Dd form 257a

dd form 2521, oct 2000. hazardous chemical warning label . 1. chemical/common name 2. hazard code 3. nsn/lsn 4. part number 5. item name 9. hazards (x all that apply) (1) acute (immediate) none slight. moderate severe (2) chronic (delayed) a. health . b. contact c. fire . d. reactivity . 7. specific hazards and precautions

Dd form 257a. We would like to show you a description here but the site won’t allow us.

The Navy Personnel Command can only issue the Honorable Discharge (DD Form 256N) certificate. The certificate may be issued in connection with a BCNR/NDRB action. Otherwise, the following persons are entitled to receive an administratively issued certificate. The person who performed the service. A person presenting a power of attorney signed ...

Specifically,this revision--o Mandates that the DD Form 214 (Certificate of Release or Discharge from ActiveDuty) be issued for all void service (para 2-1a).o Requires mandatory information on the DD Form 214, item 18 (para 2-4h (18)).o Allows authentication of the DD Form 214 by a soldier in the grade of SSG or byan authorized contractor ...DD Form 257A General Discharge Certificate (Under Honorable Conditions). READINGS RECOMMENDED . These readings contain relevant supplemental information. AR 15-130 Army Clemency Board.BOARD DATE: 6 March 2020 DOCKET NUMBER: AR20190005395 APPLICANT REQUESTS: Her general discharge be upgraded to an honorable discharge. APPLICANT'S SUPPORTING DOCUMENTS CONSIDEREDdd form 257a copy furnished: the adjutant general attn: agpr-f w-t . j t. l ' r • t . l '. hq texas military district american statesman bldg 7th a colorado streets austin, texas official busihii6s penalty for private use to avoid • payment of postage, $800 (pmgc) ...We would like to show you a description here but the site won't allow us.Feb 8, 2006 ... In any of these circumstances, the officer will be discharged under honorable conditions and issued a DD Form 257A. b. Enlisted personnel ...It is used by services in addition to the DD 214 and has a service designation at the end of it (i.e. DD 256 AF or DD 256 CG). What is a type of Army certification issued dd form 257A?

PREVIOUS EDITION IS OBSOLETE. DD FORM 577, NOV 2014 APPOINTMENT/TERMINATION RECORD - AUTHORIZED SIGNATURE (Read Privacy Act Statement and Instructions before ...We would like to show you a description here but the site won't allow us.DD Forms 2000-2499 (updated 4/30/2024) Form Availability. If the form number does not have a hyperlink, the form is not available electronically. To obtain hard copies of current forms not available in electronic format, please contact your own Military Service or DoD Component Forms Management Officer. Cancelled forms are not …DoD GTCC Regulations. DD FORM 3120, MAR 2021. DOD GOVERNMENT TRAVEL CHARGE CARD (GTCC) STATEMENT OF UNDERSTANDING (SOU) The Government Travel Charge Card (GTCC) must be used by DoD personnel to pay for all authorized expenses, to include meals, when on official travel unless an exemption is granted. This includes temporary duty travel (TDY ...15. In support of his application, the applicant provides the following documents. a. DD Form 214 with an effective date of 12 December 1973 and DD Form 257A, dated 12 December 1973, that show, in pertinent part, the ADRB upgraded the applicant's discharge to a general, under honorable conditions discharge on 10 February 1981. b.Nov 4, 2019 ... DD FORM 257A. 15. REENLISTMENT CODE. 72. 16. TERMINAL DATE OF RESERVE/ 17. CURRENT ACTIVE SERVICE OTHER THAN BY INDUCTION. UMT&S OBLIGATION. DAY.DD Form 2579, "Small Business Coordination Record" Author: WHS Created Date: 3/4/2024 12:32:13 PM ...(a) The contracting officer must prepare DD Form 254, Contract Security Classification Specification (illustrated in FAR 53.303-DD-254), for contracts involving contractor access to classified information. This form identifies for contractors the areas of classified information involved. The contracting officer may use written notice of classification for research or service contracts.

