This document is a DD Form 214, which is a Certificate of Release or Discharge from Active Duty issued by the United States military. It contains personal information about a service member including their service dates, assignments, education, awards, and reason for separation. The form instructs the holder to safeguard it as an important record, but not to use it for identification purposes. Any alterations to shaded areas would void the form.
1. CAUTION: NOT TO BE USED FOR
I DENTI FI CATION PU RPOSES
THIS IS AN IMPORTANT RECORD.
SAFEGUARD IT.
DD FORM 214, AUG 2OO9 PREVIOUS EDITION IS OBSOLETE.
GENERATED BY TRANSPROC
ANY ALTERAT]ONS IN SHADED AREAS
RENDER FORM VOID
MEMBER.l
CERTIFICATE OF RELEASE OR DISCHARGE FROM ACT]VE DUTY
This Report Contains Information Subject to the Privacy Act of 1974, As Amended.
2, DEPARTMENT, GOMPONENT AND BRANCH
ARMYIRA
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7a. PLACE OFEXiRV INTO ACTIVE DUTY I b. HoME OF RECORD AT nME OF ENTRY (Ary and state, or comptete address if known)
WEST DES MOINES, IOWA I
13108 SOUTH 14TH STREET
luaasger,r,towN rowA 50158
8a. LAST DUTY ASSIGNMENT AND MAJOR COMMAND
RCTG CO EUGENE RC
b. STATION WHERE SEPARATED
.JB LEWIS-MCCHORD, WA 98433-9500
9. COMMAND TO WHICH TRANSFERRED
N/A
{0. SGLI GOVERAGE I I NoNE
AMOUNT: $ 400, 000.00
t 1. PRIMARY SPECIALTY (List number, title and years and months in
specialty. List additional specialty numbers and titles involving periods of
one or more years.)
79R34 RECRUTTER 4 YRS B MOS / / g2F3O 8R
PETROLEUM SUPPLY SP L2 YRS 1 MOS / /NOTHTNG
FOLLOWS
12. RECORD OF SERVICE YEAR(S) MONTH(S) DAY(S)
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i. EFFECTIVE DATE OF PAY GRADE
13. DECORATIONS, MEDALS, BADGES, CITATIONS AND CAMPAIGN
RIBBONS AWARDED OR AUTHORIZED 6tt peiods of seruice)
IRAQ CAMPAIGN MEDAL W / TWO CAMPA]GN STARS
/lanuv coMMENDATToN MEDAL (3no AwARD) /lanuv
ACHTEVEMENT MEDAL (3np AWARD) I /JOTNT
MERTTORTOUS UNrT AWARD / /trtUprTORrOUS UNrr
COMMENDATTON//aRUY GOOD CONDUCT MEDAL (3nO
AWARD) //NATIONAL DEFENSE SERVICE MEDAL/ /
GLOBAL WAR ON TERRORTSM//CONr rN BLOCK 18
14. MILITARY EDUCATION (Course title, number af weeks, and rnonth and
year completed)
ADVAhTCED LEADERS CRS , 4 WEEKS , 201-1-llanmY
RECRUTTER, 6 WEEKS, 2008//Mp,,STER RESILIENCE
TRATNER CRS , L WEEK, 2AL4/ /PBTROLEUM SUPPLY
spEcrAlrsr, 10 WEEKS, 2003 / lsterroN
CoMMANDER, 2 WEEKS, 2011//WARRTOR LEADER
cRS, 2 WEEKS, 2005 / /NOTHTNG FOLLOWS
15a. GOMMISSIONED THROUGH SERVICE ACADEMY YES x NO
b. COMMISSIONED THROUGH ROTC SGHOLARSHIP (10 USC Sec. 2107b) YES x NO
c. ENLISTED UttDER LOAN REPAYMENT PROGRAM (r0 USC Chap. 109) (ff Yes, years of commitmenli NA ) YES x NO
16. DAYS ACCRUED LEAVE
PAID 6 O
17. MEMBER WAS PROVIDED COMPLETE DENTAL EXAMINATION AND ALL APPROPRIATE
DENTAL SERVIGES AND TREATMENTWTHIN 90 DAYS PR]OR TO SEPARATION
YES NO
x
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2. CERTIFICATE OF RELEASE OR DISCHARGE FROM ACTIVE DUTY lcontinuation sheet)
This Report Contains lnformation Subject to the Privacy Act ol 1974, As Amended.
,.....'.,''.'...1
z. DEPARTMENT, coMPoNENT AND BRANGH
iiiiii.iiii.i:il
ARMY / RA iiOi:,l
(specifytheitemnumberofthebtockcontinuedtoreachentry) ////////////////////////////////////////////////////////////////
coNT FROM BLOCK 18: AMOUNT: $L5100.00 DA?EDz 201-2LL',J,4//REENLISTMENT BONUS AMOUNT:
$15OOO.OO DATED: 201408L8//CONT FROM BLOCK l-3: EXPEDITIONARY MEDAL//GLOBAL WAR ON
TERRORISM SERVICE MEDAL//NON COMMISSIONED OFF]CER PROFESSIONAL DEVEI,OPMENT RIBBON (2ND
AWARD) //ARMY SERVICE RIBBoN//ovERsEAs SERVICE RIBBON (2ND AWARD) / /GALD RECRUITER BADGE W/
rwo stAR SAPPHIRES//CoMBAT ACTIoN BADGE//DRIVER AND MECHANIC BADGE V{/DRIVER-WHEEI,ED
vEHrcr,E (s) cLASp//NorHrNG FoLLows
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CAUTION: NOT TO BE USED FOR
I DENTI FICATION PU RPOSES
TH]S IS AN IMPORTANT RECORD.
SAFEGUARD IT,
ANY ALTERATIONS IN SHADED AREAS
RENDER FORM VOID
DD FORM 214C, AUG 2OO9 GENERATED BY TRANSPROC MEMBER. 1