IDENTIFICATION PURPOSES.
SAFEGUARD IT.
RENDER FORM VOID
CERTIFICATE OF RELEASE OR DISCHAGE FROM ACTIVE DUTY
1. NAME (Last, First, Middle)
HAMEL James David
2. DEPARTMENT, COMPONENT AND BRANCH
USMC-11
3. SOCIAL SECURITY NUMBER
(b)(6)
4a. GRADE, RATE OR RANK
Cpl
b. PAY GRADE
E-4
5. DATE OF BIRTH (YYYYMMDD)
19840802
6. RESERVE OBLIGATION TERMINATION DATE (YYYYMMDD)
20110425
7a. PLACE OF ENTRY INTO ACTIVE DUTY
Louisville MEPS
Louisville, KY 40202
b. HOME OF RECORD AT TIME OF ENTRY (City and state, or complete address if known)
(b)(6)
8a. LAST DUTY ASSIGNMENT AND MAJOR COMMAND
MALS-14 MAG-14 2DMAW MARFORCOM
b. STATION WHERE SEPARATED
MCAS CHERRY POINT NC 28533 (RUC 45124)
9. COMMAND TO WHICH TRANSFERRED
MOBILIZATION COMMAND 15303 ANDREWS RD KANSAS CITY MO 64147-1207 (36005)
10. SGLI COVERAGE (b)(6) NONE
AMOUNT: (b)(6)
11. PRIMARY SPECIALTY (List number, title and years and months in specialty. List additional specialty numbers and titles involving periods of one or more years.)
| 4341 - | Combat Correspondence 3 years 4 months |
| 12. RECORD OF SERVICE | YEAR(S) | MONTH(S) | DAY(S) |
| a. DATE ENTERED AD THIS PERIOD | 2003 | 09 | 22 |
| b. SEPARATION DATE THIS PERIOD | 2007 | 09 | 21 |
| c. NET ACTIVE SERVICE THIS PERIOD | 04 | 00 | 00 |
| d. TOTAL PRIOR ACTIVE SERVICE | 00 | 00 | 00 |
| e. TOTAL PRIOR INACTIVE SERVICE | 00 | 04 | 26 |
| f. FOREIGN SERVICE | 00 | 05 | 24 |
| g. SEA SERVICE | 00 | 00 | 00 |
| h. EFFECTIVE DATE OF PAY GRADE | 2005 | 09 | 01 |
13. DECORATIONS, MEDALS, BADGES, CITATIONS AND CAMPAIGN RIBBONS AWARDED OR AUTHORIZED (All periods of service)
Marine Corps Good-Conduct Medal, Navy and Marine Corps Achievement Medal, Iraq Campaign Medal, Sea Service Deployment Ribbon, Global War on Terrorism Service Medal, National Defense Service Medal, Letter of Appreciation (5th Awd), Meritorious Mast, Certificate of Appreciation, Rifle Expert Badge (2nd Awd), Pistol Expert Badge
14. MILITARY EDUCATION (Course title, number of weeks, and month and year completed)
Recruit Training 2003, Marine Combat Training 2004, Information Specialist (Journalist) 2004
15a. MEMBER CONTRIBUTED TO POST-VIETNAME ERA VETERANS' EDUCATIONAL ASSISTANCE PROGRAM(b)(6) YES (b)(6) NO
15a. MEMBER CONTRIBUTED TO POST-VIETNAME ERA VETERANS' EDUCATIONAL ASSISTANCE PROGRAMb. HIGH SCHOOL GRADUATE OR EQUIVALENT(b)(6) YES (b)(6) NO
16. DAYS ACCRUED LEAVE PAID
(b)(6)
17. MEMBER WAS PROVIDED COMPLETE DENTAL EXAMINATION AND ALL APPROPRIATE DENTAL SERVICES AND TREATMENT WITHIN 90 DAYS PRIOR TO SEPARATION
YESNO
(b)(6)
18. REMARKS
Subject to active duty recall and or annual screening.
While a member of the Marine Corps Reserve, you will keep the Commanding General, Mobilization Command (Toll free 1-800-255-5082, or if within the State of Kansas call commercial (816) 843-3806 DSN 894-3806) informed of any change of address, marital status, number of dependents, civilian employment, or physical standards.
(b)(6)
Good Conduct Medal period commences: (b)(6)
PMA Telephone (b)(6)
Serial Number (b)(6)
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.
19a. MAILING ADDRESS AFTER SEPARATION (Include ZIP Code)
(b)(6)
b. NEAREST RELATIVE (Name and address - include ZIP Code)
(b)(6)
20. MEMBER REQUESTS COPY 6 BE SENT TO ___(b)(6)___ DIRECTOR OF VETERANS AFFAIRS(b)(6) YES (b)(6) NO
21. SIGNATURE OF MEMBER BEING SEPARATED
(b)(6)
22. OFFICIAL AUTHORIZED TO SIGN (Type name, grade, title and signature)
(b)(6)
SPECIAL ADDITIONAL INFORMATION (For use by authorized agencies only)
23. TYPE OF SEPARATION
(b)(6)
24. CHARACTER OF SERVICE (Include upgrades)
(b)(6)
25. SEPARATION AUTHORITY
(b)(6)
26. SEPARATION CODE
(b)(6)
27. REENTRY CODE
(b)(6)
28. NARRATIVE REASON FOR SEPARATION
(b)(6)
29. DATES OF TIME LOST DURING THIS PERIOD (YYYYMMDD)
(b)(6)
30. MEMBER REQUESTS COPY 4 (Initials)
(b)(6)
