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Revised: 10/04/2016
INSTRUCTIONS FOR APPLICATION OF MILITARY SERVICE CREDIT
Step 1 – Submit the listed/required information to your local personnel office within 90 days of your date of enrollment in the Marine Corps NAF Employee Group Retirement Plan:
Completed eligibility checklist. (If not eligible, stop here. Submit eligibility checklist for filing purposes only).
A copy (not an original) of your DD214. If you do not have a copy of your DD214, complete the enclosed SF180 Request Pertaining to Military Records and forward to:
National Personnel Records Center (Military Personnel Records) 9700 Page Blvd. St. Louis, MO 63132-5000
A copy of your military service earnings. Complete the enclosed
Request for Estimated Earnings during Military Service form and send with corresponding DD214(s) by mail to the appropriate address. A DD214 must be submitted for each active period. Your HR office is not responsible to obtain this earnings information.
Signed and Dated Statement of Election (Intent) to Purchase Military Service Credit in the United States Marine Corps Nonappropriated Fund Employee Group Retirement Plan. Original copy. Your personnel office forwards all original copies of elections to purchase military service credit, including waivers, to HQMC/MRG for filing with your retirement record. Important: Election form must be submitted regardless of payment status or pending estimated earnings from the military retirement pay center.
Step 2 - Validation and Calculation of Amount Due Your local personnel office will forward your application to purchase your military service credit to HQMC/MRG for validation and calculation purposes. The calculation will be based on your post-56 estimated military service earnings multiplied by 5%. HQMC/MRG will notify your local personnel office of the amount due. If full payment is not received within 24 months from the date of the signed Statement of Election, 5% interest will begin to accrue and will be compounded annually until full payment, plus interest, is received by HQMC/MRG.
Step 3 – Payment Election Submit completed payment election form to your local personnel office.
Due Date –Payment must begin within 30 days of notification of amount due to purchase military service credit. Full payment is due before date of termination of active employment. Incomplete deposits of post-1956 military service will not be used to compute an annuity and the partial payment will be refunded by headquarters (except that a survivor shall be afforded an opportunity to complete the deposit in a lump sum before payment of his/her entitlement).
Revised: 10/04/2016
ELIGIBILITY CHECKLIST FOR MILITARY SERVICE CREDIT
This eligibility checklist is intended for NonAppropriated Fund (NAF) Employees applying for honorable active military service credit in the Marine Corps NAF Group Retirement Plan. Name:
Activity #: Empl ID #:
Section I YES NO
1. Are you currently receiving military retired pay (“not” related to “combat service-connected disability”, Voluntary Service Incentive (VSI), Servicemen’s Separation Benefit (SSB) or VA Disability Benefits)?
2. Do you expect to receive or be entitled to MILITARY RETIREMENT pay in the future?
3. Have you previously applied for and/or received credit for “all” of your military service under another employer's retirement system?
If you answered YES to any one of questions in Section I, you are not eligible to apply for military service credit under the Marine Corps NAF Group Retirement Plan. If you answered NO to all of the above questions, continue to answer the questions below. Section II YES NO
1.
Have you received credit for a PORTION of your military service under another NAF Component’s retirement plan (Army MWR or AAFES), CSRS OR FERS?
If you answered YES to the above question in Section II, you may be eligible to apply for credit of the remaining military service under the Marine Corps NAF Group Retirement Plan. Continue to Section III. If you answered NO to the above question in Section II, continue to answer the questions below. Section III YES NO
1. Was your military service active duty or active reserves?
2. Were you discharged from military service under “honorable” conditions?
3. Are you currently enrolled in the Marine Corps NAF Group Retirement Plan?
4. Was your enrollment date in the Marine Corps NAF Group Retirement Plan not greater than 90 days from today’s date?
If you answered NO to any one of the questions in Section III, you are not eligible to apply for military service credit under the Marine Corps NAF Group Retirement Plan. Note: If you are currently eligible for retirement enrollment, but are not enrolled, you may re-apply at the time of enrollment. If you answered YES to all of the questions in Section III, you are eligible to apply for military service credit. Follow INSTRUCTIONS FOR APPLICATION OF MILITARY SERVICE CREDIT. Employee Signature: _________________________________Date Signed:________________
Revised: 10/04/2016
REQUEST FOR ESTIMATED EARNINGS DURING MILITARY SERVICE (For U.S. Marine Corps Nonappropriated Fund Civilian Employee Group Retirement Plan)
INSTRUCTIONS: Submit this form to the appropriate military finance center for your branch of military service.
