves l.d l rvo 18. REMARKS FjLtji:i,l *' li'.]r:i-*IiF-E F'il'F; Ifii-i ljt-- ilii:p: thj+j;ai:j?-?r)i-r:; iji,rliiJE,lHi--:" l"L-'l rrl--lIi,rf:- r,ji'.i Fi::ilAi-.i- rir'.it.,r,,";t,; ft"ri'rilirli- $i-RF.l=.i,.r.li!ir'.'i.ri:-i i'r-i IiI{r Fl.il_r_.t_.iu;H 4 AU6 $ge 19.a. MAILING ADDRESS AFTER SEPARATION (tnclude Zip Code) i'I?B+ Ufirj[i?{id f':I, fiLil';r*1Efi ilfili. i4t- --ifi;ifi.ri 19.b. NEAREST RELATIVE (Name and address- inctude Zip Code) rJ I1- f'lH F rq$-{l-$r I tu sr}l.jL. &S *i?ri 20. MEugtRREeuEsrscopyogEsEETTtla iil- " DtR.oFvErAFFAlRsli lve No 22. OFFICIAL AUTHORIZED TO SlGIrl (Typed.name, grade, title aN s,gnaturfur*- l + k#^g,-r** liiild it"T" ill-iil1-ri.:'i:'!i" .',:i-{:" ti$*. FEiqi; 5rj-}- ^i'f" Ti i,o'-*"'I.P,1.'$eS1 SPICIAL ADOIIIONAL !|{FORMAfION (For use by authorized agencies only) 23. TYPE OF STPARATIOT{ t;:f i...[:F+Si: irF:i_]f"i i:.1{* i- i !ri: ;-}i.i i .i ''I$l#,',1#."H" upgrades)(lnclude 25. STPARATION AUTHORITY r_rfil i;:f,;r_.,ii"iii Cil&i, 4 26. SEPARAIIOiI CODE tt'-EAl! 27. REENTRY CODE 28. iIARRATIVE REASOI{ FOR SEPARATION ilIF' l.i;;*1-IO* r-tr' "iLftfi IiF'rlF-i.{i,;li.::ia 29. DATES OF TIME LOST DURING THIS PERIOD tiJt 1tli t-. 30. MEMI: h f,to(,Esrs coPY 4 )+V Initrats DD Form 214, NOV 88 Previous editions are obsolete. SERV|CE-2