DEPARTMENT OF THE NAVY BUREAU OF NAVAL PERSONNEL

5720 INTEGRITY DRIVE MILLINGTON, TN 38055-0000

BUPERSINST 1900.8D PERS-83 11 Jun 10

BUPERS INSTRUCTION 1900.8D

From: Chief of Naval Personnel

SUbj: CERTIFICATE OF RELEASE OR DISCHARGE FROM ACTIVE DUTY (DD 214/DD 214C/DD 214WS AND DD 215)

Ref:

Encl:

(a) DoD Instruction 1336.01 of 20 Aug 2009 (b) NAVPERS 15560D, Naval Military Personnel Manual

(MILPERSMAN) (c) OPNAVINST 7220.14

(1) Instructions for Issuance of DD 214 Certificate of Release or Discharge from Active Duty

(2) Reentry Codes (3) State Directors of Department of Veterans Affairs

1. Purpose. To provide instructions for preparation and distribution of the DD 214 Certificate of Release or Discharge from Active Duty, DD 214C Certificate of Release or Discharge from Active Duty, Continuation Sheet, DD 214WS Certificate of Release or Discharge from Active Duty Worksheet and DD 215 Correction to DD 214, Certificate of Release or Discharge from Active Duty. This instruction is a complete revision and should be reviewed in its entirety.

2. Cancellation. BUPERSINST 1900.8C.

3. Background

a. Per reference (a), Department of Defense (DoD) prescribes the DD 214/DD 214C/DD 214WS and DD 215 for use by all military services. Reference (b) provides separation/discharge reasons.

b. Enclosures (1) through (3) are used for the preparation and distribution of the DD 214/DD 214C and DD 215. The NAVPERS 1900/2, Separation Travel Orders, will be issued to enlisted personnel upon separation and marked "For Official Use Only".

BUPERS,NST 1900.8D ! 2 ..lIN 201)

c. The DD 214 I. de.iqn~ to prov ide a .hort - !o~ origina l ~hich . xclud •• "S~ial Additional I nfo raat ion" and a long fo~ copy ~l~h a dd itional I nforaation s . l ec tive ly i ncluded based on the r eclplenc · . rteedo .

d. DO 214 provide. .. llIury .. <"Vieu wah i nfonao.tion necessary f or admin i. trative proce • • i ng a rtd .rtll.~rttl r@enliB t~nt dete rminat ion as well as data requi red by separate •• for peroonal us • .

4. Intent o f the DD 2 14. The 00 214 10 a brid . c l oar-cut record o f a period or torm of acti~e ~ilic.ry . e rvice that provides,

8.. Military .~rvlcu " ith a r .... dily ava ihb le . ource of i nfor.at i on U$.o to det . r.ine oligibillty for en l i.t~nt or ue" l l.t ..... nt ,

b. service ",Tr""'u with 8. brid r ec o r d of active se<v;ce ,

c. ~ppropriate governmenta l ag~nci •• with An 6uthori t 6tive aourco of inforaation which they r equire i n tho .dminiotra tion of Federal ~nd Scate lowe .

Th"s"

proc.ou r e . to prevent unauthorized use of the fo~ ,

•• t or use An~ ~e.tructlon o f

f orme . in charge ICOIOKI .. ill appoint, in ~ rade B1. Gs-1. Or &bove to control. and i s . ue th~ DO 21 4, D0214C. DO 214W5 and when ~ppropri~te. t he DO 215. The colorc of de. I Qna ted .~parAtion ~ctl~ ;tl •• l i.ted in r . f e r e nce Ib l 1910- 812 ~y ~uthoTlz. an KS. GS -5. Or . bove to .erve in ~hi~ capacity, if 0 0 de8 ign.ted In wT ltlng. Le~teT ot app¢I"t~t s hal l not be sent t o Navy ~r.onnel C~nd INAVP£RSOOIII. but s hal l be mai ntai ned in the c"""",,nd ti le • .

,

BUPERSINST 1900 _90 t! JIll 7 ";]

b. When a command i •• uppor~ed by a pe ,-" onnel Support Activity Detachment IPERSUPPD!T). res pOnsi b i lity for i.suance o f the DO ~14 l in ... ith the PERSUPPDET.

c. Security. The foll"" ing procedures for ucurHy of ~lectronic forms a r e p rovided as fo llow. :

III co ·. mus t ~n , u '-e appropria t~ secu r i ty measure s are in p l ace to safeguard unauthorized u •• of the e l ec tron ic PDP ti l e DO 21 ' 100 214CIDD 214WS and DO 215 by p lac inq the torm on a •• ~rat. directory, u s i ng l ocal a rea network ILAN) . ecurity and r • • trleting ace • •• only to qua l i fied p@rs onnel creating the "ctua! form .

12) Assign a serial n~r in b lock 18 ot the DO 21 4 Ib l oc k 5 of the DD 2151 and ~intaln t h ••••• rial number . in ~ither an elec t ronic or paper 109. Th •• erial n~r c ons i s t s o f t our de_nn 11 4 s paces) . to I nclud .. c.,......nd uni t i denti f iCAtion cod~ IDI CI. two digit calendar year. f our digit con •• e u tlve n~r. and initials o f the pr~r.r l e .g .. SEP, 6298l-00-0001 -~ 1 .

I]) Log consio to of , ~t • ~Inl~ .•• rial n umber. Na.. o f Perlon Discharged/Separated . • nd Effective na t . of Di s chargel Separa t ion. C~dl m8y add additiona l el~nt. a s desired.

7 . Fornos

Obsol~te , blank. parti.lly the DO 21 4 . DO 214C, 00

not r~in in tact but or burni n g . No fo~ wi l l

a. Aunoriz...:! . ~paration activities will b40 provided ~orrent e l ectronl~ v e r.ions o f the DO 2l 4 I l l'CI'l(WS and 215.

b _ Fol lowing torms are available online or by ord~r i ng ~t

http ., I "",,val fO'.'!!!.: ... '1aps. d l a . • Ulwebi!?"bl i cJ 1Ioooe :

BUPERSINST 1900.81' II .lIN ;

III NAVPERS 1070"4 110-20051. Report of H~ of Record &nd PI . ce from Which ordered to ~ TOur of Ac~iv* Du'y.

1.1 NAVPERS 1900/2 106-2(1081 Se .... u.lo" TUvel. O~d .. ro.

c. '!'he followi"1I fOnnll an ,"vai l"ble onHn .. "t httP •• lwww.d.lc . .ul.~ldirectiv~8Iinfomg./fo~/fo~.progr~.htm .

III DD ~6U 105_20051 pr .. upara.ion Counselinll Chec~lht Por Active Co.ponent S .. rvic .. ~r • .

121 DO 2648 - 1 106- 20051 Pnoepara.ion CO>JnuH"'1 Cheekli.' For H •• • rve Component Service H~r. Rel~a.ed Yrom Active Duty

131 DO 2808 110- 20051 Kedical Re~ord- Report of Medical Examination.

141 DD 280? - 1 10)-20011 ~edical Record _ Heport of Medical Hi.~ory.

d. The following fo,.. i. av .. ilabl~ http',/www.vba , v".lIov •. p~o.lfor"/ht~, Applic.~icn for C~a~ion Or Pen.lon _

on l ine at VA - 21 - 526

D. P. QUINN

Veteran.

Rear Adairal. U.S. N .. vY O@puty Chief of N~val Per.on....l

Distribution: Electronic only, via BUYERS web . i • • http" i....-w. npc . navY .• 1i 11

•

BUPBRS iNST 1900.S0

t I .... J

ZNSTRUCTZONS FOR ISSUANCE OF DD 214, CERTIFICATE OF RELEASE OR DISCHARGE

FROM ACTIVE DU'l'Y AND RELATED DOCUMENTS

"""lo.ur .. 01

8UP~INST 1900.aD 11"'_ 1. Crl •• d. Cor I • .uance o f DO 2U. on.. DO 2U h pr_r,",,- to cover psrl~ of .. evlce on .. c t ivs duty ... ctlv. duty for tr.lnl"", tAM"f. Cull~t;'" tr .. ini"", duty ... ctl_ duty f or .peei .. 1 ""r~ (ADSIoIf. C41rtdn poori~ t .. ral.natscl ~ .. change o f .. atua not concurr~t with ._ra. ion fro- active a •• vlce. and ... 1 ... ... fro- ... t.tua tbat i. IA9ally d .... r.lnscl to be void. The DO 214 will be ia.uscl to .~ber. in conjunction vlth their r .. I •••• fro. actlv. duty •• rvic. and prior t o final departur. fr~ th.ir c ..... nd on pooraiulve t eq><>rAry .. ddltlonal duty. u no!""1 I.av • • nd ••• ~I.tsd t •• val.

•. !iJ.qible ""nonn.l . "111. 00 2U .. Ill be i uu'" to the ~ollovinq poor.onn.l,

will • or • pooriod

s • .vIC41 doot4I .. ined '0 be be provided to offlc •• s dlaadaaed under the aefttenc41 of • gene ra l court ­_nl.1 Or d.".""....t f...,. .h. roUa. (~, " TTl>o.n who .n plac'" on _llu. 1_". ar. NOT r.l_ascl C...,. ..,.Ive duty . ~Il.t. I •• ". is • statutor ily authorl!ad non-pay l ... v. at .. tuO. Do not. In .uch " ...... iuu •• DO 21 4 .)