If you have service in more than one branch of the military, you must request earnings for each period from the
appropriate branch. Attach DD214(s) or equivalent and any records of pay or promotions. If you do not have a
DD214 or equivalent, obtain an SF180 (Request Pertaining to Military Records), from your local personnel office
and have your service verified before forwarding this form to the pay center. The pay center cannot provide
estimated earnings unless verification is attached.
To: Employee name (Last, First, Middle)
Other names used
Social Security Number
Date of birth
Military Service Number
Branch of Service
The uniformed services must provide estimated pay by Nonappropriated Fund Employees (NAF) for military
service after December 31, 1956, for the purpose of making a deposit to the U.S. Marine Corps NAF Civilian
Employee Group Retirement Plan for retirement service credit. Please provide the estimated basic pay earned by
the above named employee. Do not include (combat pay, flight pay, etc.) Signature of Requester Relationship to Employee
Employee is Requester Survivor Other _____________
Date
To be completed by requester
based on DD214 or equivalent.
Active military service after
December 31, 1956.
TO BE COMPLETED BY AUTHORIZED OFFICIAL
Estimated Earnings (Base Pay)
(Do not provide estimated earnings for any period of service prior to
January 1, 1957)
From (Mo, Dy, Yr)
To (Mo, Dy, Yr)
From (Mo, Dy, Yr)
To (Mo, Dy, Yr)
Rate of Basic
Pay
EARNINGS
TYPE OF
DISCHARGE
$
$
$ 1. If period of service began
before and ended after December
31, 1956, enter date service
actually began (Mo, Dy, Yr).
2. Lost time
None
Number of Days ___________
Inclusive
Dates
From (Mo, Dy, Yr) To (Mo, Dy, Yr) From (Mo, Dy, Yr) To (Mo, Dy, Yr)
Signature of authorized official furnishing estimate Date (MoDyYr) Telephone number ( ) -
Typed name of authorized official Title of authorized official
Requester's Name and Address
Revised: 10/04/2016
Sources for Documentation of Military Earnings
ARMY DFAS-Indianapolis Center
Army Military Pay Operations
ATTN: Verifications Section (Estimated Earnings)
8899 East 56th Street
Indianapolis, IN 46249-0865
Phone: 1-888-332-7411 (select option #4)
Fax: 1-317-275-0123
Email: DFAS.INDIANAPOLIS-
NAVY DFAS -Cleveland Center
ATTN: DFAS-CL/JFLAGB
1240 East 9th Street
Cleveland, OH 44199-2055
Phone: 1-888-332-7411 (opt #4)
Fax: 1-216-367-3666 DSN: 580-7603
Email: DFAS.CLEVELAND-OH.JFL.MBX.CCL-
AIR FORCE DFAS-Indianapolis Center
ATTN: Verifications Section (Estimated Earnings)
8899 East 56th Street
Indianapolis, IN 46249-0865
Phone: 1-888-332-7411 (select option #4)
Fax: 1-317-275-0123
Email: DFAS.INDIANAPOLIS-
MARINE CORPS DFAS-Cleveland Center
ATTN: DFAS-CL/JFLTC
1240 East 9th Street
Cleveland, OH 44199-2005
Phone: 1-216-522-6060; 1-888-332-7411 (opt #4)
Fax: 1-216-367-3614 DSN: 580-7011
Email: DFAS.CLEVELAND-
OH.JFL.MBX.USMC-SPECIAL-
COAST GUARD Coast Guard Pay and Personnel Center
444 Southeast Quincy Street
Topeka, KS 66683-3591
Phone: 1-785-339-2200
Fax: 1-785-339-3784
Email: [email protected]
Revised: 10/04/2016
Statement of Election to Purchase Military Service Credit in the
United States Marine Corps Nonappropriated Fund Employee Group Retirement Plan
I certify that I have not applied for, nor expect to apply for or expect to receive credit for the same military service under any other employer's or military retirement system. I certify this is a truthful statement. I further certify that within 30 days of making any future application for recognition of military service credit under another retirement plan, I will notify the Administrator of the USMC Nonappropriated Fund Employee Group Retirement Plan (USMC NAF Retirement Plan) of such application. I understand that if multiple use of military service credit occurs, I authorize the Administrator of the USMC NAF Retirement Plan to make appropriate adjustments to my benefit (or to the benefit of my survivor or beneficiary) from the USMC NAF Retirement Plan to include cancellation of military service credit under the USMC NAF Retirement Plan. I understand if I intentionally defraud the United States government or one of its instrumentalities, I may be prosecuted to the fullest extent of the law.
