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APPLICATION FOR CERTIFIED COPY OR PHOTOCOPY OF MILITARY RECORD
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APPLICATION FOR CERTIFIED COPY OR PHOTOCOPY OF MILITARY RECORD 1. Date of Application _______________ 2. Type of copy (check one) ______ Certified ______ Photocopy 3.
NAME OF VETERAN ________________________________________ 4. Birthdate of Veteran _____________________ 5. Relationship of the person or agency receiving this copy to person named on the DD 214: ____Self ____Immediate Family and relationship: ___________________ ____Authorized Agent/Representative: (check one) Power of Attorney ____, Funeral Director ____, Attorney ____, Other (explain relationship) ________________ ____75-year old record ____Ordered by court ____Required by federal or state government or political subdivision (example: VA director, etc.) 6.
Reason for needing this copy: ___________________________________ 7. _________________________ _________________________ Applicant 9s signature Daytime Phone Number 8. Name and address of person receiving this copy (REQUIRED) Name: ______________________________________________ Street: ______________________________________________ City, State, Zip: _______________________________________ *** If mailing, please send photocopy of driver 9s license***
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- Username: fishero
- Name: Arago
- Category: Home > Military
- Added: 09:30 ← 21 Jul 2010
- Views: 386
- Downloads: 0
- File size: 16.9 KB
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- Status: Public
- Tags: application, certified, copy, photocopy, military, record
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