U""'''' on DO 21 4 v i ii .how

the , ' - l>er ..... or<le n. d .ul>eequent to t Nt pooriod

(a) R ... rve o-, ........ t psnonn.1 order'" to .. ctlV41 duty fo . .. contl"",."cy operilltlon will be luusd • DO lU reg.rdl .... of the n_r o f d.o.ya ... rved on ..,tive duty.

(l>j The r~ir...nt shall .Iao apply to recilliled .etlr ... revertl"", to r.tired •••• Uill. regardl ••• of th. pooriod of .ctlvo duty •• rve<!.

Enclos ure 11)

BUPERSINST 1900 . eo 1 I JIM aJrI

"" will to. The 00 214

....... <><1 on activ ..

Th .. 00 21 4 u rving on

or c~n~nt as

(~) Enl i sted Personn@l. Di s charged to accept permanent 4ppoin~nt to .Ith~r warrant or commissioned .t~t~ s for continued active duty.

(b) Officers

I. Tempor a ry appoint.ent t.~inated to accept a pe~nent warr.n~ or comais . ion in the Regu lar Navy or Navy

~ .. s"r" •.

,. i n ~nothe r braneh

Appointment t.r~inatod of the Armed Forces .

3 . upon t .. ~ination of tempo'~ry appoi ntmen t when enli .t~t contrac t ~xpir • • concurrently.

4 . O(fleers r o t .lred and cont inued on active duty in a retired a t .tus will not to. Issued. DO 214 until tho actual da t e of separ~tion (e . g . • an offlc .. r pl aced on th. r"tired list of the Navy on 30 J~no 2004 and continued for 2 year •• will not be i.sued a DO 214 unt i l )0 June 2006, the ~ctual date of separation).

fo llowing

,

aUPERSINST 1900.80 11»1"..,

Ih) ~inted ~idshipmen. U.S . N~vy Re •• rve. or a ccepted as coll8Ve program students i n N~v~l Re.erve offi~er. Training Corps (NROTC) Program.

Ic) Upon a~c~tance of comuUosion.

The DO 214 will ~ prepared ,~,;,; ,.,dohi.poen and cadeto .

i.ncluding thou . .. rving concuH~ntly 50 enli . ted member.. at th .. N.v.' Acad~. Air Foree Ac.demy. Coast Guard Academy. Or the Hiliury Acad""'Y. releued ""'~ ~ .. f ... nc . Ib ) 1910 -184 and 1531-020.

and i ssued

b. I neligible Personnel. The 00 lU "Ill not be prep""red or i •• ued i n the ca • • of peroonnel,

( I ) Who .r. d i scharged fQr i~i.t. e n l i stment or r.enliotment on . ctiv. duty,

12) Who a r e found p hyoical l y disqualified u pOn r epOrti ng for activ .. duty and who do not "",rfon> act i ve duty under o~dero;

()I Who d i e wh i l e on active duty. active du ty f or train i ng , full -ti~ tr. i n i ng duty. or acti ve duty for special work;

14 1 Who are rele •• ed from AnT of le.s than gO da¥" un le •• separated for physical d l .ability or fron a period of special AnT under a call tor ~bj lization,

(51 Who rsc .. ive • temp¢r~ry o! ! I~er appointme n t in the naval service. or when tempor~ry o!flce~ 8 tatus i s terminated ~nd reve rted to .. n l l.ted status to c~l.t. a n enl istment contract,

(61 Who are .. idshipooen. U.S_ .... vy. (NIlv41 Ac.demyl . • ~c.ptlng .. permarumt c<DII\i .. ion in tho Navy or Navy Reserve ;

(al Who ar. removed from the T~rary Di aability Retired Li ot ('l'ORLI,

,

aUP~RSINST 1900 . 8D t 1 .b Zl'".

19) Who are enlisted per sonnel t ~an.fer~ed to the rloet Reserve a nd who a n concurnntly reuined on acb v e duty ;

1101 Who a re di s charged fro. Pl eet Reserve i nacti v . status , or

1111 Who .re officer peroonnel r e tired and who are concur rentl y retained on act i ve duty .

c. Ti M*o of I o~ uanc. . Th. Do 21' will be co.plet ed for e l igible personn.l .t tlMO of r . , •••• , tr.nsf@r , c hange of . t"tus , or di s charge . ~cept ••• t.ted below.

II ) Personnel i n "Awaitin9-0rder.- St .. tue . I n the c .. . . o! personnel who have appeared be f ore a physical ev.lu.tion board IPES ) and have been p l Aced in an awai t ing-ordo r •• t a tu. pendi ng final action by the Secretary of tho N~Vy ISECNAVI. t h o command r e spon.ibl e for administering the ~r· . records end AcCOunts .. ill. compleu b lock . I through 8a; 10. II. 12 .. . I~l . 13 , 14, 19 through 22 . and 3 0 prior to the departure o f t he ~mber. The DO 21 4 ~ill not be d i . tributed unti l fi nal act;on is di r~cted by the NAVPRRSOOM. C~reer Pr09re • • ion IPERS-Ql. I n those c as • • wh. r e r.tir~nt or discharge is directed. the roma lntnq hlock. will. be complet~ and all copies of the fo~ d; s tr ibu t ed p romptl y per i nstruc .ion • • et forth in pe rag r aph , . I f the ~r i . retu rn~ to act ive du ty instead of being r.t; r ed Or di.charc~. th" original and all copie s of the DO 21 ' w;ll be d •• troy~ .

the naval a c tIvIty c~lete a a much of th~ DO 1 14WS info.--t .on .".Uabl. prior t o the member'. transfer. The worksheet wi II be forwnde<l t o t he PERS1)PPDET u r viru;r the area in Which the designa t ed DVAMC i. located . When r •• l r~nt or discharge i. direct~ b¥ NAVpERSCOK IPERS-8) , the PERSUPPO£T will cO<llpl .... the DO 214 and distdoote all cop; .. proo.ptly . A l ocal ly r eproduced copy of the co py n~r I wi l l be forwarded t o the ovAMC in which the IrI<tIOber ; . a pat;""t .

, Enclosure (11

BUPERS I NST 1900 . 60 l1JU111 1

en l iseed ~ernber i s r e tired or transfer~ed to th. Fl~et R •• ~ rve, but ret4ined on active duty. the 00 2,4 will not ~ issued until fina l separat i on f~om active se~vic. i •• ce~li.hed. The service record wi l l not ~ forwarded to N~VPERSCOM (PRRS - 112 ) but will be ret a ined at the c~and unti l th. ~r ~ompl~ t ~ .

th@ period of a ctive dut y.

"'~!~~::tt:~~~:: those memb<on s@paration leave

0"

no .14 ~i l l be pr~pared and d~livered prior to the ~r'. departure . Th. remainder "ill be distriooted as indicated in parft\luph 4.

~ DO .14 will be provided to fr~ a status "hich ha s been

void. ~~lete the 00 214 per

la) >;n eer "N/A· in bloc ~. 9, 11. 13. U. 16. and 17;

Ibl Entu · 00 00 00 " In blocks 6, 124, b, C, f. Q- • ..... d I: and

Ie) Ente r th@ be9lnning and e nding <lat •• of the void pe riod and the followl-ng a tat....,..nt in block IS,

RELEASE D1LIS'THENT VOIO. 'I'II I S

AND ~ OI SC1lAR(;E CfRTIPIC~TE HAS NOT BaEN lSSUED,

Id ) Enter "VOIO ENLISTMENT" in block 23;

,., Enter "~ERIZEO· '" bJ.ock 24;

'" Enter a uthodty currently '" effect '" '" Enter "YIlW '" bloc~ 26;

'" Enter "RB -4 o • R! - lE. " .. ,,-pproprhte . block n; . ~

(i) Enter "OBrECTIV! ENLISTMENT - LACK OF JUR I SOICTION" i n block 28,

,

b l ock

'"

25;

(II ~~n.opua ,

~~Vl~do~ddv .~~ ,,< _ ~ t t aa 0, ~aJ.~. ~~."a ' a~va t a~vl t~dv uo ~6~~~.,p 6u,aq I .UUO.~~ ~ •• iIU~ •• ~. ~OJ 'Sit oa .~ • • no~l

0. "-'un"",,, aq 111'" II ,~, «( -S><3d) ltl_6",,"'H uop"""'01"1 latru"ond '>O;J::>S><3d""" '<;HlOU .... ~ OllP "I _"uop""""01",

JI",u,"' 9p,"0~<I 0> poon .. , *"l HI" Sit 00. '61 '1"" l q '" ~a."a puv .o'l~~~ •• S. ~.,,,. '.1~11.4. ,OU 0, ~~lq • a.al~~

o. "o,.~01ul 1I ·.T~1 1VhY'ON UOl.""'-"0JUI Iq)

1·lq"~H<lclv ."" 'poo1Hwas

~. u, ""P"IU'

'~:>Olq a41 '" " 4> " I _14' UOqM

l OU };"", ~~:>Olq , ., '-" I<IclV ouop~n~l .'q Jlu''''''ltoJ ",!. '""""au

a~OO1 ~o alq"I'.". ,ou . , uo,.~o1u, uallM ' apvu aq IIT~ lvul Jl~~ ou puv ~U.lq ~1.'.1~3 'Ja l aq I I '''' ~=Tq ON

° i .~...,~ up,ua

''''''laq .~, ~oJ f ,!clv~6v~w ul P"'U l .' UO~ .~~

ouop~nn.", ~:>ON-Aq- '1~I '