I further state that I intend to pay the deposit necessary to obtain credit for my military service after 1956. I understand that I must pay the entire deposit to the USMC NAF Retirement Plan before separation of active employment and that if I do not complete the full deposit at that time, the post 1956 military service will not be used to compute my annuity and my partial payment will be refunded (except that my survivor shall be afforded an opportunity to complete the deposit in a lump sum before payment of his/her entitlement). I understand that payment must begin within 30 days of notification of amount due to purchase my military service. If I do not pay the entire deposit within 24 months from the date of signature below, interest will begin to accrue and will be compounded annually on the unpaid balance until full payment plus interest is received. If my military service credit was incurred prior to 1956, I am not required to make a deposit to the USMC NAF Retirement Plan.
I understand that this military service credit will not be used to gain entitlement to a benefit from any other retirement plan, including a military retirement plan.
I understand that this military service credit will not be used to satisfy vesting requirements.
I understand that if I elect to make payments through biweekly payroll deduction, I may not cancel or change the biweekly deduction amount.
I authorize the Administrator of any retirement system to provide information to the Administrator of the USMC NAF Retirement Plan regarding crediting of my military service for retirement plan purposes. I elect to purchase military service credit. However, I understand that I may elect to decline the
purchase of military service once I receive the military buy back amount due. I elect not to purchase military service credit. I understand waiving this election results in no
future opportunity to request a military service buyback.
TYPED EMPLOYEE'S FULL NAME
TYPED EMPLOYEE'S SOCIAL SECURITY#
Employee Street Address
Employee Daytime phone number
Employee (City, State, Zip)
Employee Work Center
Signature of Employee Date Signed
Return completed and signed form to your local personnel office. Completed by Employer
Empl ID:
Activity Number:
Company Code:
Revised: 10/04/2016
PAYMENT AGREEMENT OR DECLINATION FOR MILITARY SERVICE CREDIT
Employee's Name: LAST NAME, FIRST NAME MI Activity
Number: 000-0 Empl ID: 0
I understand that – Read all and initial
The Total Amount Due for purchase of activity duty military creditable service under the U.S. Marine Corps NAF
Retirement Plan is: $13,000.00 , before interest. If the total amount due is not paid before the Interest Accrual Date indicated below, interest will begin to accrue and
compounded annually on the unpaid balance until full payment plus interest is received.
Payment(s) must commence within 30 days from the date of this payment agreement form.
When full payment is received, additional service will be credited to my retirement record. 4.000000 years When full payment is received, military service credit will be used for calculation purposes, but not toward vesting.
Failure to complete full payment before job termination will result in no military service credit for retirement calculation
purposes.
Payments will continue until the total amount due (goal balance) is reached or until my job termination, whichever
comes first. Credit will not be given for partial payments.
If I terminate NAF employment and/or transfer to APF employment, I must remit payment in full for the balance due
toward my military service credit obligation. Credit will not be given for partial payments.
Election Date - 10/04/2016 (Date Statement of Election was signed) Interest Accrual Date- 10/04/2018 (The date compounded annual interest of 5% commences on the unpaid balance)
Military Buy Back Date - 10/04/2016 (The date of this form) Payment Election Deadline - 11/04/2016 (31 days from Buy Back Date)
Failure to make a payment election by the deadline will result in the automatic declination of this opportunity
The Total Amount Due must be paid in full within two years from the Payment Election Deadline
Election - Check One
I elect not to purchase prior active duty military service under the Retirement Plan. I understand that this decision is
irrevocable. No further purchase of military service credit opportunity will be granted.