DD Form 500-999; DD Form 1000-1499; DD Form 1500-1999; DD Form 2000-2499; DD Form 2500-2999; DD Form 3000-3499; Other Forms; Secretary of Defense (SD) Forms; ODA&M Forms; Washington Headquarters Services (WHS) Forms; ... Form Availability. If the form number does not have a hyperlink, the form is not available electronically. ...12. The applicant was discharged on 30 July 1981, under the provisions of Army Regulation 635-200, paragraph 13-4c, and his service was characterized as under honorable conditions. His DD Form 214 shows in: a. Item 12c (Net Active Service this Period), he was credited with completing, 2 years, and 26 days of active service. b.ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS IN THE CASE OF: BOARD DATE: 26 July 2019 DOCKET NUMBER: AR20190008014 APPLICANT REQUESTS: His under honorable cSUMMARY of CHANGE AR 635-5 Separation Documents This regulation has been streamlined to avoid duplication of data, and updated to reflect mandatory required data on the DD Form 214 throughout. Specifically, this revision-- o Mandates that the DD Form 214 (Certificate of Release or Discharge from Active Duty) be issued for all void service (para 2-1a).

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Instructions for Filing Forms. Minority Workforce Utilization Report (Form cc-257 AND cc-257a) Cumulative Minority Workforce Utilization Report (Form cc-257b) Small Contractor and MBE Status Report (Form cc-258a) Monthly Materials Consumption Report (Form cc-259) Map of CT Metropolitan Statistical Areas. ATTENTION: Effective 10/10/2023, all ...What is a DD Form 257a? (2) DD Form 214 (Certificate of Release or Discharge from Active Duty). (6) DD Form 257A (General Discharge Certificate Under Honorable Conditions). (7) DD Form 363A (Certificate of Retirement). (8) DD Form 2542 (Certificate of Appreciation For Service in the Armed Forces of the United States).FORM INFORMATION. Form Number: DD 2058. Title: State of Legal Residence Certificate. Edition Date: 01/01/2018. Authority: DoD 7000.14-R, Vol 7, Ch 1. Form Issue? Please Contact: The Defense Finance and Accounting Service (DFAS) The official website for the Executive Services Directorate.Microsoft PowerPoint - Benefits at Separation chart. BENEFITS AT. Honorable DD Form 256A. SEPARATION. General Under Honorable Conditions DD Form 257A. E Eligible. Other Than Honorable. NE Not Eligible TBD To be determined by Administering Agency DV Eligibility for these benefits depend upon specific disabilities of the veteran. “4”.*** The DD Form 214 has been issued by all military services since January 1, 1950. Before January 1, 1950, several similar forms were used by the military services. **** NGB Form 22 can be used to verify eligibility if it indicates prior active federal service other than for training or a minimum of 20 years total service for pay.

issued a DD Form 257A (General Discharge Certificate). 9. The applicant was discharged on 1 June 1972. The DD Form 214 he was issued . confirms he was discharged under the provisions of Army Regulation 635-200 and . DA Message 242110Z September 1971. His service was characterized as under . honorable conditions (general). The Navy Personnel Command can only issue the Honorable Discharge (DD Form 256N) certificate. The certificate may be issued in connection with a BCNR/NDRB action. Otherwise, the following persons are entitled to receive an administratively issued certificate. The person who performed the service. A person presenting a power of attorney signed ... We would like to show you a description here but the site won’t allow us.We would like to show you a description here but the site won't allow us.We would like to show you a description here but the site won't allow us.You must have the following information to complete the form properly: Your name, signature, and date. The name of the person you are authorizing to receive information on your behalf. The date that you would like the consent to expire. Your sponsor number (the Social Security Number of the family member who served)IN THE CASE OF: BOARD DATE: 18 May 2010 DOCKET NUMBER: AR20090018827 THE BOARD CONSIDERED THE FOLLOWING EVIDENCE: 1. Application for correction of military records (with supportinSelect the Get Form button to start enhancing. Turn on the Wizard mode in the top toolbar to have additional suggestions. Fill out every fillable field. Ensure that the data you add to the Dd257 Form is up-to-date and correct. Include the date to the sample using the Date option. Click the Sign button and make an electronic signature.APPLICANT'S SUPPORTING DOCUMENTS CONSIDERED BY THE BOARD: * DD Form 149 (Application for Correction of Military Record) * DD Form 257A (General Discharge Certificate), 26 August 1965 FACTS: 1. ... * DD Form 257A (General Discharge Certificate), 26 August 1965 FACTS: 1. The applicant did not file within the three-year time frame provided in ...15. In support of his application, the applicant provides the following documents. a. DD Form 214 with an effective date of 12 December 1973 and DD Form 257A, dated 12 December 1973, that show, in pertinent part, the ADRB upgraded the applicant’s discharge to a general, under honorable conditions discharge on 10 February 1981. b.

