Andre' Davis DD-214

'---\!i '..' .. ,,i- i' \ i '-." "cAUi rolrr Nor ro BE usED FoR i THrs rs AN tMpoRTANT REcoRD. { ) ANy ALTERATToNs rN sHADED AREASIDENTIFICATION PURPOSES RENDER FORM

CERTIFIGATE OF RELEASE OR DISCHARGE FROM ACTIVE DUTY

, 1,. NAME,fLasf, First,. Middle) . ..

DAVIS, .:.'ANDRE. DEVONdAE :

2. DEPARTMENT, COMPONENT AND BRANCH

ARMY,/USAR

:3:.,,,SOGlAl

::i:i:.4i2,9,i,::rl:i

sEcuRlfr.:'.',.,,, itll:: ::

5..DATE OF B|RTH (YYYYMMDD)

r-985032r-6. RESERVE OBLIGATION TERMINATION DATE

(YYYYMMDD) 201103107a. PLACE OF ENTRY INTO ACTIVE DUTY

MTIJI'INGTON, TENNESSEE

b. HOME OF RECORD A TIME OF ENTRY

236 WTIJSON CIRCI'EHAYNES ARI(ANSAS 7234]--OOOO

(Clty and state, or complete address if known)

8a. LAST DUTY ASSIGNMENT AND MAJOR COMMAND

O467ENCO A CMBT AR FC

b, STATION WHERE SEPARATED

FORT BENNING, GA 3].905-50109, COMMAND TO WHICH TRANSFERRED

SEE BLOCK 1-8

'ro. sGLr covERAGE I INoNEAMOUNT: $ 250,000.00

11. PRIMARY SPECIALTY (List number, tltle and years and months in 12. RECORD OF SERVICE YEAR(S) MONTH(S) DAY(s)

one or more years.)

21810 COMBAT ENGTNEER - r- YRS 2 MOS/INOTHTNGFOITLOWS \

a. DATE ENTERED AO THIS PERIOD 1. :i, Ar

b. SEPARATION DATE THIS PERIOD :;f*P:$f;jliil

.'i:Ut.i:r.r.ic. NET ACTIVE sERvlCE THIS PERIoD tii$l ri!2isii:r rii

d. TOTAL FRIOR ACTIVE SERVICE l: AFF,...:: ilBIiO.CIS. :*i;i;a#+,8,i*i

s. TOTAL PRIOR INACTIVE SERVICE lrii:rg:Eli:,li:{ I i:1,, E$b.ci<i iii;.:'+liCi:lririi

f. FOREIGN SERVICE :,..;:0'.0.0,0i :,.':j,:,r,,,0 e,i:,'i::l

g. SEA SERVICE :.::1]:0,0',iri .r I, ,'.00,, .,

h. EFFECTIVE DATE OF PAY GRADE ::!2:A,A:4:..I3.

DECORATIONS, MEDALS, BADGES, CIT.A,TIONS AND CAMPAIGNRIBBONS AWARDED OR AUTHORIZED (Ail p.eriods of service)

NATIONAIJ DEFENSE SERVICE MEDAL//ARMY SERVICER]BBON//ARMED FORCES RTSERVE MEDAIJ W/ Iq,DF.VICE/ / GLOBA], WAR ON TERRORISM EXPEDITIONARYMEDAI,/ /GLOBAL WAR ON TERRORTSM SERVICE MEDALL//IRAO CAMPAIGN MEDAI],//NOTH]NG FOLI.OWd

14. MILITARY EDUGATION (Course title, number of weeks, and month andyear complated)

NONE/,/NOTHING FOIJLOWS

{5a. MEMBER CONTRIBUTED TO.POST-VIETNAM ERA VETERANS, EDUCATIONAL ASSISTANCE PROGRAMb. HIGH SCHOOL GRADUATE.OR EQUIVALENT

YES

YES

X NO

NO

I6. DAYS ACCRUED LEAVEP.A|D 0

17. MEMBER WAS PROVIDED'COMPLETE DENTAL EXAMiNATION AND ALL APPROFRIATEDENTAL SERVICES AND TREATMENT WITHIN 90 DAYS PRIOR TO SEPARATION

YES NO

X

jFQL,LOWS

sSPAIATION (lnclude ZlF.Code)

:l'i ,i::, :' ;::,iiti

.:,':,':il :il ,,';.l ti.i:t:it,

' , lti tl;: r ' ii !:: ;::,!,: :lij i ::';

20:, MEMBER;,REQUE llliili,r::::..4R'r ir r,':':,:r,iii:r, :,:,:t,, :,,l:DIRECf,OR OF,VEIERANS::AFFAIRS., lX,r;r;liiiYESrt rNo

.:21r:1,::SIGNATURE 22t

iT,IMOTHY

VOID

SPECIAL ADDITIONAL INFORMATION (For use by authorized agencles only)

23. ryPE OF SEPARATION

REIJEASE FROM ACTIVE DUTY25, SEPARATION AUTHORITY

AR 635-200,CHAP 4

c (lnclude upgndes)

27.

NA

IIONORABI,E

LBK

RiT..ICTRY CODE

28. NARRATIVE REASON FOR SEPARATION

COMPI,ETTON OF REOUTRED ACTIVE SERV]CE29, DATES OF TIME LOST DURING THIS PERIOD (YYYYMMDD)

NONE

30, MEMBER REQUESTS COPY 4(lnitials)

2000 SERVICE.2

Ii

L-