I elect to purchase activity duty military service credit under the Retirement Plan and elect the Payment
Option below:
Payment Options/Agreement - Check One
One Lump Sum Payment (Personal Check) –
I elect to pay the total amount due in one lump sum payment to be received by - #N/A
no later than the Election Deadline Date. (Make check payable to your local MCCS Command. )
One Lump Sum Payment (One-time biweekly payroll deduction) – I elect to pay the total amount due in a
one-time lump sum payroll deduction in the pay period beginning - . Biweekly Payroll Deductions (Minimum Biweekly Deduction = $250.00 ) - I elect to pay
$ biweekly commencing pay period beginning - - - - - .
I understand that I may increase my biweekly milbuy deductions or pay an accelerated lump sum payment at any time.
I have read and acknowledge the payment agreement requirements. I understand that failure to honor this payment
agreement will result in irrevocable cancellation of this military service credit opportunity.
Employee’s Signature Witness’ Signature Date
Revised: 10/04/2016
RETIREMENT PLAN MILITARY SERVICE CREDIT
QUESTIONS AND ANSWERS
Q. Is there a deadline by which current participating employees must elect military service credit? A. Employees currently enrolled in the retirement plan must apply for military service credit within 90 days from date of enrollment.
Q. Will military service credit count toward vesting? A. Military service credit will not be used to satisfy the 5-year vesting requirement of the retirement plan. It will be used for annuity computation purposes only.
Q. What is the cost to purchase military service credit for retirement calculation purposes? A. For applications submitted on or after January 1, 2011, the cost is 5% of all military service earnings after December 31, 1956, plus 5% interest on any unpaid balance compounded annually to commence two years from the date the statement of election was signed. The interest accrual date is 24 months from the election date to purchase military service credit for retirement calculation purposes. This means there is a two-year grace period in which the employee can make the deposit for military service credit without paying interest. The cost is subject to change, based on pension funding requirements.
Q. Do employees pay the full amount in one lump sum? A. A lump sum payment for military service credit is acceptable. All lump sum payments are made directly to the local MCCS activity before date of separation (except that a surviving spouse will have the opportunity to complete the deposit before receiving a benefit). You may also elect payment through biweekly payroll deductions. Effective August 1, 2014, the minimum biweekly payment is $100.00, provided it does not exceed 52 pay periods (2 years). Payment must begin within 30 days from notification of the amount due to purchase military service credit.
Q. Does this affect the employees who are receiving Voluntary Separation Incentive (VSI) or who received a Servicemen's Separation Benefit (SSB) payment or who are receiving VA Disability Benefits? A. No. VSI, SSB and VA Disability benefits are not considered military annuities. Military members with those benefits are still eligible to apply for military service credit.
Q. What if the military service was before December 31, 1956? A. Pre-1957 military service time is creditable, but there is no charge to the participant because military earnings were not subject to Social Security tax at the time.
Q. Is there a limit to the number of military service years for which an employee can apply? A. Not currently; however, this is subject to change based on plan provisions.
Q: If an employee is receiving combat-related military disability, is the employee eligible to apply for military service credit? A: Yes, if it is documented as such. Q. Does my normal reserve duty (drill duty, etc.) count? A. No, only “active” duty reserve service is eligible.
Revised: 10/04/2016
RETIREMENT PLAN MILITARY SERVICE CREDIT
QUESTIONS AND ANSWERS
Q. If an employee previously elected military service credit under civil service or another NAF component, would the employee still be eligible to apply for military service credit under the Marine Corps NAF Retirement Plan? A. No. However, if partial credit has been used under CSRS, FERS, another NAF Component’s Retirement Plan (Army MWR, Air Force MWR, and AAFES) or Military Service Retirement Plan, only the difference is eligible for credit under the Marine Corps NAF Retirement Plan. If the employee can provide evidence of a refund for the military service deposit, all of the refunded service may be creditable.
Q. If an employee is currently receiving or is expecting to receive a military annuity for the same service, would the employee still be eligible to apply for military service credit under the Marine Corps NAF Retirement Plan? A. No. Provisions of the Plan require that purchased military service credit be used as credited service under one retirement system. If this service is considered under any other retirement plan, it is ineligible for consideration under this Plan.
Q. Is active reserve service creditable under military service credit? A. Yes, provided you are not receiving or expect to receive a military annuity using the same service.
