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Get DD 149 2019

15. SIGNATURE Applicant must sign here. 16. DATE SIGNED DD FORM 149 DEC 2014 PREVIOUS EDITION IS OBSOLETE. Adobe Designer 9. REMARKS DD FORM 149 BACK DEC 2014 Records SAF/MRBR 550-C Street West Suite 40 Randolph AFB TX 78150-4742 Department of Homeland Security Office of the General Counsel 245 Murray Lane Stop 0485 Washington DC 20528-0485. APPLICATION FOR CORRECTION OF MILITARY RECORD UNDER THE PROVISIONS OF TITLE 10 U*S* CODE SECTION 1552 OMB No* 0704-0003 OMB approval expires Dec 31 2017 Please read Privacy Act Statement and instructions on back BEFORE completing this application* The public reporting burden for this collection of information is estimated to average 30 minutes per response including the time for reviewing instructions searching existing data sources gathering and maintaining the data needed and completing and reviewing the collection of information* Send comments regarding this burden estimate or any other aspect of this collection of information including suggestions for reducing the burden to the Department of Defense Washington Headquarters Services Executive Services Directorate Directives Division 4800 Mark Center Drive Alexandria VA 22350-3100 0704-0003. Respondents should be aware that notwithstanding any other provision of law no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. RETURN COMPLETED FORM TO THE APPROPRIATE ADDRESS ON THE BACK OF THIS PAGE* 1. APPLICANT DATA The person whose record you are requesting to be corrected* b. NAME Print - Last First Middle Initial NAVY c* PRESENT OR LAST PAY GRADE 2. PRESENT STATUS WITH RESPECT TO THE ARMED SERVICES Active Duty Reserve 3. TYPE OF DISCHARGE If by court-martial state a* BRANCH OF SERVICE X one ARMY AIR FORCE MARINE CORPS d. SERVICE NUMBER If applicable the type of court. National Guard Retired Discharged Deceased COAST GUARD e. SSN 4. DATE OF DISCHARGE OR RELEASE FROM ACTIVE DUTY YYYYMMDD 5. I REQUEST THE FOLLOWING ERROR OR INJUSTICE IN THE RECORD BE CORRECTED AS FOLLOWS Entry required 6. I BELIEVE THE RECORD TO BE IN ERROR OR UNJUST FOR THE FOLLOWING REASONS Entry required a* IS THIS A REQUEST FOR RECONSIDERATION OF A PRIOR APPEAL YES b. IF YES WHAT WAS THE DOCKET NUMBER c* DATE OF THE DECISION NO 7. ORGANIZATION AND APPROXIMATE DATE YYYYMMDD AT THE TIME THE ALLEGED ERROR OR INJUSTICE IN THE RECORD OCCURRED Entry required 8. DISCOVERY OF ALLEGED ERROR OR INJUSTICE a* DATE OF DISCOVERY YYYYMMDD b. IF MORE THAN THREE YEARS SINCE THE ALLEGED ERROR OR INJUSTICE WAS DISCOVERED STATE WHY THE BOARD SHOULD FIND IT IN THE INTEREST OF JUSTICE TO CONSIDER THE APPLICATION* 9. IN SUPPORT OF THIS APPLICATION I SUBMIT AS EVIDENCE THE FOLLOWING ATTACHED DOCUMENTS If military documents or medical records are pertinent to your case please send copies. If Veterans Affairs records are pertinent give regional office location and claim number. 10. I DESIRE TO APPEAR BEFORE THE BOARD IN WASHINGTON YES* THE BOARD WILL NO.

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