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Honorable Completion of Term

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  1. 1. AiIY ATTERATIONS SHADED til RECORO. THIS ri AN IMPORTANT CAUTIOil: NOT TO 8E U5ED FOR FORMVOID AREASRENOER IT. SAFEGUARD ID E NTI F I C A T I O T IP U R P O S E S d#{ELEASE OR DISCHARGERSM ACTIVE DUTY F CERTIFICATE NO. SE€URITY 3. SOCIAL. 2. D E P A R TME N T,C OMP ON E N T A N D B R A N C H 1. NAME (Lart, First, Middle) 5 ? ?' 16 ,1.' : 5', 1,64 NrVY-l-lSN SCOTT AI-LAN LA}fBERTUS, 5. DATE OF EIRTH(YYMMDD) TERM.DATE 6. RESERVE OBLIG. 4 .b - PAY GRADE 4.a. G RA D E , R A T E O R R A N K Y e a r( i Montif A I'I Daylr i2NOv10 D,g3 E4 7.b. HOME OF RECORD TIME OF ENTRY AT GiA and state, or cornplete 7.a. PLACEOF ENTRYINTO ACTIVEDUTY addressif known) !..1 i {:i i }.i + h 5 {J I WF S I ' H I r R i 'F P i t l quot; N r }A t f r 't Z irH {uil.lli 8 . b . S T A T I O N E R ES E P A R A T E D WH 8 .a. LAST D U T Y A S S I G N M E NT AND M AJOR COM M AND ( f f 'f } I j : f s A N l f s s i quot; l l 1 : t j J {l l ! ) {'r TFr {i {t i ':i t 155 A i . . il ' _ r il- { ' { i 1i i'li:j{:.1 ltone 10.sGLlGOVERAGEll 9. COMMAND TO WHICH TRANSFERRED -1t! li l - 'i l r E r ( ) R L F A N S , Amount: l - r 1 7 t l 1 I '1 ' S i' i: - N' I ' I : ii | il f I r-tft RFSF:Rii'- l' Elil: i) l, lN! quot;t - i' l;V , t r ! - ' Day(s) t't. pmirtanY (Lirt number, title and years and months in Month(s) 12. RECORD SERVICE Yea(s) OF SPECTALTY List additional specialty numbers and titles involving specialty. a. Date EnteredAD This Period fl AE ld Qd one or more Yean.) periods of b. SeparationDate This Period U AE t4 98 This Period nn c. Net Active Service nt l {l t, rjs-tJrrtifl d. Total Prior Active Service fr {i ,.l r:l fifr oo e. Total Prior InactiveServrce O,-I nn f- ForeiqnService fin ft a'l g. Sea Service nt dtrt 1quot;7 r:rl:r -t< h. E ffecti ve D ate of P ay Grade o c A M pA tcH R | B 8oN sA w A R D E D oR A U TH oR l zE D (A l l peri dsof ser vice) i l {.y}t- i i r , i. t bt . t i. l' f$ F L ' rA L ,l ,l A l ' t{ )N A I- D l l IrFN ,S I: sE I-l V I{ l l .l l d[]I]A L. N A .rJ quot; Fquot; R l i l fJt-]N 5 l :,1 . ' l; t i : I i] F l) Il :Pl i i fF l i j fl T i i tB U { -i i .l -. i {Mfrtj {i QR L' I:]S l l X P } :i D i l Ii ' l ^i i l t)' Mti l i ,l . .{ { l ? Ii fl 'l l: quot; f r quot; f ilf l g l i N quot; of weeks, and month and year completed) iimber i, 1- 455 quot;. , quot; l . . l WK S - $CHrtut.. f '--1 fi* x 5 i'l- : , . t . 1 Lt Si ii[]l; ! i,r-J ,{ i,'i LEAVEPAID 15. DAYS ACCRUED Yes I No 15.b. H IG H SC H O O IG M OU AIE OR ves I No ERA 15.a. MEMBERCONTRISUTED POST-VIETNAM TO x EQUIVALENT VETERAilS'EDUCATIONAL ASSISTA'{CEPROGRAM T tlt rrf NO ANO TREATM€ilT WITHTI{90 DAYS PRIORTO S€PARANON Y6 DENTAL SENVICES ANO ALL APPROPRIATE COMPI-ETEDEIITAL EXAMIT{ATIOT{ M€M8ER WAS PROVTDED I7. quot;;*rui* 18. REMARKS GI BILL. MEMFER CONTITIBUTED TO I{ONTGOT{ERT * TTIE INFOB.MATION CO}ITAINED T{EREIN TS SI-JBIECT t} COMPUTER HAreHlN* DEI*ARTff-EI.IT oF DEFENSE OR S.ITI{ IfTHER AFFECTHD FET}TIRAL OR NON-FEDFRAL ACENCT FOR, A,bID/OR COI'TTIIltIED AHII T,() DHTERMINE El-t'fiIBILITY F*R .ER{FICATIOI{ I.URF,OS,ES WIT}Iquot; T1IE :REQUIREI{ENTS OF A FESERAL BE}{EFIT PRO$RAUquot; . .. , .. ' ,',-:l Ci}gPLIA}{c€ Dft t14 .{{)[{INIS]'RATIVEL.Y,quot;ISSUFD ON eSHARl !i, x n K t 1|r include 'ZiP Code) eOOnrSS AFTER SEPARATION(lrdude Zip Code) lg.ajvtAtLlntG CITERTL LAUBER'IUS i ITCIT$ER 65 O tr } {iJO1 $ERCER I-N HERCER LFT GI..ENDAL.E &Z 853$4 cli E'rJDil.E L:Z B5 3O4 E9ry5y1,,oyJ.ryg>1.oyyqv {elgeoe. rade, itte nd ta s NO OIR.OTVETAFFAIR 5IIVC S 20 . M E M B E RR € QUE S T 5 COP Y 6BESEIUTTO stgnaturq4-/rT l{.-.aquot;f {* i' 21. STGNATURE MEMBEI* ElllQfranafto OF t-!5N PFRSCFF rf.E V t-,tfIi J F. rquot; N C S i $,S ) (For use by authorized agencies only) spEaAL ADD|TIOI{AI INFORMATTON (lnclude upgrades) 24. CHARACTER SERVICE OF Ttor{ 23. TYPEOF SEPARA RELEASED FROM ACTIVE DUTY ttnrtnD i flt CODE 27. REENTRY 26. SEPARATION OD E C AUTHORITY 25. SEPARATION rrll D EDC Ia A l 2 .4 tnt <n tt8ilFeBfr6fi'SFquot;ftfffrifi1$ AcrrvE sE rcE Rv COPY4 ouine rHts P€RtoD 30. MEMBERREQIJESTS ffi *-; Inttials / . ,,1 N 0102-LF-006-5500 previous editions are obsolete DD