SolaeannA ARERR — Pon
CAUTION: NOT TO BE USED FOR THIS IS AN IMPORTANT RECORD. ANY ALTERATION HADI EAS
IDENTIFICATION PURPOSES RENDER FORMA VOAD
CERTIFICATE OF RELEASE OR DISCHARGE FROM ACTIVE DUTY
4. NAME (Last First, Middle)
7a. PLACE OF ENTRY INTO ACTIVE DUTY b. HOME OF RECORD AT TIME OF ENTRY (City and state, or complete address if known)
ATLANTA, GEORGIA
3952 CORONET DRIVE
ICOLUMBUS_GEORGIA 31907
Ga, LAST DUTY ASSIGNMENT AND MAJOR COMMAND. b. STATION WHERE SEPARATED
0518SCTIN HEC G6 FORT GORDON, GA 30905-5020
9. COMMAND TO WHIGH TRANSFERRED
USAR CON GP (REINF) 1 RESERVE WAY, ST LOUIS, MO 63132 AMOUNT: $400,000.00
41. PRIMARY SPECIALTY (List number, title and years and months in 12. RECORD OF SERVICE YEAR(S) MONTH(S) DAY(S)
specialty. List additional specialty numbers and titles involving periods of a. DATE ENTERED AD THIS PERIOD 20048 Ses (ea
one or more years.)
25010 MULTICH TRANS OP/MNT - 3 YRS 7 MOS// b. SEPARATION DATE THIS PERIOD The IL we lees
NOTHING FOLLOWS C.NETACTIVESERVICETHISPERIOD 0004 01 10
d. TOTAL PRIOR ACTIVE SERVICE 0000 oo oo
e. TOTAL PRIOR INACTIVE SERVICE oooo0 oo oo
f. FOREIGN SERVICE (COO 2ms O 2am m2
ean service RARER NA 900007 et00 = 7500-0]
REFFECTIVEDATEOFPAYGRADE 2006 05 13 -
73. DECORATIONS, MEDALS, BADGES, CITATIONS AND CAMPAIGN 14. MILITARY EDUCATION (Course title, number of weeks, and month and
RIBBONS AWARDED OR AUTHORIZED (All periods of service) year completed)
ARMY GOOD CONDUCT MEDAL//NATIONAL DEFENSE IMULTICHAN TRANS SYS OPER/MAINT CRS, 2004//
45a, MEMBER CONTRIBUTED TO POST-VIETNAM ERA VETERANS’ EDUCATIONAL ASSISTANCE PROGRAM
b. HIGH SCHOOL GRADUATE OR EQUIVALENT
16. DAYS ACCRUED LEAVE 47. MEMBER WAS PROVIDED COMPLETE DENTAL EXAMINATION AND ALL APPROPRIATE
PAIDO DENTAL SERVICES AND TREATMENT WITHIN 90 DAYS PRIOR TO SEPARATION
18. REMARKS V1, TITITTITATUTT TTT ATTLG TTT TT TAT TLL AA TA LAL LAT
SUBJECT TO KEL Sone REAL! HOSTER DUTY AND/OR ANNUAL SCREENING//BLOCK 6, PERIOD OF
DELAYED ENTRY PROGRAM: 20040405-20040512//SERVICE IN KUWAIT 20061021-20080113//MEMBER HAS
COMPLETED FIRST FULL TERM OF SERVICE//NOTHING FOLLOWS
‘The information contained herein is subject to computer matching within the Department of Defense or with any other affected Federal or non-Federal agency for
Verification purposes and to determine eligibility for, and/or continued compliance with, the requirements of a Federal benefit program.
49a. MAILING ADDRESS AFTER SEPARATION (include ZIP Code) b. NEAREST RELATIVE (Name and address — include ZIP Code)
BLAIR A WEBB
3952 CORONET DRIVE 3952 CORONET DRIVE
COLUMBUS GEORGIA 31907 COLUMBUS GEORGIA 31907
20. MEMBER REQUESTS COPY 6 BE SENT TO GA
21. SIGNATURE OF MEMBER BEING SEPARA 22. OFFICIAL AUJAORIZED TO SIGN (Typed name, grade, title and signature)
PS
24, CHARACTER OF SERVICE (Incfiide lpg
om
HONORABLE =
26. SEPARATION CODE
MBK