Q. If an employee paid for military service credit, then terminated before becoming vested in the retirement plan, would the full payment of the military service credit be refunded? A. Yes Q. What types of military separations are considered honorable? A. The following types of separations are honorable: Under honorable conditions; Separation because of hardship; Transfer to retired list because of age or disability; Transfer to Fleet Reserve; Furlough to Reserve Forces; and General discharge under Honorable Condition.
Q. If I elect NOT to purchase military service credit, can I change my election at a later date, such as after I become vested in the retirement plan? A. No. An election NOT to purchase military service credit is considered a waiver. All waivers are irrevocable, even if re-hired in the future. Q. If I terminate or transfer from a NAF employer to an APF job, can I continue to make bi-weekly payments toward purchase of my military service credit? A. No. If you transfer to an APF job, you’ll be required to remit payment in full for balance of your military service obligation. Biweekly payments cease at the time of NAF termination of employment. Note: Transfers to another MCCS NAF position are not considered terminations under the plan.
Q. If I elect to purchase eligible service, will it retroactively change my pension plan enrollment date? A. No, it will not change your enrollment date. Military service credit is added to retirement credited service for retirement calculation purposes only.
INSTRUCTION AND INFORMATION SHEET FOR SF 180, REQUEST PERTAINING TO MILITARY RECORDS
1. General Information. The Standard Form 180, Request Pertaining to Military Records (SF180) is used to request information from military records.Certain identifying information is necessary to determine the location of an individual's record of military service. Please try to answer each item on the SF 180. If you do not have and cannot obtain the information for an item, show "NA," meaning the information is "not available". Include as much of the requested information as you can. Incomplete information may delay response time. To determine where to mail this request see Page 2 of the SF180 for record locations and facility addresses.
Online requests may be submitted to the National Personnel Records Center (NPRC) by a veteran or deceased veteran’s next-of-kin using eVetRecs at http://www.archives.gov/veterans/military-service-records/ . 2. Personnel Records/Military Human Resource Records/Official Military Personnel File (OMPF) and Medical Records/Service Treatment
Records (STR). Personnel records of military members who were discharged, retired, or died in service LESS THAN 62 YEARS AGO and medical records are in the legal custody of the military service department and are administered in accordance with rules issued by the Department of Defense and the Department of Homeland Security (DHS, Coast Guard). STRs of persons on active duty are generally kept at the local servicing clinic. After the last day of active duty, STRs should be requested from the appropriate address on page 2 of the SF 180. (See item 3, Archival Records, if the military member was discharged, retired or died in service more than 62 years ago.)
a. Release of information: Release of information is subject to restrictions imposed by the military services consistent with Department of Defenseregulations, the provisions of the Freedom of Information Act (FOIA) and the Privacy Act of 1974. The service member (either past or present) or the member's legal guardian has access to almost any information contained in that member's own record. The authorization signature of the service member or the member's legal guardian is needed in Section III of the SF180. Others requesting information from military personnel records and/or STRs must have the release authorization in Section III of the SF 180 signed by the member or legal guardian. If the appropriate signature cannot be obtained, only limited types of information can be provided. If the former member is deceased, the surviving next-of-kin may, under certain circumstances, be entitled to greater access to a deceased veteran's records than a member of the general public. The next-of-kin may be any of the following: unremarried surviving spouse, father, mother, son, daughter, sister, or brother. Requesters MUST provide proof of death, such as a
copy of a death certificate, newspaper article (obituary) or death notice, coroner’s report of death, funeral director’s signed statement of
death, or verdict of coroner’s jury.
b. Fees for records: There is no charge for most services provided to service members or next-of-kin of deceased veterans. A nominal fee ischarged for certain types of service. In most instances, service fees cannot be determined in advance. If your request involves a service fee, you will receive an invoice with your records.
3. Archival Records. Personnel records of military members who were discharged, retired, or died in service 62 OR MORE YEARS AGO have beentransferred to the legal custody of NARA and are referred to as “archival records”.
a. Release of Information: Archival records are open to the public. The Privacy Act of 1974 does not apply to archival records, therefore, writtenauthorization from the veteran or next-of-kin is not required. In order to protect the privacy of the veteran, his/her family, and third parties named in the records, the personal privacy exemption of the Freedom of Information Act (5 U.S.C. 552 (b) (6)) may still apply and may preclude the release of some information.
b. Fees for Archival Records: Access to archival records are granted by offering copies of the records for a fee (44 U.S.C. 2116 (c)). If a fee appliesto the photocopies of documents in the requested record, you will receive an invoice. Photocopies will be sent after payment is made. For more information see http://www.archives.gov/st-louis/archival-programs/military-personnel-archival/ompf-archival-requests.html.