'tl~ a o a,!l JO UOIl.~W.~<I lV" 11 a4' u, ~"o~a P"" · • • • U ••• I~~ '~~v~n~~v a~ n "u& o. oaov~

I I. "1 ""on aq IT'~ SM'I Z ocr .~~ 'S~t l t aa 1 0 . on It)

'(90 ) };lIp a'!. 10 0.,6,p ~ I~)

pu. ' (90) '!'UOW . '!' ~OJ UOI'Vl~~qqv .,~,P ~ (q )

'(900Z) ~v ..... H"IP ~"O .. (0)

.. poo~~."a aq I n~ n . vc 'qn JO ."o>p "'4' ,!~no~,!l ~n ~""'Iq ,

UIO~J ".'1 ,~,ou """ '." ' 4.0 oUI"n . '!' O' KtUo .'~la~ c~,~.ua l t~

'·""'tlOl ~~lq " I UMO'!. •• U01'0~.ao~

J O "'lOp . '!' nd 'uu~=

m

' pa~.,"~ aq ~~ .~., P~,!,o,!.nv ~IUO " . ,aldWo~ puv .'v~n~

lUO,~~, uv "l tl~ CO a~ po~a, ,

'~'''''<I,,~<ldw •• · .~~p~o 1"13,1 . ° puv 'sp~oJO~ };w ·'!'lO.'! ·.~l~"'. ~~J POUjV,qo aq l ti~ ~ tt an

~,!. uo pe~.,ua aq 01 o,oa ·uO!,r='OJUI'O •• ~~nos ."

IIOl rrr I I a s '0061 lSN!S~3dnS

nt oa ~l JO uOn .. ~idUd 'r

BVPERS INST 1900.80 11JUMM

bloc k • . and the CO will i •• ue t he DO 21S when t he needed info",,",tlon has been received fn"" IIAVPDlSCCO< (PERS _8) .

'0' bloc l<.o 11 . u . t he last t~ l i ne .

Whenever there i. unuoed ope~e i n a diagonal line o f "X' , - below

When n>On ol>"~' 10 r~lred to i nfo~tion . ente r "s ••

r"""'r~ o " ;.;::::~::~:: infonllltion i n bloc~ 19 . "Remuk • . " s pace ino"Ui chnt, requ i red infonMtion will be on a DO "",. and will uhr.n~ .. in f ormation free b locks 1 through 3 and the appropriate b l oc k (s l being continued. the ~r'. signature. date. and authQri. ing of f icial 's signature. 110 , ntri ... ~y btl ~d. on th .. back of the DO 21 4 . The u •• of plai n bond p aper a •• continuation s heet i. no lon~@r author i .ed.

c . Each copy o f t ho DO 21 4 DUot be leg i blo and wil l be a r eproducibl e 'Cre.n ti n t using appropri a u in~ on Blockll I . 3. 44 , 'b. 12 . a nd 18 through 30. Blocko 3 , 21 . and 22 of the DO ~ 1 4 C and hlock£ 1 . 3 , S . 6, and 8 of the DO 21S ~i l l be s i mi larly print . d to ."ke altufttiono r ... d lly dh~ .. rnibl", No corrections "Ill be permitt@Q in the s creened .r • ••.

d, Error. and Alt.rotlon.. The use of the DO 21 ' WS .houi d p r event e rror. fr~ appearing on the DO 21 4. No cn..noe. or corrections may be ~d. to t he a had@Q b l ocks o f the f o rm, Any unavo i dable c orrections Or cn..ng ... ~da I n the un.haded area. of t ha DO 21 4 during preparat ion wil l be n ... t. loo i ble. and in;tl.oled on all ~opiu by th .. au t hori <i ng offldal. The recipient " il l be lnto~ t ha t making .. ny unauthor l .ed c hange or alt"ra tion o f the DO 2 14 .. Il l rend@r it void .

• , Block 1 . NAME. Enter .ember ' s name: l •• t name (i n c .. p i tal lettenl, flut "'"""*. an d .. idd te nlll<!<: , Do not in~lude s pace , . hyphen . or apo . trophe. i n las t name , Type a c~ aft .. r the l ... t~. I f t ho ~r do ... not have a midd l e name . indicate by "WIN." If t ho ~r u ...... n initi .. l in.toad of a fiut or middl e n_. i ndi~ a ta h'l "nclo.ing the i n i tial i n

, Enc losu r .. 01

BUPERSINST 1900 . 80 I I ,Mj 2811

quo t at ion marks , e . g., 'J' o r "K". Al .o i nelu~e , when applicabh , Jr . , Sr .• III, e tc ., fol l"",ing the -..ber's ", iddle --,'

Enter the following ,

USN. USNR , USNrR , USNRFR. USN-RET , or USN- KIDN .

, social 00 0 00 0000 .

the ~r · . grou p<!d ; ... g .•

Ente r the abbr eviat i on or rate in which

':;;;;:'::;'~ .e~; shown fcr .. tempo r ary officer a p.moanent .... n offi cer, or nverting to per""nen t ~~' : ~ ~.~ s tatu. for the p"rpOu of t ran . f .. rrin~ to the f leat Ra . .. rv. an~ r ele .. s .. f r~ ac t i va duty .. ffec t ive on the .~ data. The perman.nt enl i s ted grade and da t e o f ra ta for a t emporary office r wi l l ba i~"ntif i ed i n block 16, • .... _rh· 100 00l' USE FROCK!D GRADE, AAN1>. OR RAT~I. for

o . paygra~e i n which For mi~hipman enter

-N" .•

f. Block S. DATE or BIRTH. Enter the correct dat e of birth, a .g. , 19740915.

Enter. wh .. n ;;;, .,. obligation

"'Y Se l ective Service "ct. which i. 8 years fr~ enli.t~nt Or appointment. Refer .. nce Ibl

11]] - 010 appl ies . Enter 'NA " if t he ~r is discharged.

lal f or .nl is~ed ~r.onnel linc luding t~r .. ry ~~is. i Qned officerSI ~hQ iMm@d i ately ent ered on ~ctive duty at the tl~ of enli.t~nt or r.an l i .t~nt a f ter d br .. a ~ i n oe r v ice.

BuPERS!NST 1900.80 1 1 .All 2Ir.l

~nt~~ the pla~e the ~r ind leat.o Iclty or eounty and State I on t h . dat •• hown in block 12 • .

{bl For enlisted personnel ordered to a~tiv. duty from inactive duty. @nte r the city or county and St~te o f th. h~ addr~ • • to which the act ive d uty orders war e 5ddre •• ed.

{21 Officer.. For an office r ~ho r e?Qrted for active duty on or after 1 January 1957. en t e r the p l ace of entry ahawn on NAVPERS 1070/;'. R@por t o f Kome o f Record and PI~c. from Wh ich ord~r.o to a Tour ef Activ e Duty.

wh ich the Admi n ion

Fer midshipmen. USN, enter the p l ace t o a t t~ u.s. N~v.l Acad~ for

j . Enter rel@as8 from act i ve duty {er a ss ig~nt will be entered.

, u!.,u., ~.Cgraph 1c loe~tion.

Refer to

ucept cu. o f wh@n the trainin~ duty

Enter th. place of or otation l and Ita

1. For per. ¢ nn.l being r et ired . or In t he c ase a • • lqned or r eve rted to enli.ted . t . tu. , ent~r "Canmander . Navy Personnel C~ IfERS_9 121, Millington. TN 38055 ." For ~id~hipmen p laced on act i ve duty. ent~< the name of the c~nd t o which t rans ferred. I n the caoe of ~r.onn~l bei ng d i .cha rged or c ontinuing on active duty with a change o f s t a tus. enter ·NA.'

•. ~~~!i~"':.'f'::::';~f,~ The ,coverage If none, ente r 'X" i n the bo~.

, . ·11 ..

, Enclosure II I

BUPERSINS~ 1900.80 I I JIM bII

n. Bloc~ II. PR!MAPY SPEC!ALTY

(II Enlis~ed Personnel. Ente< the prl~ry Navy En li.ted Classificat ion (NEe l coda . title. dnd year s and ~th. in 'p4cialt~. The NEe ~i ll ba t h e late.t primary NEe a • • ignment recorded in the s~rvice ~ •.• El~tronic Service Record. Bn l isted Qualifications History of the service •• cord. Wh~n no NEe has b@@n a.signed. ~nt~r t~e rdting abb<eviation followed by ·0000.- Th~ NRC tiHe wi ll b@ listed in NAVPERS 18068F. se-etlon I I. Manu. l of the n.vy Enlisted Manpower .nd Personnal Ch .. Hications ~nd Occupationa l StMldard.. If appropriat .. . tha B~bt i~le ~ill precede a . "ET -1S16 ~dar ISPS_40B/CI01 Technician. " In th~ C~8e of ~n QA_DG NEe. includa the rating &bbr~viation and the Nee title: e.g ., "DG-9"O IHTI Cra f tsman , " Enter add itional secondary NBC number •• nd titl ... held for periods of I year or more.

