AN IN RT RECORDSAFEGUARD IT. ¿Cy&wc<2.

1. LAST NAME - FIRST NAME - MIDDLE NAME . 2. SERVICE NUMBER 3, SECURITY NUM

ERICK RA 19 \i

4. DEPARTMENT. COMPONENT AND BRANCH OR CLASS Sa, GRADE, RATE OR RANK b. PAY 6 DAT, DAY MONTH YEAR

ARMY RA unson ser (T) T¶ER K

L U. S. CIT E 8. PLACE OF BIRTH (City andState or Country) 9. DAY MONTH YEAft

PAYETTE Inano,°,

', M10a. SELECTIVE SERVïCE NUMBER b. SELECTIVE SERVICE LOCAL BOARD NUMBER. CITY, COUNTY. STATE AND ZIP CODE c. DATE INDUCTED

DAY MONTH VEAR

1 LB #2 WISER IDAEO SA1¾a. TYPE OF TRANSFER OR DISCNARGE b. STATION OR INSTALLATION AT WHICH EFFECTED

TRED TO USAR SEE ITEM #16 US ARMY PERSOTHEL CENTE OAKLAND CALIFOMIAc. REASON AND AUTHORITY d. DAY MONTH YEAR

SEC VII CE 5 AR 635-200 SPr 411 osmT (RAD) EF TIVE

12. LAST DUTY ASSIGNMENT AND MAJOR CommAND 3a. CHARACTER OF SERVICE b. TYPE OF CERTIFICATE [SSUED

USARY APO 96266 HONORABLE NONE14. DISTRICT, AREA COMMAND OR CORPS TO WFt!CH RESERVIST TRANSFERRED 15. REENLISTMENT CODE

USAR CONTROL GROUP REIEF US ARKf ADMIN CKHTER ST LOUIS MO RE 116.TERMINAL DATE OF RESERVEi 17. CURRENT ACTlVE SERVfcE OTHER THAN SY INDUCTION b. TERM OY c. DATE OF ENTRYUMT&S OBL1GATION ydOURCE OF ENTRY. SERVICEDAY Mogyn Í YEA (Years) DAY MONTH YEAR

ENLisTED (First Enfietment) O ENLISTED ( or Service) FIEENLISTED

OTHER

18. PRIOR REGULAR ENLISTMENTS 19. GRADE, RATE OR RANK AT TIME OF 20. PLACE OF ENTRY INTO CURRENT ACTIVE SERVICE (City andState)

NONE Ñ Re av active svc BOISE IDAllO21. HOME OF RECORD AT TIME OF ENTRY INTO ACTIVE SERVICE 22. STATEMENT OF SERVICE YEARS MONTHS DAYS

Sr et, RF City, County, State and ZIP Code)a. (!) NET SERVICE Tuts PERIOD

FORR ED AcBPY f2) OTifER RERVtCE

PURPOSES2aa.sPEC ALTY NUMBER & TITLE b. RELATED CIVILIAN OCCUPATION AND 83) TOTA£,[Z.Ineft.hpfue I.Ine(2)}D,0.T. NUMBER

b- TOTAL ACTivE BERvicE

OPKS & INTEL SP NA c. FÒREIGN AND/OR SEA SERVICE24. DECORATIONS, MEDALS, BADGES. COMMENDATIONS, CITATIONS AND CAMPA1GN RIBBONS AWARDED OR.AUTHORIZED

KATIONAL DEF2BiBE SERVICE i šDAL VIETNAM SERVIU ISDALCOMBAT INFANTRYMAN BADGE PURPLE HEARTVIETNAM CAMPAIGN MEDAL

25. EDUCATION AND TRAINING COMPLETED

LT wras Ixy USArc Oggy 8 wa 65in conFarm rec rem-gy AUS om, M. 2 8 Wo 66

RAmo TEL OPER syTo IT 3RAGG TY 16 «s €7

196

26a. NON AY PERIODS TIME LOST (Preceding b. OAYS ACCRUED LEAV PAID S N A LLOTMENT c, MO ALLUOTDMENT

NONE 19 "" I"° 6 NA NA28. VA CLAIM NUMBER 29. SERVICEMEN*S GROUP LlFE INSURANCE COVERAGE

C. 580,000 Q 55.00 NONE

SO. REMARKS

ITEM #5A: SPA 84 (P) APTU: a ya 68 von: 1 Ana 67CIVILIBi EDUCATIO 12 YESBLOOD GROUP:

3L PERMANENT ADDRESS.FOR MAILING PURPOSES AFTER TRANSFER OR DISCHARGE 32. SIGNATURE OF PERSON BEING TRANSFERRED OR DISCHARGED(Street, RFD. City, County, State and ZIP Code)

BOX 3T9COTECIL IDAHO 83612 i

AME. GRADE AND TITLE OF AUTHORIZING OFFICER 24. SsŠNATU DF A HORIZED SIGN

E. T. FISCH2R BLT AGC MST ADJ 6Il0

CAUTION: NOT TO BE USED FOR IDENTIFICATIONPURPOSES ANY ALTERATIONSIN SHADED AREAS RENDERFORMVOIDi

CORRECTIONTO DD FORM 214,CERTIFICATEOF RELEASE OR DISCHARGEFROM ACTIVEDUTY

This Report Contains Information Subject to the Privacy Act of 1974, As Amended.

1. NAME (Last Fast ivliddle) 2. DEPARTMENT,COMPONENTAND BRANCH 3. SOCIAL SECURITYNUMBERERICK ARMY/RA/UNASGD (Also. Service Numberif applicable)

4. MAILING ADDRESS (Include ZIP Code)

1012 BOSTON STREET, CLARKSTON, WASHINGTON 99403

5. ORIGINAL DD FORM 214 IS CORRECTEDAS INDICATEDBELOW:

ITEM NO. CORRECTEDTO READSEPARATION DATE ON DD PORM214 BEINGCORRECTED: 19 6 8 / 0 6 / 0 6

24 ADD: BRONZE STAR MEDAL WITH ONE BRONZE OAK LEAF CLUSTER AND "V" DEVICE//NOTHINGFOLLOWS

6. MEMBEF REQUESTSCOPY6 BE SENT TO (Specify statellocality) WA OFFICEOF VETERANSAFFAIRS X YES No

a. MEMBEI REQUESTSCOPY 3 BE SENT TO THE CENTRALOFFICEOF THE DEPARTMENTOF VETERANSAFFAIRS I

(WASHI JGTO 1, DC)X YES NO

7. DATE 8. OFFICIALAUTHORi2EDTO SIGN(YYYYMMDDI a. TYPED NAME (Last. First, Middle initial) b. GRADE c. TITLE U

20140219 CPT ASST CH, PLANS &OPERATIONS

DD FORM 215, AUG 2009 PREVIOUSEDITIONIS OBSOLETE. MEMBER-1GENERATED BY TRANSPROC