4. Where reply may be sent. The reply may be sent to the service member or any other address designated by the service member or other authorizedrequester. If the designated address is NOT registered to the addressee by the U.S. Postal Service (USPS), provide BOTH the addressee’s name AND “in care of” (c/o) the name of the person to whom the address is registered on the NAME line in Section III, item 3, on page 1 of the SF 180. The COMPLETE address must be provided, INCLUDING any apartment/suite/unit/lot/space/etc. number.
5. Definitions and abbreviations. DISCHARGED -- the individual has no current military status; SERVICE TREATMENT RECORD (STR) -- Thechronology of medical, mental health, and dental care received by service members during the course of their military career (does not include records of treatment while hospitalized); TDRL – Temporary Disability Retired List.
6. Service completed before World War I. National Archives Trust Fund (NATF) forms must be used to request these records. Obtain the forms by e-mail from [email protected] or write to the Code 6 address on page 2 of the SF 180.
PRIVACY ACT OF 1974 COMPLIANCE INFORMATION
The following information is provided in accordance with 5 U.S.C. 552a(e)(3) and applies to this form. Authority for collection of the information is 44 U.S.C. 2907, 3101, and 3103, and Public Law 104-134 (April 26, 1996), as amended in title 31, section 7701. Disclosure of the information is voluntary. If the requested information is not provided, it may delay servicing your inquiry because the facility servicing the service member's record may not have all of the information needed to locate it. The purpose of the information on this form is to assist the facility servicing the records (see the address list) in locating the correct military service record(s) or information to answer your inquiry. This form is then retained as a record of disclosure. The form may also be disclosed to Department of Defense components, the Department of Veterans Affairs, the Department of Homeland Security (DHS, U.S. Coast Guard), or the National Archives and Records Administration when the original custodian of the military health and personnel records transfers all or part of those records to that agency. If the service member was a member of the National Guard, the form may also be disclosed to the Adjutant General of the appropriate state, District of Columbia, or Puerto Rico, where he or she served.
PAPERWORK REDUCTION ACT PUBLIC BURDEN STATEMENT
Public burden reporting for this collection of information is estimated to be five minutes per request, including time for reviewing instructions and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of the collection of information, including suggestions for reducing this burden, to National Archives and Records Administration (ISSD), 8601 Adelphi Road, College Park, MD 20740-6001. DO NOT SEND COMPLETED FORMS TO THIS ADDRESS. SEND COMPLETED FORMS TO THE APPROPRIATE ADDRESS LISTED ON PAGE 2 OF THE SF 180.
Standard Form 180 (Rev. 11/2015) (Page 1) Authorized for local reproduction
Prescribed by NARA (36 CFR 1233.18 (d)) Previous edition unusable OMB No. 3095-0029 Expires 04/30/2018
REQUEST PERTAINING TO MILITARY RECORDS
Requests from veterans or deceased veteran’s next-of-kin may be submitted online by using eVetRecs at http://www.archives.gov/veterans/military-service-records/
To ensure the best possible service, please thoroughly review the accompanying instructions before filling out this form. PLEASE PRINT LEGIBLY OR TYPE BELOW.
SECTION I - INFORMATION NEEDED TO LOCATE RECORDS (Furnish as much information as possible.)
1. NAME USED DURING SERVICE (last, first, full middle) 2. SOCIAL SECURITY # 3. DATE OF BIRTH 4. PLACE OF BIRTH
5. SERVICE, PAST AND PRESENT (For an effective records search, it is important that ALL service be shown below.)
BRANCH OF SERVICE DATE
ENTERED
DATE
RELEASED OFFICER ENLISTED
SERVICE NUMBER (If unknown, write “unknown”)
a. ACTIVE
b. RESERVE
c. STATE
NATIONAL
GUARD
6. IS THIS PERSON DECEASED? NO YES - MUST provide Date of Death if veteran is deceased:
7. DID THIS PERSON RETIRE FROM MILITARY SERVICE? NO YES
SECTION II – INFORMATION AND/OR DOCUMENTS REQUESTED
1. CHECK THE ITEM(S) YOU ARE REQUESTING:
DD Form 214 or equivalent. Year(s) in which form(s) issued to veteran:
This form contains information normally needed to verify military service. A copy may be sent to the veteran, the deceased veteran’s next-of-kin, or other
persons or organizations, if authorized in Section III, below. An UNDELETED DD214 is ordinarily required to determine eligibility for benefits. If you
request a DELETED copy, the following items will be blacked out: authority for separation, reason for separation, reenlistment eligibility code, separation
(SPD/SPN) code, and, for separations after June 30, 1979, character of separation and dates of time lost.