(~I Ent e r the Navy Officer Billet C,..""".,; I fo~ tha "",st . igniticant duty ~uigrtm<Ont. Se~ NAVPBRS 158391. vol~ I. Manual o f N~vy Of ficer Manpower .nd Personnel Classification, for noac number.. Incl u de title ~nd y~Ar. and ~nths in specia lty , Enter additiona l .ub.~cl.lty numn.rs and titles held for peri~ of 1 ~ • • r or !DOn _

o . 81oc~ l~. RECORD OF SERvICE

'" TIl .. date.::,::'::~ • for the ~;,;.;; 00 21' ~as not pr~viou . ly i •• u ed _ For ~~r. who have previou. ly enlisted . r<'~nlisted . or accepted an &ppoin tment ~ithout being l •• ued a 00 214. and who are being • • p.r.ted with sny disch a r ge characterltation e xc ept "HOno rab le. " The following s ta t-.en~ . hall ~Pp4.~ u the Hut ~ntry in bl""k 18, " R~r~ •. " on the DO 21 4, "CONTINUOUS HONORABLE ACTivE SERVICE mOM lapplicable dat e) UNTIL I~ppllc.bl. datal. " TIl. " f r """ dat .. s hall be the d.t .. of initial entry I nto active duty: the "untIl " dat a s hal l be the data before c~ncement o f the currant .n l i.t~nt ,

Enclosu re {II

BUPBRSINST 1900.9P 1 1 JI.lI ZOII

or holiday. In such such rel~a.@ is not of obligated .ervice.· di acharQed i n order to

acc~pt perzanent appo i ntment. ent .. r to P<O""",,, .. nt appointmen t . Por personnel being enter the I".t day of actlv" duty I n this b l oc k . "nd ~t .. r the e f f@c t ive date of retir .... ""t i n bloc k 18 , "",_rk. _" FOr ~ra rel .. aoed on separation leave , enter tha ~te tha active duty obl igation i . compl.t ed. For r .... rvi.t ... ntitled t o trav",) ti~e incid""t to separat ion , en t .. r the . ffeetive date of r .. l ........ from acti ve duty. En.e' the actual date the ~r w .... detached fr~ the duty .t"tl on e ff ecting •• par"tion and the number of day. travel time in bloc k 19 , "",_rk. _" FOr s ervic .. member. being transfe rred to the Individu,,1 Re"dy R .... rv. IIRR) . entar in block 18 , "Subiect to active duty recall/annua l .crlHming. "

Enter the y .... n. Note that oervice .. rvice a "'idshiP"'l\n. USN. or u a for .. nlisted reverted to .. n l i s ted statu • . but i n nO ca s e i_ .t creditabl e for warrAn t or c"",",iuion""- oHice.. . 1Pt> not include l o. t H_ in d .. terminin~ net active s~rvice.)

yur".:,,~~:: ~" prior

yooars. i nactive

'"

'" "",nths. and perfonl>8d ,;,,~. whil .. on d"plo"..""t.)

n

Enter the

~;C~~~; (bas .. , .. rvic ..

Enter the year., period. (Servica

Stat .. s (OCONUS ). &xcept

,,. .n

Enter the SUM o f a l l sea lost which occurr@d

i rt nhnnc .. (c).

Enclosure (I)

( e ) Block 12h. I NI 'I'IAl. ENTRY 'l'R.l. INI OO

BUPERSINST 1900.eD I I .MI 21m

( .. ) Enlis ted. Enter t ha su. of time s l"Int i n initia l e ntry ~rainin~ which inc l udas Recruit Tra i ning and S~i l l T~"lnlng lo~ 'A ' $¢hoo l) .

(b) Officers. Ente r '!IA'.

EnCer the e n<>e ti ve 4b a8

follows :

(a) Enlisted Pe< . onnel. Actual date of adv&nc~nt.

'" dat .. o f """ "u

q. T<> assist the fo,....,~ Serv i ce and job counseling . formal su~c .. ss t ully completed during t hi . poo riod wi ll boo i n chh b lock, " .0 .. ""dical and dent. l. e l ectron ics. s upp l y. admini s trat ion. peroonn .. l. or heavy equiP'""nt ol"lu tlon o . Tu ining cou r u s for combat .kill. will. not be li . ted. Couroe title. nurher of w@~ks .. t tended . and month and yea r of completion wi l l 0. .n~.red. Refer to the Gui d . to the £V .. l uation of Edyc~tional ~~~.nc .. s i n th. ~ Services for course t i t les and abb~eviAt i¢n.. Ava ilabl e at http"'~.oUlitaryguid"s.dc~n.,t .eduJ .

pl .. c e

BUPERSIUST 1900.80 i I JUH 20!;

Place o f c.,.,..lt_nt.

u. Bl""k 16. DAYS AC(:RI)ED LEAV£ PAlO. If tha menber recei ved a l~-.~ le.ve payment, enter the n~r ot day . for which payment was received. The amount of the pa~nt wil l nc~

be .h~. It no lump- s um Ie.va payment i. made. enter "NONo.­Ensure the l eave pai~ r. fl ec~ed i n this b lock exclude. ~he l e~ve

~r ha~ t.ken prior to .~ra~ion I~erminal/.@parat ion le"vel.

v. B l oc~ I'. En~e r An "X - In <he Appropria~. box indicating whether or not w'eber completed the d@n~al eXanUnatlon an d all ~ppropr;.te dental aervlc •• an~ ~r.atm@nt wi th in 90 day. prior to separa t ion .

w. al""k lao REMAR~S. Dltriu In this b lock con.'U of information not .hown e h_hue . • pecltied bel"" . or in 5up plementftry d i rective . And =ay include o~h.r i nformation pertinent t o the .eparatee . Do not repe.t mat e rial i n other bloc k. . Tn. unused portion of b lock Ie ~u.t be f illtd by diAgona l l i n e . o f -X' ~yped ~hrouqh the blank space.

(11 Cont ; nuat i on ot Information. Continue in t his blQC< any it~ wh ich Cannot be compl e ted within the space provided. In such CASe_, a cro •• _ re f ~ r.nce MUst be mad e to indic~c. che ,c~ being continued : • . ~ .. -Block 13 continued.- If .ore .pace is required. ente r -Conti n ued on DO 21'C' in the la.t l ine o f t he b lock 5nd c~l.te t he ton. a . d irected by paragraph 2b1311 d l.

available be<on .... d.

Wh@n Information i . not che DO 21' and ~he ent ry h. s

entu in bloc k 18: "00 n ~ will boo

(]I Di .charg e for Physical D,sab,l,ty. In c~.e. of ~r.onnel beln~ di s charged tor r.ason of physica l di.abillty. mAke Appropriate entry •• l i sted below. Members who plan to apply for ve~e~.n·. c~nsation or pens,on should boo Info~ that It I . ;n the i r bois t int e r e . t t o a pply a t the time of 5~ration. If ~hey ... ;t, they may expect ~al.y i n the p rocess i ng of their applicftclon o until the Depar~~ent ot

u

BUPERSINST 1900.80 11 ..... 2BII

Veterans Affairs IOVAI can obtain th. ir medical recor~s fr~ the Navy. In no case wil l the natur@ of ~he p hysical disability be described. The necessary in fonsation wi l l be obtaine~ by t he pers onnel off i cer fr~ the 00. ~ appropria~e . e nter one ot the foll owing .t.t~nt. :

"iNam.1 has executed a cla im for c~nsation, pension. or hos pita l i.ation to be filed with the OVA."

"The ~igh~ ~o fi le a c l ai~ with ~he OVA fo~ c~n • • tion., pension •. o~ hospitalizat ions has been expl a ined to In~1 ~nd they have s i9ned stat embnts that they do / do not de . i~e to .u~it a claim at this tim@."

' Vi _ability severance pay authori~ed in amount of S I~untl bu~ not paid. ·

'Di s ability severance pay aY~hor i zed ~nd paid ~n ~unt of S lalOOuntl."

I.) separa tion Pavzent. ~he a~unt. type .• nd n~~ of of any .epa~.tion pa~nt. The symbol . for ex~le

An entry "ill be "",de s howi"9 year. to be paid. if approp~iate, ent~y .hal l include the DO' s

·V~IABLB S!PARATION INC~rVE " $'.310.00 PAID AtlNUA.LLY PQR 12 YEARS - orSBUPS1NG OFFKE SYKllO"J .~ ___ _ •

·SPECIAL SEPARATION BENEFIT HS,700.00 D!SBURSING OPPIC~ SYMBOL ___ __ •

·SEPARATION P~YHENT - $lS.BOO _ O'SBURSING OFFICE SYMBOL _____ '·

15 ) Ef feetiv. Oot. of Reti~ement O~ Tran.fe~ to rl~et Wh.m a _r i s be i ng rel"",sed hom .. c~iv" duty .nd

th. data of ~al~a •• In h lock 12b will usually be th~

;:: :,:: ;'; "i:",:enactlv. date of r e tir..-nt (30 Jun~ 2006 and list .. o f 1 July 2006). When DeIrIbtIr i s being ; :~;. Fle~~ Re *erv., the dat. of r . l .a •• in block 12b wil l usually be th~ .~ dat • • • reflacted hy Fle. t Reserve Tran8 fer ~uthQri.atiQn me ••• ge itr.n. f . rred to Fl~et R~s@rve on lO June 2006 and Yleet Pes~rv •• t a tu. c~n~~~ the fo l lowing d &y 1 July 2006). Yor Servlc~ ~~. t~.n.f~rrlng to the PI.et

Enclosure (1)

SUP£RSINST 1900.8D 1 1 -"' tttJ

Re.erve or r~tirin9 from ac~iv. duty .• nt~r in b l ock 18, ' Subject to activ .. duty recall by S@cretary o f the Navy.-