Lawyer's Assistant chat. Customer: dischared in 1975 with TC-300 need infomati on type of discharge it is. Answered by PhilCave in 4 hours 14 years ago. PhilCave. 33+ years of experience. 640 satisfied customers. Specialities include: Military Law, Rights, Benefits, Tax Exemptions, Claims Questions.

DD FORM 1701 PDF995 DOWNLOAD DD FORM 1701 PDF995 READ ONLINE Retiree and Dependent ID Cards - What You Should Know DD…DD - No. 2 outlet 90 CW from inlet Design Rotation (Viewed form shaft end of pump) L - Left hand for counterclockwise R - Right hand for clockwise Special Suffix 167 -2-bolt, 5” dia. pilot (25**V only - N/A for VS or VM models) 12 7 9 10 12 Note: For options other than listed in the model code, i.e. shafts, ports,The separation authority approved the recommended action on 16 July 1987 and directed the issuance of a DD Form 257A (General Discharge Certificate). 13. The applicant was discharged on 25 July 1987, under the provisions of Army Regulation 635-200, paragraph 14-12c, by reason of misconduct - commission of a serious offense.(a) Use the DD Form 2579 as prescribed in DFARS 219.201 (c)(10)(B). (b) General instructions. (1) The Contracting Officer is responsible for the coordination and completion of the form. (2) Coordination on this form is not required when the agency will satisfy a requirement through the use of a mandatory source listed at FAR 8.002 or FAR 8.003.A Discharge Certificate (DD Form 256A, DD Form 257A, DD Form 258A, DD Form 259A, DD Form 260A, depending on the character of discharge) is not normally given until the completion of the six year obligatory enrollment in the Reserves under the Selective Service and Training Act of 1952. The Army can, for one of several reasons (e. g. medical ...DD Form 1000-1499; DD Form 1500-1999; DD Form 2000-2499; DD Form 2500-2999; DD Form 3000-3499; Other Forms; Secretary of Defense (SD) Forms; ODA&M Forms; Washington Headquarters Services (WHS) Forms; Standard Forms (SF) ... Form Availability. If the form number does not have a hyperlink, the form is not available …Mar 22, 2018 · DO-257A supports the electronic depiction of airport surface situation awareness (SA) maps and vertical situation awareness displays. The revision includes requirements and guidelines for the... RTCA DO-257 DD 256AF Honorable Discharge Certificate DD 256CG Honorable Discharge Certificate DD 256MC Honorable Discharge Certificate DD 256N Honorable Discharge Certificate …Former or current members of the National Guard or Reserves are not considered to be veterans unless they had prior or subsequent service with an active component of the Armed Forces (activated to federal service).Since the DD Form 214 is issued to those leaving the active military as well as to members of the National Guard and Reserves completing their initial active duty for training ...FORM INFORMATION. Form Number: DD 2910-7. Title: High Risk Response Team (HRRT) Meeting Notes for the Sexual Assault Prevention and Response (SAPR) Program. Edition Date: 06/07/2023. Authority: DoDI 6495.02 Volume 1.

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We would like to show you a description here but the site won't allow us. TPL form and TPL requested medical record submissions: TRICARE East Region. Attn: Third Party Liability (TPL) PO Box 8968. Madison, WI 53707-8968. Fax: (608) 221-7539. Attorneys or insurance agencies: Subrogation/Lien cases involving TPL for TRICARE East beneficiaries should be submitted through the contact methods below: Humana Military. GENERAL. The DD Form 2792 and attached addenda are completed to identify a family member with special medical needs. There is a Certification Section on page 3 that should be signed AFTER the entire form is completed by medical provider(s) and the form has been reviewed for completeness and accuracy. The Parent/Guardian or Person of Majority ...IN THE CASE OF: BOARD DATE: 5 June 2008 DOCKET NUMBER: AR20080004971 THE BOARD CONSIDERED THE FOLLOWING EVIDENCE: 1. Application for correction of military records (with supportinIt is used by services in addition to the DD 214 and has a service designation at the end of it (i.e. DD 256 AF or DD 256 CG). What is a type of Army certification issued dd form 257A?Form Approved OMB No. 0704-0248 MATERIAL INSPECTION AND RECEIVING REPORT PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE ABOVE ADDRESS. ... DD FORM 250, AUG 2000 PREVIOUS EDITION IS OBSOLETE . Title: D D Form 2 5 0. Material Inspection and Receiving Report. August 2000. Form Approved, O M B Number 0 7 0 4 - 0 2 4 8.BOARD DATE: 11 September 2014 DOCKET NUMBER: AR20140001041 THE BOARD CONSIDERED THE FOLLOWING EVIDENCE: 1. Application for correction of military records (with supporting documentCompleting this section terminates the original appointment. If partial authority is to be retained, complete a new DD Form 577. 17. Enter the date the termination is effective. Completion of this item is not required if item 21 is signed digitally, since the electronic signature includes the date. 18.DD Form 2873, "Military Protection Order" Created Date: 3/23/2021 10:09:18 AM ...Military personnel are required to designate a payment that equals the total of their outstanding government travel card balance to the GTCC contractor. NOTE: A split disbursement is only necessary when a GTCC is used while on official travel for the Government. 2. NAME (Last, First, Middle Initial) (Print or type) 3.We would like to show you a description here but the site won't allow us.Veterans. Don't Ask, Don't Tell Resources. Department of Veterans Affairs. National Resource Directory. Veteran Service Organizations. ….

