. 0. 2015 12:45PM Mil itary_Records_Branch No. 1914 P. 9

CAUTION NOrro 111i USl!D POR IPENllFICA1ION PURPOSES

THIS IS AN IMPORTANT RECORD

8AfEGUARD IT

ANY ALTERATIONS IN SHADED AREAS RENDER FOAM VOID

CERTIFICATE OF RELEASE: OR DISCHARGE FROM ACTIVE DUTY

1 NAME (La$1 PIISI MldtJlaJ 2 DEPARTMENT, COMPONENT AND BRANCH 3 SOCIAL SECURITY NUMBER ARM'i/1>.RNGUS .

4a GRADE, RATE OK RANK II PAY GIWJE 5 OATE OF BIRTH (VVVVWDD) 8 RiS&RVE OILIGATION 11:Rllll""TION DATE SPC B04 (VVVVMMDDJ 00000000 71 PLACE OF ENTRY INTO AC'l'IVE DUTY b HOMI Of RECORD Af TIME OP INTRV t°"¥ and acete or comp/•t• tldorfno rf /urownJ

BRAINTREE, MASSACHUSE'l'TS 8a LAST DUTY ASSIGNMENT AND MAJOR COMMAND b STATION WHERE SEPARATED C CO 1ST BN 18� I�F (LJ (124) FC CAMP SHELBY MS )9407 9 COMMAND TO WHICH TRANSFERRl5D 10 SGLI COVERAGE NONE

COMPANY C 182ND INFANTRY (M!CH) BRAINTR21!: MA 02184 AIIOUNT $400 000 00 11 PRIMARY SPECIAL TV (I.ISi nuniw tlflo II/Kl }'NII efld mofll'IB 111

apKlll/ty LIO( /IOdit/OflB/ speca/ly fllJff'lbetB IHld mlt,5 NIVONlfltJ penods of otJe or mon, )'flB'5)

12 RECORD OF SERVICE VEARl8) MOtmf(9) DAV(S)

11B10 INFANTRYMhN - 13 YRS 3 MOS//NOTHING FOLLOWS

U Dl!CORATIONS 11l!DAl.& BADGES CITATIONS AND CAMPAIGN

• DATE ENTeltiD AD 1M18 PERIOD 2004 05 18 II SEPARATION DATE THIS PEICIOD :3006 07 03

c Nl!T ACTIVE lleRVICE 1HIII PliAIOD 0002 01 16 d TOTAl- PRIOR ACllV& &&IMCE 0000 11 29 • lOTAL PRIOR IMAC11Ve SERVICE 0000 00 00 f fOAEIGN BEill\flOII: 00 01 05 l.G 9 81:ASERVICI: 0000 00 00

RIBBONS AWARDED OR AUTHORIZED (All� ol urvie.1 PURPLE HEART//ARMY COMMXNDATION MEDAL// NATION1',� PEFKNS� SERVICH MSDAL (2ND A��"'RP)// I:RAQ C"1P�IGN MgDAL//GLOBAL �AR ON Tl!:RRORlSM EXPEDITIONARY MEDAL//GLOBM. WAR ON TERRORISM SBRVICE M2DAL//ARMY SERVICE RIBBON (2ND AMAJU>)//OVERSEAS SERVICE RIBBON (2ND AWA!lD) //ARMKD FORCES RESERVE MBDAL//CONT IN BLOCK 18

1, MIU'l'.AJW EDUCATION tCowsetllte ,wmberofKH/ca 1P1dmor,th end yearcomplslod)

COMBAT LIFE SAVER COURSE, l WBEK 2005//NOTHING FOLLOWS

1k MEMBER CONTRIBUTED TO POST VIETNAM ERA VETERANS EDUCATIONAL ASSISTANCE PROt;RAII b JtlGH SCHOOL GRADUATE OR EQUIVALENT

VEI YES

X NO MO

16 DAV8 ACCRUED LEA\'Ei PAID o 18 -�

17 NEMIERWA9 PROVIDEll COa.t.ETE DENTAl EXAMINATION AND L APPROPRIATE DENTAL SERVICES AND TREATIENT NTHIN 90 DAYS PRIOR TO &l!PARATION

X

DD FORM 215 NILL BB ISSUED.TO PROVIDE MISSING INFORMATION//ITEM 12D .ABOVE DOBS NOT �CCOONT FOR ANNUAL AND/OR WEKICRND TRAINI�G 'XHlS SO�DIER "11,Y HAW ACCOM�t1SUEP PRIO� TO DATE Eln'EkJm IN I'I'Et,l J.2.A.//INllIVIPUAL COMl?LETID l?BRIOD FOR WHICH ORDERED TO 1'CTIV'li: DUTY FOR PURPOSE OF POST 86VICE BENEFITS AND ENTITLEMENTS//ORDERED TO ACTIVE DUTY IN SUPPORT OF OPERATION IENDURING/IRAQI FRSBDOM IAW 10 use 12302//MEMBER HJ\S COMPLETED PIRST PULL TBllH OF SD.VICE// /SERVED IN EGYPT PROM 20040?14r2ooso114 // SUVXCE !N Kt.JtilAIT / !AAQ �ROM 20050626 TO 20060610 SE�VBD IN A D!SIONATBP IMMINENT DANG�R P�Y A�:tA // ARCOM WITH V-DBVICE.-2////CONT FROtJ BLOCK l3 W/ M DBVICK (3RD AWARD)//MULTINATIONAL FORCE AND OBS!RV!RS MBDAL//COMBAT INFANTRYMAN BADGE//EXPBRT INFANT.RYMAN BADGB//PARACHUTIST BAOOB//NOTHING �OLLOWS

ihe llll'ormation containad ti...n 11 IKq&cl IO carnpulaf �ng Wlltt11 lhe Department of Oelv11• or will! er,y Olher 11ffDc:11d Fodetal or non Federal aaen� torvtnllcation llnC! to delllllllll8 el tor ■lldlar conllnued cgm 111nce WIii! 11\e ll1el\ll Off • Fllldeta benelll m

23 TYPE OF SEPARATION RELEASE FROM ACTIVE

COMPLETION 0� REQUIRJ!!b ACTIVE SERVICE Z9 DATES OF TIME LOST DURING THIS PERIOD (YVYVMMDDJ

lilONli: DD FORM 214•AUTOMATED, FEB 2000 PREIIIOUS EDI TIOti IS 08&O!.l!l

f

. GENERATED BYTAAHSl'ROC STATE DIRECTOR OF VETeRAN8 OF APfAIRS II