· Elf.etl". d<ote of t-.:<>ury/p'u·_nen~. <.t.\<_n~/~ransf .. r ~o

Fleet Rnerve Status, Idat.I. ·

u",ice . ~~ke , ;:C', ~.s.rve with

' ~''"' entry,

•

'M~r i s retiring as provided by .~tion 44 03 of the FY 1993 Nat ional Defen.~ Authoriz5tion Act INOAAI and .. y ~a lify for. ~.computation of retired pay a t a96 62 Isectlon 4464 of • • ~ 1·"'1 .-

• ruerviBt i. trav .. l tim.. ent er

~~. d.tached fr~ t h • • • par.tlon .c t ivity and th .. number of d<oy. travel ti~ &dded 00 arrl~ .t the .ff.ct'v. date of release from active duty entered in block l~b a . fo l low. ,

·Dat@ d~tached s«pdration activity, t\"" I . •

IBI Extension of Bnli.t~entIA¢tiv. Service. Th . fo l lowing i s applicable to thooe indlvldu.l. wno .re s«pdrated/ d; aeh.rged upon completion of their initial enl\.t~nt and a DO ~14 is i • • ued. When a ~r'. ~nli.t~nt or ac tiv. ~uty comm l tPent ~a. extended. ex~@pt for the purpose of making up lost time, the te~ of . uch @xtens ion $hall ~ @ntered i n block lB. ·R ...... rk •. - u shown below. I'or u - e=pIOY""lnt right •. ,,11 e x tens ions of enlistment or "ctiv~ s ervice ~r. con.\der.~ to be .t the ~eque .t and "for the convenience of the Government· and . ha l l be .0 noted on the DD 214. -Ext~n.ion of .ervice w~ o .t t he reques t ~nd tor the conveni@n~e of the Gover~nt. ·

d5tu of

1101 Pennonent Enli.te<l "~..:le. When a tempoury comni . sioned office r grad~ i . entered in bloc k 4 • . ent .. r the t~r.ry officer d ... ignator and da t e of commission. and the

Enclosure III

eUPERSINST 1900.8D I I.UI ZOII

h ighe.t enll .t~ T~tingl~Y9r.de he ld. and e ff . ct ive dat e i n this b lo-ck . le .~., "C~i .. lon~ te<opo .... y o fHcu on 2006 08 01 . D8SIGNATOR 6~12. Highest enli . t ed r.t l n9 /payqcade he ld PSC/E" effective 20 05 0 7 16 ." 1

I II) PI~ce of 8lrth . If t he ~c is a di s charged Alien Deserter . ent~ r the p l ace o f birth.

112 )

Enter t he dates the ~r at t ended oe rvic a academyl .

. """,, .. in block 18. - l\_rko . · to ot

be<>n YP'1uded , t he ute "u "",d .. : and th~ effective dau o f th .. corr<!Ctiv~ &c tion.

1151 For Se rvice ~r. who refu . e to sign the DD 21 4 ~t the ti~ of separa tion/discha rge. ma~e the tollawing ~ntry i n block 18, "Suvi c e . ember re fused to .ig n ~o-c~nt at the ti .... of lenter • • appropriatel." In addition . ." Administrative Remar' . entry wi l l ~ .ad .. in ~r'. electronic oe rvic. r@cord docu.entin~ re • • On tor r e fu • • l to .ign the DO 21 4. upon completion of the DO 214. di.trihution wi l l be made a . Indicat~ , n paugraph 4 .

(161 ror ind l vld~alo .. he have p"rticip"ted for advancement and:

(al Selected fo r advancemant ~uring the last &dvanc~nt cycl~, but not ~dv.n~~ by tha time o f separ.tion, enter the followi ng i nfo.,....tlon In block 18, "!':x_ination ~QrnPl .. t@~, se lected for advance~ ent but ne~ a~vanced by t he tl~e of s_parat ion, member · s fi nal mu ltiple acere an~ ddt_ of examination: e.g . , HTI . PASS . FIIS -66, 200303 06."

Ibl pa~.~ th. 8xamina tion but no t advan~ed, enter th_ following info~tlon f nr up to last four advanc~nt cycles

BUPERSlnST 1900.8D 11 ..... 2011

i n blod: 16 if data I •• v.lI.bh, """""'inaHon """,,,leted, member' . final ~ltipl •• cor •• n6 6.te ot ~~ination, ... g., HT1. P"SS. F>\S - H, 200l 03 06 _" I n .ddltlon, i nelude lIl"mber' . t ime in rat e , advanc~nt rec~n6ation fro~ ~he ~r' . ' •• t «va l uation report. p@riod ot report and highest a dvancement ~ .quir~nt. compl.ted .

1111 Poe a Service membe r who i . being tr.n.rerred to the Individual R~a6y Reser ve {IRR) , make the f o l lowing encTY'

I i al FOT • s"rvlce ~r ord.r~ to ~ct iv .. duty in ti~ o f Nation.l ~Tgency OT w~" . ot.r .0 b l oc k 18 the ac t ua l dates of deplo~enc Into ~he theate r of operationa , e.g., -IRAQI FREEDOM TIlEilTER FRCOi Ol Ft:a17 TO O~1.PR 1 0. ·

1191 For S .. rvice ~rs retiring or aep.ratinq fr~ act i ve duty. doe~~e parti~ipation in ~ontingency oO@r~tion • .

1201 If Serv i ce .. rr .... ~ e hcto, entn an ,, - mail a<lclreu and te l ephone number to ~ l low contact by .gen~ i .o r eceiving copie s of the DD 214. I f the ~~r po • • ••• e ••• e rvice ' a - mall for l ife" address it is preferred .ince it wi l l provide a • • ~ure e _mail .nv iro~nt .