Verification of Service letter from the VA. Summary of Military Service Record From various states. * Forms DD 256 and DD 257 must indicate a period of active duty service dates …Microsoft PowerPoint - Benefits at Separation chart. BENEFITS AT. Honorable DD Form 256A. SEPARATION. General Under Honorable Conditions DD Form 257A. E Eligible. Other Than Honorable. NE Not Eligible TBD To be determined by Administering Agency DV Eligibility for these benefits depend upon specific disabilities of the veteran. “4”.7. ACTIVITY FOR WHICH DESIGNATED: 8. I acknowledge my designation as shown above, and shall faithfully discharge the duties associated with this designation. I also agree to obey all laws and regulations established by the United States Postal Service and the Department of Defense. (Signature of Designee) (Date: YYYYMMDD) 9a.PRIVACY ACT STATEMENT DD FORM 2278 (BACK), SEP 1998 AUTHORITY: 37 USC 406; 5 USC 5726; and E.O. 9397. PRINCIPAL PURPOSE(S): Primarily used as a checklist for shipment of personal property under the Do-It-Yourself Moving Program. Use of the form ensures a Do-It-Yourself mover is familiar with requiredDD Form 256 series, Honorable Discharge Certificate DD Form 257 series, General Discharge Certificate DD Form 363 series, Certificate of Retirement NGB Form 22, Report of Separation and Record of Service DAVID L. PETREE ... Army, DD Forms 256A or 257A. (See part 2, this fig.) Prepare these documents in the following manner:A copy of a federal DD-214 form cannot be printed online. The request form necessary to procure a copy of a DD-214 can be found online at the National Archives (Archives.gov). The ...Issuing and reissuing DD Form 214. • 2-7, page 9 Requirements by agency maintaining records • 2-8, page 10 Section II Preparing Other Separation Documents, page 10 DD Form 220 (Active Duty Report) • 2-9, page 10 DD Form 256A (Honorable Discharge Certificate) and DD Form 257A (General Discharge Certificate) • 2-10, page 10The Navy Personnel Command can only issue the Honorable Discharge (DD Form 256N) certificate. The certificate may be issued in connection with a BCNR/NDRB action. Otherwise, the following persons are entitled to receive an administratively issued certificate. The person who performed the service. A person presenting a power of attorney signed ...If the DD Form 250 covers performance at multiple locations, or if identical to Block 9, enter “See Block 9.”. (iii) Enter on the same line and to the right of “FOB” an “S” for Origin or “D” for Destination as specified in the contract. Enter an alphabetic “O” if the “FOB” point cited in the contract is other than origin ...Munitions and Explosives Safety. Materiel Condition Tag (Color) Tool for the following tags: DD Form 1574-1 - Serviceable Label-Materiel (Yellow) DD Form 1575 - Suspended Tag-Materiel (Brown) DD Form 1576 - Test / Modification Tag-Materiel (Blue) DD Form 1577 - Unserviceable (Reclamation) Tag-Materiel (Red) DD Form 1577-2 - Unserviceable ... Dd form 257a, DD 257A * – General Discharge Certificate; DD 257AF * – General Discharge Certificate; DD 257CG * – General Discharge Certificate; DD 257MC * – General Discharge Certificate; DD 257N * – General Discharge Certificate; DD 303 – Certificate in Lieu of Lost or Destroyed Discharge; DD 303AF – Certificate in Lieu of Lost or Destroyed ..., Microsoft PowerPoint - Benefits at Separation chart. BENEFITS AT. Honorable DD Form 256A. SEPARATION. General Under Honorable Conditions DD Form 257A. E Eligible. Other Than Honorable. NE Not Eligible TBD To be determined by Administering Agency DV Eligibility for these benefits depend upon specific disabilities of the veteran. “4”., The following forms have been superseded by the above DD eForm 2648, and are no longer utilized to document a Service member's separation. DD Form 2648 - Active Duty Pre-Separation Checklist. DD Form 2648-1 - National Guard and Reserve Pre-Separation Checklist. DD Form 2958 - Individual Transition Plan (ITP) Checklist., DD Form 500-999; DD Form 1000-1499; DD Form 1500-1999; DD Form 2000-2499; DD Form 2500-2999; DD Form 3000-3499; Other