1. CAUTION: NOTTO BE USED FOR
IDENTIFICATION PURPOSES
TH]S IS AN IMPORTANT RECORD.
SAFEGUARD IT.
ANY ALTERATIONS IN SHADED AREAS
RENDER FORM VOID
CERTIFICATE OF RELEASE OR DISCHARGE FROM ACTIVE DUTY
This Report Contains lnformation Subject to the Privacy Act ol 1974, As Amended.
1. NAME (Last, First, Midcile)
SONZALES, GREGORY MANUEL JR
2, DEPARTMENT, COTT,IPONENT AND BRANCH
ARMY/RA
3. SOCIAL SECURITY NUI/IBER
s23-l 47 l7e1o
4a. GRADE, RATE OR RAIIK
PFC
b. .PAY GRADE
803
6. RESERVE OBL]GAT]ON TERMINATION DATE
(YYYYMMDD) 20150L28
5. OATE OF BIRTH (YYYYMMDD)
19840905
7a. PLACE OF ENTRY INTO ACTIVE DUTY
DE}i-VER, COLORADO
b. HOttIE OF RECORD AT TIME OF ENTRY (C,ty and state, or complete address if known)
4765 SOUTH XENOPHON WAY
MORRTSON COLORADO 80455-0000
8a. LAST DUTY ASSIGNMENT AND MAJOR COMMAND
HSB (2-2ND FA BN) TC
b, STATION WHERE SEPARATED
FORT SILL, OK 73503-5100
9. COi,III,IAND TO WHICH TRANSFERRED
USAR CON GP (REINF) 1600 SPEARHEAD DIVISICN AVE, FT IONOX, KY 40]-22
10. SGLI GOVERAGEL_l NoNE
AMOUNT: $ 400, 000.00
11. PRIMARY SPECIALW (Ust number, title and years and months in
speciery. List additional specialty numbers and titles involing peiods ot
one or more yea/s.)
l-381O CANNON CREWMEMBER - 3 YRS 11 MOS/ /
NOTI{ING FOLLOWS
12. RECORD OF SERVICE YEAR(S) MONTH(S} DAY(S)
a. DATE ENTERED AD THIS PERIOD 2007 02 L4
b, SEPARANON DATE THIS PERIOD 2411 06 L2
c. NET ACTIVE SERVICE THIS PERIOD 0004 03 ao
d. TOTAL PRIOR AC]IVE SERVICE 0000 00 00
e. TOTAL PRIOR INACTIVE SERVICE 0000 00 00
f. FOREIGN SERVICE 0002 10 00
q. SEA SERVICE 0000 00 00
h. INITIAL EIiITRY TRAINING 0000 04 26
i. EFFECTIVE DATE OF PAY GRADE zUtr OZ UJ.
13. DECORATIONS, MEDALS, BADGES, CITATIONS AND CAMPAIGN
RIBBONS AWARDED OR AUTHORIZED fAil peiods or sevice)
IRAQ CAIVIPAIGN MEDAL W/TWO CAMPA]GN STARS//
ARMY ACHIEVEMENT MEDAL (2ND AWARD) //ARMY
GOOD CONDUCT MEDAL//NATIONAL DEFENSE SERVICE
MEDAL//GLOBAL WAR ON TERRORISM SERVTCE
MEDAL/ /AP-MY SERVICE RIBBON/,/OVERSEAS
SERVTCE RIBBON (2ND AW'ARD) //CERTIFICATE OF
ACHTEVEMENT (3RD AWARD) //COUT IN BLOCK 18
14. MILITARY EDUCATION (Course title, numberof weeks, and month and
year completed)
BLACKI{AWK FIRST RESPONDER CRS, 3 WEEKS,
2008/ /COMBAT LrFE SAVER CRS, 1 WEEK, 2009
//C]MBAT LIFE SAVERS CRS, ]. WEEK, 2OO9//
HAZMAT CERTIF,, 1 WEEK, 2OOB/ /HAZMAT MAT DVR
TNG CRS, 1 WEEK, 2OOBI/NOTHING FOLLOWS
15a. COMII/IISSIONED THROUGH SERVICE ACADEIIIIY I YEs x NO