y _ Block 190. nEAREST RELkTIV!. Enter the c~lel. nAme ,

. tra. t and n~r , city . county, Sta t e or country, ~nd .Ip code o f the ne are .t r.lativ. where mail say be forwarded followi ng sap.>n tion.

~~~~f;; of the DD INA. SU.te Director. , ~ ch@cked, the 5bbrev iation of the State s pecif i ed by the ~r must be entered in the bl.n~ _ EnclO$ure 131 contAi ns ~ddre •• e. o[ the Stat. Directors and the t~-let ter

Enc l oou re {II

au~ERSINST 1900.8D 1 1 JIll ZOII

4bbr.vi.~ion for th. Sta te • • dr . Wrt from the N&t1onal Pca~ Ott i e * &n6 Zip C06. Dir*Ctory .

bb. Block 21 a. MDIBER SIOWlTURE. The electronic aignatur* i . th* preterr~ metho6 an6 will be us~ as capabiHHu .. volve. H . h cuonic signature is not used. en aure ~he . ign&ture i s l egible on all copl . .. The ~r must be ~6. ~~~r. of diffe renc •• In the info~tion ~ont.ined on certAin copie. of t~e DO ~ l '. When & ~r i . di .cnarg~ in ab.~nti a . enter "Di . cnarged in Abeentia · in thi s block. For a member who i s physically unab l e to sign d u e to phy.lcal Incapacitation or r e fuse . to sign. ~nter "Signature unAttainabl e " and ~nter th. r •• • on in b l oc k 18.

cc. Block 21 b. DATE. Ente, the ~t. ~r· •• ign8~ur. i s obta i ned..

-, IE5 or ~ '; : by dir..,Hon. block.

"" Official

". "ftld81 to si~n

thh

ff. Bloc k .3. TYPE OP S~~APATIOH. Ent~r the type of separation effected from one of th. fo l lowing,

III Di.ch~rge<l;

121 Tu.naf~rnd to VSN/VSA/>lARCORPS/USAF/USCIl,

Encloaur* III

lIl}PERSINST 1900.80

11 .... 2011

'" Released «_ Active DoJty ,

'" Rd ... se<!. h_ Ac tivo Dut y and Tanoferre<! " , .. ,,~ Rue.ve:

'" PelMSed ,,- Ac t ive ~" '"' Spechl. work (ADSW I:

'" Uhu .. d «- AcHvo ~" '"' Trainin<;J 1.0.01'1:

171 Rui<;Jned;

lSI COImiuion Uvok e<!;

191 Di"",iue<!;

1111 oischarg<!<l and R"appo inted tn n. Navy Reser" " ,

11 2 1 Tran.f .. rud to th .. Pleet Reo"rv",

11.41 p"tire<!,

( 1 51 Di . chug<!<l frOlO th .. ",""al Acad .... y;

1161 Ol.charge<!. froe the Naval Acad .... y. Re s umed/A.signed Enli s ted StAtu.,

( 171 void (Uncharacterizedl: or

(tal Dro~ FrO<ll the Roll • .

g<;l. Block ~4 _ CHARACTER or sERVICE. Enter in capita l letter. or. .. of the f ollowing,

HONORABLE lQ."l)ER HONORABLE CONDITlOOS (GENERALI

lINDER OTHER "mAN iiONORABLE CONDITIONS ~O~

DISHONORABLE UNCHARACTEIUZED

BUPERSINST I900 . 6D t t JlII lOll

I n the ~aQ@ of an office r di~ls aed or dropped fro. the roll s , ent e r only ' x's," The character of • • .vlce MUst be appropriate and consi . t ent ~ith the reason a n d authority for .eparation,

hh. Blo<:k ~S, $EPAJlATIOti AVTHORI'I'Y

'" releas .. i. reteren~ .. Ib).

Ente r the a uthority un der ~hich appropriate article n umber fr~

12) Office r s and Midshi~n . Cite t h e o r ders authori,i n g upooration.

" Separation Ent. r the appropriate The l ist of authori.ed SpD

aha.} not be r e l aased to DoD. NAVPERSCOM IP£RS- SJl l

code. i. 'For any agency or wl .1 provide the requut.

li s t to authori.ed ."pooration ac tl vitie. upon

jj. Block 21. R£&NTRY OOD~

11 ) En l i sted Personn .. l . Enter t h e appropri a t e r@entry code ~ons~te to th" rea s on for • • poor.t lon a. 11 . t ed in e nclos ur e 12) and usi ng guidelin". contained In r e tere n c e Ib ) 1160_030.

12) Otf i ~.rs and Mi d s hi pmen. Enter · NA. ·

kk . Enter the r .. ason t h e gPD

Code u . ed I n block 26.

11. Block 29. DATES OF TI ME LOST DURING THIS PERIOD. 2nt .. r i nclusive date. for •• 1 period. of t i me l ost ~uring t his per iod o f activ .. duty , inc l ~de per i od. of UnAuthori~ed absen c .. or .Ickness du e to -usconduct. but do no t i~ntify types of time lost o t her than by "TL. "

""""'Ph., TL 2004 06 21 ro 2004 06 29 Or TL _ NONE

-i n itials

Enclosure I I I

BUPERSINST I~OO.6D 1 1 JIll 2111

the ~mber elec tron ice l lY signs block 21e then the member sust aho dectronicellY sign bloc k 30.

• "

The dlotrlbutlon of al l c op te. of del ay. The original and copy

the ~r in conjunction with their and prior to f inal departure

additional duty.

un..,..,loyment Service ~r cannot f i le for unemplo~nt in any week before the 5th week be9inning after th~ week in which the e ~ -Service met<ber IOU upo. r&t ed.1 Prepo.ration of the 00 21 4 will not be delayed becau •• i nform.eion i. not aval lebl e for ~ompletinQ all pertin ent It...",. Rathe r, it wi ll be (>repo. u d u compl.eely as po • • i b le and a DO 115 wi ll be completed to s upp lemen t it. Member. wi l l be advi.ed t ha t they will be provided the DO 215 wi thout having to r~ • • t it. For those en l i sted pe r.onn~l being discharged On ~ppellat. leave . • n t.r "Refer to 00 215 ' i n the ~ppro(>ri~te blOC k • . ~nd the 00 wi l l I • • ue the DO 215 wh.n the needed info~tion he. been received fr~ NAVPERSCOM (P!RS - BI. In a ll other cue. wher .. inc~ht. 00 JU · . are i.sued. NAVP!RSCOH, Record s An«lysis (PBRS-1121 wil l be advised that a DO 215 will be nec ...... ry . Oiotrlbution of th. DO 214 shall be ~~de a. fo l low. ,

a . II<!mber· . Copy I~r t _ Or101nall. o..livu to th~ ~r the oriQinal DO 21. in conj unction with the ir release f rorn activo duty . orvice and prior t o final departure from their c~nd on per.i.sivo temporary additional duty . t ermi na l leave and as.ocl a ted travel. Th. or i g i nal OD 114 will be mai led under condition. precl~dlng physical d.liv.ry or when the ~~r departs well in ~dvance of norm. l departur. time, • . g .. on h~ awai ting order •. Or tran.ferred to a OVAHC. If th. ~r is dlochbrged •• a" AI l e" De •• rear ... r~roductlon o f copy n umber 1, with the place of biTth ."tered in bl~k 18 . • hal l Do .ent to, U.S. D<\'pa«"""t of State . Vi .. Offie. seA/YD. State Annex Nwnber 2 . Washington. OC 20520. to ... h t thO vi .. OHic .. In precluding th~ unw~rranted i • • u e nce of vi .~. to dloch.rged and Allen deserter •.

'0

BUPERSINST 1900.SD I I .llI 2011

.u~I • • lort of the DD 214 I. the ~ •• f •• red

Fo~a~d copy n umber 2 evolv~, electronic ~thod. Continuo

exist.

(I) For .~ •• tlng offlc.ro, attach tho or i g inal DD 2648 I~ctlve Dutyl Or DO ~64a - 1 IR •••• v. co=ponent ~r. rele5sed fr~ ~ctlve Duty ) Pre .e~rat lon coun • • ' l ng Ch.ckl ist, a co~y of the off icer 's oe~r.tion orders . nd endor.~nt. a copy of the separat ion phyo i cal (DO .908 5nd DO 2907-11, and any •• quired NAVPERS 1070/613 .. ntrieo. l'!ruIure the DO 214 t o the top document.

(21 FO. officer candidate or midshipman discharged with an e ntry - level . e~ratlon, .u~lt with Midshipman Oath of Office, separation order. and endor.~nt, d~~ntation authorizing d i s charge, and o ther service record d~ument •. ~n.ure the DO 21' i. the top document.

(ll FOr natur.li~ed Se rvic o ~rl. 1 separated with an Under Other Than Honorab le Conditiono characterizat ion of s ervice before serving honor~b l y to~ 5 ye~r., forward locally reproduced copy 2 to:

,

II.S. Citizens ~ I ... igr"tion Se rvice. Domestic Operat ions 20 Ma •• achu.~t t . ~venue. NW. Suit. 1100 W • • hlrt9ton , DC 20529

Dep"r~nt ot Veteran Affairs Data Proce •• ln9 C.nter (21 ' 1 1614 Ila ~t woo<tw •• d St. ~u.tin. TX 79772

;

Enclos ure III

BUPERSINST 1900.80 110M! 20IJ

Note ' ~ loc~l l y reproduced copy of copy n~r l will be placed in the ~ber · s hea lth treat~nt record per rete rence (bl 6150 - 01 0 .

(21 If th ..-r is trans ferred o t relun. f orwa rd a locally ::": ",~"~ hard copy or electronic copy to 'hat ho"pital. ~ttach the copy t o ~r· . clinical recorda, x -ray f( lr~, and a COpy of the ~r·. he~ l th r ec o r d.

(3) H conple teo V~ 21 -5 ~6, or Pen. ion, i nc lude a c opy .. ith the cla i", package t o the VI< OU ice jurisdiction ov .. r the ~r' s home address. ~r ~y .1.0 e l ec t to have a duplic a t e ot Copy] f orwarded. to the Centnl Office of t he 0'11< in the Oi'trict of Col umbia. Th . clai. package ahou l d be p repand par nhrence Ibl 1910- 80 4 . (Not " Do not forward the chi. t o the DVI< St .. te Director· * oHice.1

d. Melllboor· . COPy (Nwnber 41. Enouu ~r initial . b l oc k ~ Q and de l ive r copy number 4 to the ~r. !t should be ~liv..r"" a t tho ."'"" d .... as the orlgl n. l. "_<0 "'il l boo a dvised that s houl d they subsequent ly reque ot unemplo~nt

c~n •• tion. it ~y boo dolayed unt i l s .. rvice ~t. can be verified.

e . u.s. DepOrt,""n~ of Lal>or Copy (>lumber 51

( t l P.rsonne l Continuing on Active Duty. When an i ndividual I . In •• rvic. and @n l i s ti ng or reenli.ting in an active duty s t.tus or otherwi.e continu in~ on active duty in ano th~r status . copy number 5 wi l l no t be forwar~ to t he Depart_nt of Labor.

u.s. Depart""'nt ot Labo r Federal Cl ai~s Control Cen t er P .O. BOX 78 5Q70 Or l ando. FL 32S18-SQ70

copy

5U PERSINST 1900.80 11M"

or t u nder r ed to th@ Ph .. t ~":::;':: .~~.~ t o appropriate OVA S t a te Dlr~tor Isee

11)), if the ~r.o nquut. by checki n\! " ¥ES ' i n bloc~ 20 of DO 21 4. The ~~r ~u.t .~clfy the State . If the menber does not r~e.t th~t the copy be ~iled, copy number 6 will be dutroyed.

g. Service CoPY (number 71. Copy number 7 ~111 be dutroyed.

hard

r.,.uut an _v_liable from the

L ~. 00

r •• u l n~ e~n~ au. t f ile a for 2 y".n froo> dolote of

number S wi ll be de8 troyed I n the ev~nt the membe r

cop y ot I •• u i n\l e~nd .

the torm, a copy i&

separation. Provi de ~r copy Inumber 4) to denobi l izing res~rv~ par sonn@l who w@r8 mobilized in suppor t ot a contingency operation. This advanced copy wi l l be pr ovided to the ~r durin~ t he d@mDbilizat ion proce&. prior t o the ~r d«partin\! the Navy Mobili.ation proce& s i ng Sit. INMPS I on separat ion leavft and is proYl~.~ ~ol.ly to r the purpose ot pr. -registering Sailors for Vet8ran'. Adnini.tration ~~Ical / d~nt.l ben~flt •• t NMPS and i s not to be provided to any o ther c~nd for any ""4Oon .

, .t ~ l k.a~r • . er •• ure., th e the 00 214 ,

I. chango Or correc t ions entered on DO 21 4 th8 form void unleu they ue i nitialed by offici~ l. The ~r will be advised that any chafige or altera t ion wil l render tho form member t o wh~ t h ft DD 214 i s issued wi l l be in f orD@d of thft proper procedure for having o t ticial corr@ction& ~d@ wh@n e rrors ar@ d i s covftred deu r~elpt.

Enclosure (I)

BUf'ERS!NST 1900. 80 1 1 JIll 2DIl

a. Official Chana •• an~ Correction s . Once the DO ~I' has b@~n Issu~ and copi •• ~i .tribut~. official correctiQno ~y be md~e ~ i • • uance of DO ~15 •• ~cePt a . notRd i n paragraph 6 belo... The DO 21S wi ll be ~i.tribut~ I n th .. ...... l'I>II.nner as the original DD 21 4 which it correct.. Since the infor ..... Uon contained in block s 25. 26. an~ 27 (SBP~TION ~UTHOR!TY .

SEPARATION CODE. AND REENTRY CODE. respectively) haa 11=lted ~i .t. rlbution. coruction to th ..... it-.. on a 00 :llS r<Oq>Ji r u the l imitation on di.trlbutlon of the DD 215 . It other item5 a s .... 11 u bloc~. 25. 26. and 27 ar .. corr .. ~ted . issu ing au~horitie. mu.t a ssure tha~ copies of ~h. DO 21S is.ued to agencies no~ entitled to rec.ive block. 25, 26 .• nd n info,.,...tion. receive DO 215 copi~s which omit tha t into~tlon.

b. ~ correction requ • • t mu.t con tain oocial ... c urlty n~r. pooriod.s ~IUng addr .... of the "",mber conc .. rned. Th e ~orr ec t ion r ftqUe.ted =US ~ al . " be i d @ntifled. and If neCe •• ary . supporting documen~ati"n provided. If a copy of the DO 214 for which t h e reque. t i. being ~d. I. availabl e , it should be t orwarded with ~h8 request to one of the follOWing loca tions,

•• •

Navy Pe r sonn e l Com.and (P~S-)12) 5720 Integrity Dr. MlllingtQn . TN laOS5_lHO

National Personnel Record. Cent .. r Military per.onne l Records 9100 Page AV@nu. St. Loul •• MO 63132 - 5100

The DD 214 will normally be t ha member is separated.

I •• ued. NAvPERSCOM (PERS-) 121 may

BUP~lNST 1900 .80 1 I JI.lI ZOII

i.su~ or d i rect i s.uanc e of a DO 214. The fact that th~ 00 214 WdS admini.tr ativ~ l y I.su~d "R@mArk$," un le •• o therwi.e

will 0. ~nt.red in block 18, d'ucted . IS .. p.o.ra~raph )lv)I11I).

b. Rainuance. NAVPSRSCOt! IPSRS - J12 1 ""'y ni .. ue or dir'""'t r.lssuance wh en ,

111 Dlr~ctad by appropriate a~llat e authority, Ex~utlve Order. or s~v.

121 ~ DO 214 cannot 0. co r rected by the I . s uanes of a DO 215 or the correction would requ i re the i •• uance of mDre than t wo DO ns's.

131 The r e i. a change directed by competen t au thority vice a cor<.otion of a~!ni.tratlve error to Ch4racter of Service in block 24 .

Requests for as indicated in Shi l l

7. ~Inl .tratlv. Chan?. While M8mber i. on Terminal Leave. Prior to .ePara tion each member .ust 0. couns.led regarding actions to be taoen Or that cou l d I ncur In the event of death, .er'ous injury and ~i.conduct prior to actual separation/ discharge date.

a . 10 tl>e ."ent of the deatn of ~r, the f...,ily i. required to not,fy the meMber' s c~nd an d servicing PERSUPPOET in order to void the DO 214 ~nd tao. required action r egardi n g the ~r'. death.

h . rn t h e ~v~nt t h e ~r s u fters a serious injuryl Illn ...... h e IHlOboor or f "",iIy l it IIH!"mber is incapacitatad) 10 r equired to contact ~r'. command and 5ervicing PBRSUPPOET to en. ur. ~ieal I •• u •• Are properly addre •• ed. The DO 214 ~y require cancel la tion or .aditication if a&dicAI action. extend ~r ,n an act i v o duty .tatus or PEB Action. lead to d h ahll.lty.

c. Member IOust be """de aware tht i f •• r i ous .,iIiury or cl"illan misconduct i. di.covered or c~itted prior to aeparation date. t h e ~r ~y be reca l led i n order to addres 5

BVPERSINST 1900 . 8n 1 I .AlII _

po • • f b l. cou rt.-m.r t iAI O~ ~dmi ni.trative .epa~fttion proce • • l ng _ Th io ac~ion may resu lt i n cancellat ion or correct ion to on 214 ~ith ~eg5 rds to type and charac~.ri%a~ion of d i s charge.

a. Gftneral. I n order to obta i n a copy of a DO 21 4, a signed request mus t i nclude adequa~. i d enti f ying data; i .•.. full nama. rank or ra ~ • •• = ial security n!llrlb4or. Na vy urvicft numb@r(.) . da t •• of service . .nd a ~urr.n~ re~urn address.

" aign.d o f iuue f o llowing,