Forms; Secretary of Defense (SD) Forms; ODA&M Forms; Washington Headquarters Services (WHS) Forms; ... Form Availability. If the form number does not have a hyperlink, the form is not available electronically. ..., Request for Post-Government Employment Opinion (DD Form 2945) (exp 2025) PGE Restrictions under President Biden's Ethics Pledge (2021) (See "President Biden's Ethics Pledge" on the Other Ethics Topics page under the Ethics Topics tab.) Note: These Handouts provide general information. They are not a substitute for obtaining advice from ethics ..., Munitions and Explosives Safety. Materiel Condition Tag (Color) Tool for the following tags: DD Form 1574-1 - Serviceable Label-Materiel (Yellow) DD Form 1575 - Suspended Tag-Materiel (Brown) DD Form 1576 - Test / Modification Tag-Materiel (Blue) DD Form 1577 - Unserviceable (Reclamation) Tag-Materiel (Red) DD Form 1577-2 - Unserviceable ..., Form No. 6, U.S.N. Discharge Certificate NAVCG-2510 Honorable Discharge, U.S. Coast Guard NAVMC-455 U.S. Marine Corps Certificate of Service, In Lieu of Lost or Destroyed Discharge Certificate ... DD 257A General Discharge Certificate DD 257AF General Discharge Certificate, BOARD DATE: 31 March 2011 DOCKET NUMBER: AR20100022885 THE BOARD CONSIDERED THE FOLLOWING EVIDENCE: 1. Application for correction of military records (with supporting documents pr, The Official DoD Website for DoD Forms. FORM INFORMATION. Form Number: DD 3057. Title: Application for Search and Seizure Warrant Pursuant to 18 U.S.C. § 2703. Edition Date: 03/14/2019. Authority: Manual for Courts-Martial 2019. For use of this form please contact: The Department of the Army., (6) DD Form 257A (General Discharge Certificate Under Honorable Conditions). (7) DD Form 363A (Certificate of Retirement). (8) DD Form 2542 (Certificate of Appreciation For Service in the Armed Forces of the United States)., The Next Generation USID card incorporates an updated design and security features to deter counterfeiting and fraud, and is printed on a plastic cardstock. Initial issuance of the Next Generation USID card began on July 31, 2020 at select DoD ID card facilities, with phased implementation at all DoD ID card facilities, and completed in ..., DD Form 1000-1499; DD Form 1500-1999; DD Form 2000-2499; DD Form 2500-2999; DD Form 3000-3499; Other Forms; Secretary of Defense (SD) Forms; ODA&M Forms; Washington Headquarters Services (WHS) Forms; Standard Forms (SF) ... Form Availability. If the form number does not have a hyperlink, the form is not available electronically. ..., The separation authority approved the recommended action and directed the issuance of a DD Form 257A (General Discharge Certificate). 9. The applicant was discharged on 2 April 1981. His DD Form 214 shows he was credited with 10 months and 19 days of net active service, and contains the following entries in: * item 24 (Character of Service ..., DD 257A * - General Discharge Certificate; DD 257AF * - General Discharge Certificate; DD 257CG * - General Discharge Certificate ... *** The DD Form 214 has been issued by all military services since January 1, 1950. Before January 1, 1950, several similar forms were used by the military services., 23. The separation authority approved the recommendation for discharge on 18 February 2003 and directed that the applicant be issued a DD Form 257A (General Discharge Certificate). 24. The applicant went AWOL again on 21 April 2003. 25., The Next Generation USID card incorporates an updated design and security features to deter counterfeiting and fraud, and is printed on a plastic cardstock. Initial issuance of the Next Generation USID card began on July 31, 2020 at select DoD ID card facilities, with phased implementation at all DoD ID card facilities, and completed in ..., ARMY BOARD FOR CORRECTION OF MILITARY RECORDS Record of Proceedings BOARD DATE: 8 November 2019 DOCKET NUMBER: AR20190011082 APPLICANT REQUESTS: His under honorable conditions (ge, Voluntary. Failure to sign the authorization form will result in the non-release of the protected health information. This form will not be