CAUTION: NOT TO BE USED FOR

IDENTIFICATION PURPOSES
THIS IS AN IMPORTANT RECORD.
SA*;EGUARD IT.
ANV ALTERATIONS IN SHADED
AREAS RENDER FORM VOID
CERTIFICATE OF RELEASE OR DISCHARGE FROM ACTIVE DUTY
1. N A M E (Last. First, Middle)
DUSZA CHRISTOPHER ALAN
2. DEPARTMENT. COMPONENT AND BRANCH
NAVY-USN
3. SOCIAL SECURITY NO.

4.a, GRADE. RATE OR RANK
AD3
4.b- PAY GRADE
E4
5. DATE OF BIRTH (YYMMOD)
69JUN12
I 6. RESERVE OBLIG.TERM. DATE
[Year 94 Jjvlonth 11[Day 17
7.a. PLACE OF ENTRY INTO ACTIVE DUTY
CHICAGO IL
7.b HOME OF RECORD AT TIME OF ENTRY (City and State, or complete
address if known)
WILLOW SPRINGS IL
8.a. LAST DUTY A SSIGN M E N T A N D M A JOR COM M A N D
NAVAL WEAPONS CENTER CHINA LAKE CA
8.b. STATION WHERE SEPARATED
PERSUPPDET CHINA LAKE CA
9. COMMAND TO WHICH TRA N SF E RRE D
NAVAL RESERVE PERSONNEL CENTER NEW ORLEANS LA 70149
10. SGLI COVERAGE | |None
Amount: S 100,000
11. PRIMARY SPECIALTY(Lift number, title and years and months in
specialty. List additional specialty numbers and titles involving
periods of one or more years.)
8331-A6 SYSTEM ORGAN. MAINT. TECHNICIAN-2YRS
12. RECORD OF SERVICE Year(s)
a. Date Entered AD This Period
87
b. Separation Date This Period
91
C. Net Active Service This Period
04
d. Total Prior Active Service
00
e. Total Prior Inactive Service
00
f. Foreign Service
00
g. Sea Service
00
h. Effective Date of Pay Grade
89
Month(s)
ATTG
AUG
00
00
09
00
00
MAY
Dayfe)
20
20
00
00
00
00
16
13. DECORATIONS, M E DA LS, B A DGE S, CITA TION S A N D CA M PA IGN RIB B ON S A WA RDE D OR A UTHORIZE D (All periods of service)
NATIONAL DEFENSE SERVICE MEDAL, FIRST GOOD CONDUCT AWARD PERIOD ENDING 91AUG20, NAVY
ACHIEVEMENT MEDAL
14. MILITARY EDUCATION (Course title, number of weeks, and month and year completed)
ENLISTED BASIC AVIATION TRAINING CLASS AP, 10DAYS, NOV87; AD CLASS "A" SCHOOL, 7.75WKS, FEB88
AE P-P/RELAT SYSTEMS, 1WK, APR88
15.a. MEMBER CONTRIBUTED TO POST-VIETNAM ERA
VETERANS' EDUCATIONAL ASSISTANCE PROGRAM
X
IS.b HIGH SCHOOL GRADUATE OR
EQUIVALENT
X
NO |16. DAYS ACCRUED LEAVE PAID
0- 5
17. MEIIBHt WAS PROVIDED COMPLETE DENTAL EXAMINATION AND ALL APPROPRIATE DENTAL SERVICES AND TREATMENT WITHIN 90 PAYS PRIOH TO SEPARATION | ||No
18. REMARKS
DD FORM 214 ABMINlSTRATIVELt ISSUED ON 91AUG20 IAW NMPCINST 1900. IB.
DENTAL GLASS II DENTAL EXAMINATION COMPLETED ON ' 9UOB26 ' ..
- ' - " . : ' . 1JEPT-48 DISCHARGE
. TIS8B 8 IRAN 2752
' '
OK5K Q3UNTY
19.a MAILING ADDRESS AFTER SEPARATION (Include Zip Code)
214 KILL Sf "
WILLOW SPRINGS IL 60480
(Typed name, grade, f f t f e and
HN CSfSS) DET SCPO
19.b. N E A RE ST RE LA TIVE (Name and address- include Zip Code)
WALTER W DUSZA _J
IL 60480
DD Form 214, NOV 88 S/ N 0102-LF-006-5500 Previous editions are obsolete.
MEMBER 1
UTO TRASSFE8RSD 10 RAVAL RESERVE
25. SEPARATION AUTHORITY
fTTFKH,RMAff M79199
28. NARRATIVE REASON FOR SEPARATION
J5H RKLK&SE rROn ACTIVE DimAMD TKAnSFKK TO Ifc
29. DATES OF TIME LOST DURING THIS PERIOD
rL-aoNE
HONORABLE
26. SEPARATION CODE
UK
kVAL KKSEKVC
27. REENTRY CODE
B1-R1
30. MEIBER REQUESTS COPY 4
Ct&j Initials
DD Form214. NOV 88 S/N 0102 -LF-006 -5500 Previous editions are obsolete.
MEMBER - 4