CAUTION: NOT TO BE USED FORI 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DD FORM 214, AUG 2OO9 PREVIOUS EDITION IS OBSOLETE.GENERATED BY TRANSPROC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 AREASRENDER FORM VOID
MEMBER.l
CERTIFICATE OF RELEASE OR DISCHARGE FROM ACT]VE DUTYThis Report Contains Information Subject to the Privacy Act of 1974, As Amended.
2, DEPARTMENT, GOMPONENT AND BRANCHARMYIRA
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I7a. 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 STREETluaasger,r,towN rowA 50158
8a. LAST DUTY ASSIGNMENT AND MAJOR COMMANDRCTG CO EUGENE RC
b. STATION WHERE SEPARATED.JB LEWIS-MCCHORD, WA 98433-9500
9. COMMAND TO WHICH TRANSFERREDN/A
{0. SGLI GOVERAGE I I NoNE
AMOUNT: $ 400, 000.00t 1. PRIMARY SPECIALTY (List number, title and years and months in
specialty. List additional specialty numbers and titles involving periods ofone or more years.)
79R34 RECRUTTER 4 YRS B MOS / / g2F3O 8RPETROLEUM SUPPLY SP L2 YRS 1 MOS / /NOTHTNGFOLLOWS
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 CAMPAIGNRIBBONS AWARDED OR AUTHORIZED 6tt peiods of seruice)
IRAQ CAMPAIGN MEDAL W / TWO CAMPA]GN STARS/lanuv coMMENDATToN MEDAL (3no AwARD) /lanuvACHTEVEMENT MEDAL (3np AWARD) I /JOTNTMERTTORTOUS UNrT AWARD / /trtUprTORrOUS UNrrCOMMENDATTON//aRUY GOOD CONDUCT MEDAL (3nOAWARD) //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-llanmYRECRUTTER, 6 WEEKS, 2008//Mp,,STER RESILIENCETRATNER CRS , L WEEK, 2AL4/ /PBTROLEUM SUPPLYspEcrAlrsr, 10 WEEKS, 2003 / lsterroNCoMMANDER, 2 WEEKS, 2011//WARRTOR LEADERcRS, 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 LEAVEPAID 6 O
17. MEMBER WAS PROVIDED COMPLETE DENTAL EXAMINATION AND ALL APPROPRIATEDENTAL SERVIGES AND TREATMENTWTHIN 90 DAYS PR]OR TO SEPARATION
YES NO
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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
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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 ONTERRORISM SERVICE MEDAL//NON COMMISSIONED OFF]CER PROFESSIONAL DEVEI,OPMENT RIBBON (2NDAWARD) //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,EDvEHrcr,E (s) cLASp//NorHrNG FoLLows
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CAUTION: NOT TO BE USED FORI DENTI FICATION PU RPOSES
TH]S IS AN IMPORTANT RECORD.SAFEGUARD IT,
ANY ALTERATIONS IN SHADED AREASRENDER FORM VOID
DD FORM 214C, AUG 2OO9 GENERATED BY TRANSPROC MEMBER. 1