b. COiiIMISSIONED THROUGH ROTC SCHOLARSHIP (10 USC Sec. 2107b) I YEs x NO
c. ENLISTED UNDER LOAN REPAYMENT PROGRAM (70 USC Chap. 109) (lf Yes, years of commitment: NA ) I YES x NO
16. DAYSACCRUEDLEAVE
PAIO O
17. MEMBER WAS PROVIDED COMPLETE DENTAL EXAMINATION AND ALL APPROPRIATE
DENTAL SERVIGES AND TREATMENT WTHIN 90 DAYS PRIOR TO SEPARATION
YES NO
x
ls.REMARKS / // / / /// / / / / // / / / / // / // / / ////1/ / / // // / // / // // / // / / // /// // // //// / // // / t/./ // / / / / // // // // // / / / ///// // /
SUBJECT TO ACTIVE DUTY RECALL, MUSTER DUTY AND/OR ANNUAL SCREENING/,/BLOCK 5, PER]OD OF
DELAYED ENTRY PROGRAM: 2OO7OI29-2AA'?021,3//SERVED IN A DESIGNATED IMMINENT DANGER PAY
AREAI/SERVTCE rN rRAQ 200?0901-200?1r-30//SERVTCE rN rRAQ 2008a20a-2A09aa1a/ /MEMBER HAs
COMPLETED FIRST FULL TERM OF SERViCE//CONT FROi"i BLOCK 13: //DRIVER AIiD I.{ECHANIC BADGE
W/DRIVER.WHEELED VEHICLE (S) CLASP//NOTHING FOLLOWS
The informatron coniained herein rs subject to computer matching within the Department of Defense or with any other affected Federal or nor!.Federal agency for veriiicalior
purposeB and to determine eiigibility for, andior conlinued compliance wiih, the requiremerds of a Federal benefrl program.
19a. MAILING ADDRESS AFTER SEPARATION (tndude zP Code)
17286 E WAGONTRAIL PKWY
aTTpnPA anT.naann qonl <
b. NEAREST RELATIVE (Name and address - include ZP Code)
AMY GONZALES
]-7286 E WAGONTRATL PKWY
rTTDrDl anT.nDln^ Qnnl q
20. MEMBER REQUESTS COPY 6 BE SENT TO (speciry slerte/tocatity) 'CO OFFICE OF VETERAilS AFFAIRSI X lyEs NO
*
ltT[P*i[sr11r:Esrs
GoPY 3 EE sENr ro rHE cElrrRAL oFFTGE oF,rHE DEFARTTET{roF vErERAfls enrerns
I x YEU NO
21,a. MEi,IBER SIGNATURE
ESIGNED BY: GONZALES.GRE
30RY. MANUEL.,fR. 12 95 975 5 0
n
D, L'AIE
(YYYYMMDD)
20L10526
22.a. OFFIGIAL AUTHORIZED TO SIGN (Iypad n ame, grade, fiAe, signature)
ISIGNED BY : WINNS. CYNTHIA. EXLEY. 1058939451
SYNTHIA E WINNS. GSO9. SUPERVISOR SAS
D. UAIE
(YYYYMMDD)
20}Lo526
SPECIA,L ADDITIONAL INFORIIIIATION (For use by authorized agencies only)
23. TYPE OF SEPARATION
RELEASE FROM ACTIVE DUTY
24. CHARACTEROF SERVICE (include upsreies)
]ONORABLE
25, SEPARATION AUTHORITY
AR 635-200, CHAP 4
26, SEPARAT]ON CODE
MBK
27. REENTRY CODE
1
28, NARRATIVE REASON FOR SEPARAT]ON
:OMPLETION OF REQUIRED ACTIVE SERVICE
29. DATES OF T[riE LOST DURING T]llS PERIOD (YYYYMMDD)
IONE
30, MEMBER REQUESTS COPY 4
(lnftiars) GMG
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