An UNDELETED copy will be sent UNLESS YOU SPECIFY A DELETED COPY by checking this box: I want a DELETED copy.
Medical Records Includes Service Treatment Records, Health (outpatient) and Dental Records. IF HOSPITALIZED (inpatient) the FACILITY NAME and
DATE (month and year) for EACH admission MUST be provided:
Other (Specify):
2. PURPOSE: (Providing information about the purpose of the request is strictly voluntary; however, it may help to provide the best possible response and may
result in a faster reply. Information provided will in no way be used to make a decision to deny the request.)
Benefits (explain) Employment VA Loan Programs Medical Genealogy Correction Personal Other (explain)
EExplain here:
SECTION III - RETURN ADDRESS AND SIGNATURE
1. REQUESTER NAME:
2. I am the MILITARY SERVICE MEMBER OR VETERAN identified in Section
I, above.
I am the VETERAN’S LEGAL GUARDIAN (MUST submit copy of Court
Appointment) or AUTHORIZED REPRESENTATIVE (MUST submit copy of
Authorization Letter or Power of Attorney) I am the DECEASED VETERAN’S NEXT-OF-KIN (MUST submit Proof of
Death. See item 2a on instruction sheet.) OTHER
(Relationship to deceased veteran) (Specify type of Other)
3. SEND INFORMATION/DOCUMENTS TO:
(Please print or type. See item 4 on accompanying instructions.) 4. AUTHORIZATION SIGNATURE: I declare (or certify, verify, or
state) under penalty of perjury under the laws of the United States of
America that the information in this Section III is true and correct and
that I authorize the release of the requested information. (See items 2a or
3a on accompanying instruction sheet. Without the Authorization Signature
of the veteran, next-of-kin of deceased veteran, veteran’s legal guardian,
authorized government agent, or other authorized representative, only
limited information can be released unless the request is archival. No
signature is required if the request if for archival records. )
Name
Street Apt.
______________________________________________________________
City State Zip Code
* This form is available at http://www.archives.gov/veterans/military-service-
records/standard-form-180.html on the National Archives and
Records Administration (NARA) web site. *
Signature Required - Do not print Date
Daytime phone Fax Number
Email address
Standard Form 180 (Rev. 11/2015) (Page 2) Authorized for local reproduction
Prescribed by NARA (36 CFR 1233.18 (d)) Previous edition unusable OMB No. 3095-0029 Expires 04/30/2018
LOCATION OF MILITARY RECORDS The various categories of military service records are described in the chart below. For each category there is a code number which indicates the address at the bottom of the
page to which this request should be sent. Please refer to the Instruction and Information Sheet accompanying this form as needed.