used for the authorization to disclose alcohol or drug abuse patient information from medical records or for authorization to disclose information from records of an alcohol or drug abuse treatment program., What is DD Form 256? A Form DD 256 is a certificate of honorable discharge utilized by the U.S. Department of Defense and the different branches of military service. An honorable discharge occurs when a service person successfully completes a term of duty with one of the military branches. Jun 12 2019., *** The DD Form 214 has been issued by all military services since January 1, 1950. Before January 1, 1950, several similar forms were used by the military services. **** NGB Form 22 can be used to verify eligibility if it indicates prior active federal service other than for training or a minimum of 20 years total service for pay., Aug 18, 2023 · Best Answer. general under honorable conditions means you screwed up but not bad enough for dishonorable. Wiki User. ∙ 11y ago. More answers. wayne wilson ∙. Lvl 2. ∙ 3y ago. CAN WE GET ... , DD 257A * General Discharge Certificate DD 257AF * General Discharge Certificate DD 257CG * General Discharge Certificate DD 257MC * General Discharge Certificate DD 257N * General Discharge Certificate DD 303 Certificate in Lieu of Lost or Destroyed Discharge DD 303AF Certificate in Lieu of Lost or Destroyed Discharge, DD Form 257A General Discharge Certificate (Under Honorable Conditions). READINGS RECOMMENDED . These readings contain relevant supplemental information. AR 15-130 Army Clemency Board., please do not return your completed form to the above organization. send this form in accordance with the instructions contained in the dfars, appendix f-401. 1. procurement instrument identification (contract) no. order no. 2. shipment no.3. date shipped (yyyymmdd) 4. b/l. tcn 5. discount terms 6. invoice no. date (yyyymmdd) 7. page. of 8 ..., He would be discharged under the provisions of AR 635-212 for unsuitability and would be furnished a General Discharge Certificate (DD Form 257A). n. On 5 December 1966, he was discharged from active duty under the provisions of AR 635-212, Separation Program Number 46A, issued a general, under honorable conditions discharge, and ., ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS IN THE CASE OF: BOARD DATE: 10 October 2019 DOCKET NUMBER: AR20190009648 APPLICANT REQUESTS: .Upgrade of his Ge, IN THE CASE OF: BOARD DATE: 3 May 2011 DOCKET NUMBER: AR20100026349 THE BOARD CONSIDERED THE FOLLOWING EVIDENCE: 1. Application for correction of military records (with supporting, Mar 9, 2023 ... ... DD 214. Learn More ... DD 257A * – General Discharge Certificate; DD ... * A DD Form 256 or DD Form 257 must indicate ..., DD FORM 2870, DEC 2003 Adobe Professional 8.0 16. DATE (YYYYMMDD) ACTION COMPLETED 7. REASON FOR REQUEST/USE OF MEDICAL INFORMATION (X as applicable) PERSONAL USE INSURANCE CONTINUED MEDICAL CARE RETIREMENT/SEPARATION SCHOOL LEGAL OTHER (Specify) (Name of Facility/TRICARE Health Plan) TO RELEASE MY PATIENT INFORMATION TO: ss, ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS IN THE CASE OF: BOARD DATE: 20 June 2019 DOCKET NUMBER: AR20170008576 APPLICANT REQUESTS: an upgrade of his und, Address Forms. DD 2866. Retiree Change of Address/State Tax Withholding Request. Apply for Retirement. DD 2656. Retirement Application - Data for Payment of Retired Personnel. DD 149. Application for Correction of Military …, (11) User's Signature. User must sign the DD Form 2875 with the understanding that they are responsible and accountable for their password and access to the system(s). (12) Date. The date that the user signs the form. B. PART II: The information below requires the endorsement from the user's Supervisor or the Government Sponsor. (13)., DD Form 257A, "Privately Owned Vehicle (POV)/Government Owned Automobile (GOA) Shipping Document - Deck Loaded," is a document used for reporting the shipment of privately owned vehicles or government-owned automobiles that are deck loaded onto a vessel. The information that must be reported on DD Form 257A includes: 1.