~~~ , In ..... pon .. te an indiv i d ual '. t h e pn 214. and ~.ed on the dat e

individua l will .. .c.ive the

11) In the ca.~ ef a DO 21 4 iss ued on o r after 1 Octobe r 1979. en. copy of th. on .14 I n~ luding ~h~ Special Additiona l Information Iblock . 23 through 30).

12) In the case of 5 DO 21 4 i •• u ed before 1 Octo~r 1979 . one cepy of the PP 21~ fram which the Authority lot S@paration. Narrative Reas en f er Sepa ration. SPO , ~nd R •• nt~y Cod@s hav@ be@n d@le t ed , 5n d one copy of t he on 214 containin~ the Au~ho~ity fer S~paration . SPD. and Reentry Code . If op*eifiCal , y ~~e.t~. the i nd ividual may alo o be provided 4

p lai n lan~~ge "Narrative Stat~nt " o f ~he reason for the 8 ftparft~ion. The .t at~nt wi l , 0. p~ovided i n a separa t e let t e r.

I n tho •• cas~. whe r ft i nd ividua ls h a v e to receiv. a cepy of their DP 214 , the

c opy provided ~i,l not i nclu de t~. Sp*eial Additional Inf o rmation fro. a PO 21 4 i ssued on or a fter 1 OCtoo.r 1979. or in th~ cas@ of a PO 214 i s sued be f ore ~~t date. th. sepe ra tlon Au thor ity, Na r rative Reason for Separation. SPD . • nd Reenlistment Code.

d. Request fo r Repl.c~t Copieo _ Re~est. fo~

~@placement c opi.s s hou l d be a ddre •• ed •• i ndieat~ in 5bll) or 5b(2).

pa.ralluph

9. Rftporti ni R~irements _ Enl isted/Offi cer. When repor t i ng personne l 100. due to .epar.tion/ret l r~nt . ensura ful l comp l iance wi th current pay and per s onnel p roc~ure . direetiva • .

Enclosure 11)

REENTRY CODES

itE-RI Rec"""",nded for prefeued uenl l .t .... " t.

BUPERSINST 1900.8n t t JIll ZIII

RE - IE Eligibl~ f or reenli.~nt, but not r een listed due to Perfora t o Serve lPTSI r~uletions.

RE_2 I ne l igible tor r eenl •• t ment bee ..... e o f the fo l lowi ng a tatu.,

Ret i red lexcept for tra"ofer to TDRLI.

Warrant offi ce r _

El igibl@ for reenli .t~nt e~cept for disqua l ifying factor. Add l etter to indica te statue at ti .... of .. patation,

itE-3B Pa r enthood/Pt egn4ncy/Childbirth .

RE_3C Conscientious objector.

RE-3E Inducted/EnlistedIExtendedIRee" llsted i n er r or.

Rl - 3F Pailed the phyoical fitness a • • e ...... ot IPFAI.

RE-3 G Condition Inot phyolcal diubilityl interhd ng with perfo~oc. of duty.

RE- 3M Hardship/Dependency .

RE _3J Fai l ed entry leval drug test, not drug depend."t .

Enclosure 12 1

RE - )

RE- 4

RE_6

RE-7

8upERSINST 1900.80

I I JIll 2011

RE- )K Oi oenrolled [rom ~vol A~ad~ or other offic@r proqu."'.

R.E-3M Indigibl .. for u .. nlist .... nt i n current rating.

R!- JP Phyaical di . ab ility linclud ... d i.ch a rg. and tran.fer to TORL).

RE_)Q Oi.qualifiood for officer candldat . training Inot phYOica l ly qualifiood for appoin~ent a& officer i n tha ",",v.t urvlc.) .

R!- )R Not ...... ting th .. prof ... . ianal growth ~rite ri a ( S .... ufuence (b) 1160- 0)0 ).

RE-JU lIinority age.

RE - JX Non-awinm<!L

RE - ]y Rece iV<><l. voluntary Separation I ncentive IVSI).

uSNR- R r elea.&d a fter .erving 90 or ~re day. of Active Duty for Training (ADT) . Ret urned to Reae rve unit/activity without r ... nli&t~nt ~ligibility being d .. t .. ",in.od.

In .. ligible or deni ood r e .. nli.~nt due to lIigh Year Tenure.

c~pleting the initia l 2-y .. ar active du ty obligat ion und"r the ~ ~a Navy R •• erve proqr~.

BuPERSIN5T 19 00.8D 1 I .11M ZOIJ

T~~a<y ~ica' con~i~ion. or uns a tisfacto<y initi.l ~rformanc. ~nd conduc e I.v. i l.bl . to r.crui~. assigned to Recruit Tra ining Command tor initi. l t~ainin~ onl y).