BRANCH CURRENT STATUS OF SERVICE MEMBER ADDRESS CODE Personnel
Record
Medical or Service
Treatment Record
AIR
FORCE
Discharged, deceased, or retired before 5/1/1994 14 14
Discharged, deceased, or retired 5/1/1994 – 9/30/2004 14 11
Discharged, deceased, or retired 10/1/2004 – 12/31/2013 1 11
Discharged, deceased, or retired on or after 1/1/2014 1 13
Active (including National Guard on active duty in the Air Force), TDRL, or general officers retired with pay 1
Reserve, IRR, Retired Reserve in non-pay status, current National Guard officers not on active duty in the Air Force, or National Guard
released from active duty in the Air Force 2
Current National Guard enlisted not on active duty in the Air Force 2 13
COAST
GUARD
Discharge , deceased, or retired before 1/1/1898 6
Discharged, deceased, or retired 1/1/1898 – 3/31/1998 14 14
Discharged, deceased, or retired 4/1/1998 – 9/30/2006 14 11
Discharged, deceased, or retired 10/1/2006 – 9/30/2013 3 11
Discharged, deceased, or retired on or after 10/1/2013 3 14
Active, Reserve, Individual Ready Reserve or TDRL 3
MARINE
CORPS
Discharged, deceased, or retired before 1/1/1895 6
Discharged, deceased, or retired 1/1/1905 – 4/30/1994 14 14
Discharged, deceased, or retired 5/1/1994 – 12/31/1998 14 11
Discharged, deceased, or retired 1/1/1999 - 12/31/2013 4 11
Discharged, deceased, or retired on or after 1/1/2014 4 8
Individual Ready Reserve 5
Active, Selected Marine Corps Reserve, TDRL 4
ARMY
Discharged, deceased, or retired before 11/1/1912 (enlisted) or before 7/1/1917 (officer) 6
Discharged, deceased, or retired 11/1/1912 – 10/15/1992 (enlisted) or 7/1/1917 – 10/15/1992 (officer) 14
Discharged, deceased, or retired 10/16/1992 – 9/30/2002 14 11
Discharged, deceased, or retired (including TDRL) 10/1/2002 – 12/31/2013 7 11
Discharged, deceased, or retired (including TDRL) on or after 1/1/2014 7 9
Current Soldier (Active, Reserve (including Individual Ready Reserve) or National Guard) 7
NAVY
Discharged, deceased, or retired before 1/1/1886 (enlisted) or before 1/1/1903 (officer) 6
Discharged, deceased, or retired 1/1/1886 – 1/30/1994 (enlisted) or 1/1/1903 – 1/30/1994 (officer) 14 14
Discharged, deceased, or retired 1/31/1994 – 12/31/1994 14 11
Discharged, deceased, or retired 1/1/1995 – 12/31/2013 10 11
Discharged, deceased, or retired on or after 1/1/2014 10 8
Active, Reserve, or TDRL 10
PHS Public Health Service - Commissioned Corps officers only 12
ADDRESS LIST OF CUSTODIANS and SELF-SERVICE WEBSITES (BY CODE NUMBERS SHOWN ABOVE) – Where to write/send this form
1
Air Force Personnel Center
HQ AFPC/DPSIRP
550 C Street West, Suite 19
Randolph AFB, TX 78150-4721
6
National Archives & Records Administration
Research Services (RDT1R)
700 Pennsylvania Avenue NW
Washington, DC 20408-0001
11
Department of Veterans Affairs
Records Management Center
ATTN: Release of Information
P.O. Box 5020
St. Louis, MO 63115-5020
2
Air Reserve Personnel Center
Records Management Branch (DPTSC)
18420 E. Silver Creek Avenue
Building 390 MS 68
Buckley AFB, CO 80011
7
US Army Human Resources Command’s web page:
https://www.hrc.army.mil/TAGD/Accessing%20or%20
Requesting%20Your%20Official%20Military%20Pers
onnel%20File%20Documents
or 1-888-ARMYHRC (1-888-276-9472)
12
Division of Commissioned Corps Officer Support
ATTN: Records Officer
1101 Wooton Parkway, Plaza Level, Suite 100
Rockville, MD 20852
3
Commander, Personnel Service Center
(BOPS-C-MR) MS7200
US Coast Guard
2703 Martin Luther King Jr Ave SE
Washington, DC 20593-7200
8
Navy Medicine Records Activity (NMRA)
BUMED Detachment St. Louis
4300 Goodfellow Boulevard, Building 103
St. Louis, MO 63120
13
AF STR Processing Center
ATTN: Release of Information
3370 Nacogdoches Road, Suite 116
San Antonio, TX 78217
14
National Personnel Records Center
(Military Personnel Records)
1 Archives Drive
St. Louis, MO 63138-1002
eVetRecs:
http://www.archives.gov/veterans/military-service-records/
4
Headquarters U.S. Marine Corps
Manpower Management Records & Performance
(MMRP-10)
2008 Elliot Road
Quantico, VA 22134-5030
9
AMEDD Record Processing Center
3370 Nacogdoches Road, Suite 116
San Antonio, TX 78217
5 Marine Forces Reserve
2000 Opelousas Avenue
New Orleans, LA 70146-5400 10
Navy Personnel Command (PERS-313)
5720 Integrity Drive
Millington, TN 38055-3120