,

IIOntgotHry. AI. 16102-1 509 Dove r. DE

BUPERS!NST 1900.80 I I. .... 2111

Vet e r"". AHa in Blvd

. • suit e 100

"i..dc • .. I Col_i. (Ie)

<>t VeUr""" A« . 1r. ""yor· . Offic. o' V.eu~n. A .. . i n P .O. "",x 'aoo .. , . " St . • "" Fore Richard. on . AI< '''08 _ 0800 Sui,. "'" SOueh

W •• hi""t<>n OC 20001_2111

Offk. V.tuAna Affair.

<>f V.Ur Ano S~rvi~ea lJll ""rth C.ntra l Ave . ""ic. 10,2 Phoenix. AZ 850.2

............... ( .... ) ""P<'rt.-tt of V.tarana Aft.ln 1S01 l1i. ""ry l and AVOI. N",rch Linl. Rock. >Jl 12120

" A .. U'O.''''A (CA) [>Op.>rt-.,c of V.t. ,a", Aftaln 1n7 0 St .• R""", 100 Sa"r..-nto. CA 94291

C"O'QP''''' (CO) Diviaion of Hilicary • Vu.cart. Affair. 7H5 ~ . j " Ave . • Suit e C ""nvee. CO 80'JO - 6817

W~y. Suio. 180 ]:l1 .. _701 ~

lOJH-4800

QIWI (GIl)

v.t." •• no "'H~ira Off i~. Offlc. of tho Gov~r""r Gover..-nt of au ... P.O. IlOx 5178 Ko.ga t ..... GU 96932 - 8659

....... I'''> I ..... ho Div!.lon of Vet.un. s..rvicea 320 CoB I"" M . Boloe . ID 8)")02 - 4519

BUPERSINST 1900 . 80 11JUll1ll

B'l'Aft Dllt&CrOIIS Or m:rAII..a&M. or vrrDtIoJI1I AFrAID (e..rU'tll:D)

Affai r .

0606'

tJo> ........ (U)

"" .... rt_nt of Veteran. Affair. J02 ..... Ifaohi09ton St , . ROOf!! E- 120 1,><;1) """..,11. , IN H20. - l7JS

IOIIA IU)

I""" C~i • • i.on of V.tuan. AHd .. C""" 1><><%1., BId\! MA HOS "" "10'" Ave. John . ton , IA 50111 - 19)5

.:.n ••• c""",i • • ion of v.toron. ' Affair. J ayh/owk TOW<!t . 5~1t e 701 700 sor., Jackaon St. !'<>!>eh. ~s 6660J - J976

fZ IUC"," In)

Oivi.ion of Vot.ron. Aff . i n 1111 Lo>J.i oville Rd . pranH oTt .• ' '0601-'HS

t.<X7Uua>. 1t.>.1 ~rc-nt of Vot .. a n . Aff,h. P.O. Box 9<095 , Capitol Stat ion ... tOn Rougo , LA '0800_909S

"" .... ''''1 Buroau of I<Ioln. V ••• ran ... rvlc .. In Stat . w"" •• Station A"VUO la, ME Oull - 01l7

I" !W')u (n) ""pO.rt _nt of VH .. a". Athi r . P.O . Box 19U 1 Sprin.,-Hdd. IL ~219' _9U2

IlICIII...... ( .. I Depar<_nt of IIllltary • Vetoran. Affair. H2J N. ""rtin ""oM, .In~ 81vd . .... n.I""' . II ! 'U06- 29H

St ... Votor .... AHoin Board P.O , Box 5H7 f .. r l. !IS 191H- 59 41

.. ...,.,.. lMO)

lIi •• ""rl V • • • ran. cowolo.lon P.O. Drawer H"I J o ff ... "" City , MO 65102 - 2901

......... ( .... 1

V.Ur an. AU,lro Divlolon P.O , IIOx 571, H. l e na. lIT 5HO'-57lS

<>avar"-n t or V_U Tan. Aff a ir . P. O , Box 950 ~J

Lincoln . N! 6aS09-~08'

!nclo.ure 131

ItUIn.a>ID I .... )

'IHyland ""'""rt~< of V4t O~""O Affairo Tho Jeff ... on Building, 4" Ylo<>r 16 Fr",,~i. S' Anna~l!., lID 21401 - 1100

...... PC1<\l'.~ IIUo f

""""n_nt QI V.t.un. s.rvic •• ~OO ..... hington SL. s~it. llOO fIo.ton, IVI 0'1l1-'-'0.

..... <I¥Nn i llJ )

Dopo.rt_nt o f Mi lita ry ~ '1aUr""O' Mf~ ; ro

• . 0 . fIox 140 Trenton. NJ 0062,_oltO

..... ax.co I D )

'leU."" . Servio. c.-i .. ion P . O. !lox ~)" SanU F_ , ~ 0750)_2120

RDf T<)ltJ; I .... )

oivi . ion of Vat. r a". Affalr. S Fmplr .. Stat a Plua Sult. 28)6 Albo.ny, Ifi 1::22l - 15oo

-... C .. ",JU lEI

Divioi<>n of W t . r aru. AHair. AI_rl e Building, SUite 10~5

125 Norlh Salishury St. 1l~1 .... 11 s.rv iee Conter ""Iaigh, NC :17699_1115

,

EVP~RS INST 1900.80 1 1 .All !II

.......... 1""1

Offlc. of '1etuans .ervlc .. 1201 T.noina l Way, p~ ;US Reno, "" 895.0 - 3258

>IDI ........... U I " )

NR S,at e '1e •• ran. Council 27~ Chastnut St .. ~""" nl !<aneh •• ter, NH 01l01 - 1UI

• . .LV"" ... I U f Dopo.r ..... nt of NH!t~ry Affa in Buruu [or Veteun. ~ff~ i .. For t Ir .. cli~ntown Go" Bu11dl"" S- 0 - 4'l Annvlll . , p~ 1100)-5002

...att'O U CO In )

PUblie Advoc.te 'or V~tuan. ~H~ln P. O. lOox 1l'lH Fernancle . Junco. St~ti"n SAn Juan, PI' 00110_2837

.,....,r<-ent of H.....n s . rv le .. O;v;.ion of '1et.ranO' AHain M.t..,,.. Ave , Br i . to l, Rl 02809 - 0689

Otfie. of V4taran. AHal •• Br""" St . ... Offic e Bl40. 120' Pencl1u"" St .. SuI<. Hj Co l ,..wia, SC 29201 - )151

Enclosure 131

_ ... I>.UOTA ("")

_n_nt of Veteun. Affoi .. P.O. 1Io~ 900J • o r go. NO 5810~-900J

~ (011)

Governo<'s office of V.'.ron.

11 S. High St .• JO " Floor <:01\...00 • • "" 4l:11~ - 6111

OJ'! . .... (01<1

""PI>"'_nt or V.terana AHa!<_ P.O. Box ~J067 Oklah""" Cit~ , O~ 7)15.

0'" , •• 10lI1

llepftc~t or Veter~"" Mfalr& or..,on v . u r . .... Building 700 S...-r St., ","" "'1_, OR nllO - 12e5

~ (""I Oeporu,.nt of Veteran. Aftain 550 Footh!ll Blvd .• Suite ~02 Salt LaX. City , til" enoe

V".:_' ( ..... 1 Soat . Vn. ran. Afhlc. 120 Stat. "'. II<>n", .. 118r. 'IT O~620-HOl

VU"nlUo ( .... 1

Doopart_", of V .. t .. ,an.' Affair. 990 Elln .... 1" st. "".t Wing. G,ound p i"", 210 F n nklin Rd . SW . Roooa SOl R;ct-md. VA 23219

,

BUPERSINST 1900.80 1 1 .MIl ZOIt

..,.,... I>.UOTA (.,,)

Olvi.ion of Vetenno "Haln Soldiers. hllon ,,-,>cl.1 21"" •• 5 Ran Co"Hol Av., . r;~He, SO 57501-5070

H __ lan<! S4<:u<lty o n.;! "eteuno Aff.i,. 215 Eight h Ave .. Nonh ~ao~vlIl • • 'l'N lnU-1010

ftVoII (ftl

T.x~. V.t."~n. Com.i •• iQn P. O. Box 12277 Au .. ln , TX 7~711

-*" vuo . ..... !WV,

D!VIs!.", <>f V.U.""" "n.1U Chorlest~ ~~n ".our~. Con<~ r Inl Plu. g.,.t. Suit. '01 Chocl .. ton. "" '~J01_"OO

~rt-.,t "I V. t<tran.o Affair. •. 0. I\Q~ 7S'1 ~;.on. WI 5J707 _78,l

Ill ...... UrTl

Wy<>ool"" Veteran. ' ~!faln co.al • • ion 851 .... ""u Ct . •• uit. 120 C",poor. "" 8260 1_1308

IWlBUICI ' .... (""'I

Depo<"-<lt of Vetec~n. "".in P ,O. Box n150. ><oil St"" 1150 Ol YMl'lo. wA 9850' - 1150

Enclosu re (J)

BupERSINST 1900.80 n .... 2IIlI

8"l" .. n oIKZCToIUI or DU'AIi ..... or ~ ArI''''''U (eoorrIlOllKO)

offio . of ".<uon. Affair . KabC. Lowoor r.ov .. X!"Il".~Ul. St. Croix. VI ""8,0

,

.... r1.nd I.hn<b P.O. Box SOlH6 Sa l""". liP 969S0