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HomeMy WebLinkAboutCaptain Edwin D. Maberly 1980 B RA ZO S - CO UNTY 0 ' a ' JAKE CANGLOSE OFFICE OF R. HARRY STITELER COUNTY DIRECTOR AND CHAIRMAN TEXAS A•M UNIVERSITY DIRECTOR E.E. BURNS CIVIL DEFENSE & EMERGENCY PLANNING GEORGE L. HUEBNER COUNTY DEPUTY DIRECTOR COUNTY COURTHOUSE COLLEGE STATION DIRECTOR ERNEST R. CLARK BRYAN,TEXAS 77801 NORTH BARDELL BRYAN DIRECTOR COLLEGE STATION DEPUTY DIRECTOR F€'2ruary 21, 1980 TO: Department of the Air Force ARPC Hq. Air Reserve Personnel Center Denver, Colorado 80280 THROUGH: Mr. Frank Cox, State Coordinator Texas Division of Disaster Emergency Services 5805 North Lamar Blvd. Box 4087 Austin, Texas 78773 Dear Mr. Cox: The attached Air Force forms 1288 and 231 are being for- warded for your consideration for approval, regarding a MOBDES assignment request of Capt. Maberly. We have need of his services to assist us in our Emergency Planning Operations. As you know our office operates on a limited budget and our MOBDES Officers have performed a vital and out- standing service in our Emergency Planning Program. I sincerely hope his assignment can be approved. Your assistance in processing this application through the proper Federal Channels will be sincerely appreciated. Jake Canglo$ _ County Director and Chairman Brazos County Civil Defense \ 1 i 1 . i APPLICATION FOR RESERVE ASSIGNMENT (11 more space is needed for any item, attach additional sheets indicat- f . (THIS FORM IS SUBJECT TO THE PRIVACY ACT OF 1974) ing applicable Item numbed AUTHORITY: 10 U.S.C. Section 275, Personnel Record; E0 9397, 22 Nov 43. Numbering System for Federal Accounts Relating to Individual Persons. PRINCIPAL PURPOSE(S): Request for reedy reserve assignment must contain current personal information to complete processing. Use of Social Security Number is necessary to make positive identification of the individual and records. ROUTINE USES: Provides personal data and information concerning your requested assignment. Information contained hereon may be disclosed to any DOD component including the Department of the Air Force at base, major commend, and HQ USAF levels, and upon request, to other Federal, State, and local agencies in the pursuit of their official duties. 11 may be used for other lawful purposes including law enforcement and litigation. DISCLOSURE IS VOLUNTARY: Individuals choosing not to submit necessary documentation will not be eligible for ready reserve assignment. . INSTRUCTIONS Complete application in triplicate. Attach three completed copies of DD Form 1644 and a Certificate of Availability of Federal Employee as required. TD'D epartment of the Air Force i. LAST NAME - FIRST NAME - MIDDLE L INITIAL ARPC- aAo Crt C a r (s v Hq .Air Reserve Personnel Center 2. DATE OF BIRTH 8. RESAF GRADE 4. DATE OF RESAF Denver, Colorado 80280 c Ill )4.'5 G P i '4 /jx 5. ADDRESS AND TELEPHONE NUMBER at different from t o 1 t+ ,4�� " ��-" I tK 6 ADDITIONAL AFSC'S 9. DATE AND TERM OF APPOINTMENT c_c,ttzt:` i-.AT U x 4,-; r N x4, OR ENLISTMENT �l -i,g4+C i� , 1 F i0I tA /4`i 10. DRAWING DISABILITY COMPENSATION yea, state percent) 14, n0,-6(11-1063 EVES 0 No td s 11 AERONAUTICAL RATING (Indicate if on flying status. 1f requested assignment will authorize flying duty, indicate flying experience by type aircraft and hours in each, date and type o instrument card now held, and date of last phyafcal examination.) I Nci0 ►E 12. CIVILIAN EDUCATION (Indicate yearn completed, 13. CIVILIAN EXPERIENCE (In chronological order showing latest experience major subject and degree, if any) ��tp first, indicate pertinent experience to include employers, poaltions held, and T p ®r A. E. (- 0116mit_s 1041 b duration.). - ro t ou, tyt4 . 6coOc,v111c1 Iat`i Ar 1STaAi P roSc. blcr 1 Jtvt c+. ac.... -tflMu u . ; , ,,k,,,,. r e (A. M. Magi ill* \A lg- 1`111 { kftu iph.1b. Fr NwN,:t till 14. MILITARY SCHOOLS ATTENDED (Indicate date, 15. MILITARY EXPERIENCE (Indicate position title, level of corm »and. DAFSC course number or title, and location) highest grade and duration. List only experience that directly substantiates ON y L L t•) L u C..% C R ‘G your qualifications for asslgrlcrent requested.) ti tt . 4 . We,cvcS 10 SAN VY1 Lcw004r Crtw CGri+iy% 5A -C \% 1�- ) CaPrAim ,Li. , t e"v-s v� 1 j I t l L ( +.1..1 e tAi- "l C IPA C" 6 16. PRESENT ASSIGNMENT AND ATTACHMENT 17. ASSIGNMENT DESIRED (Indicate unit if any preferred, training/pay category (Indicate unit and training/pay category) or description of type of training desired) IN 0.c-t-Je. tAsiF P ea,e5 C,0014 t L -i01\ O-€'tNIS( . (Ze.scroes Asst.County SheYter Division Officer a.Coordinator Shelter Inspections b.Radiological Instrument Inspections c.Coordinator Shelter & Radiological Monitoring Plans I CERTIFY THAT THE DATA CONTAINED HEREIN IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. 1 ALSO ACKNOWL - EDGE THAT UPON MY ASSIGNMENT TO THE READY RESERVE 1 AM RESPONSIBLE TO NOTIFY MY EMPLOYER OF MY READY RESERVE STATUS AND THAT AS A READY RESERVIST I SHALL BE SUBJECT TO. INVOLUNTARY ORDER TO ACTIVE DUTY IN TIME OF WAR OR NATIONAL EMERGENCY DECLARED BY THE CONGRESS, A NATIONAL EMERGENCY DECLARED BY THE PRESIDENT, OR WHEN OTHERWISE AUTHORIZED BY LAW. DATE SIGNATURE OF APPLICANT "- 6 1 . .1 l • READY RESERVE SERVICE AGREEMENT PRIVACY ACT STATEMENT. AUTHORITY: Title 10, USC Section 269, Ready Reserve: placement in; transfer from; and EO 9397, 22 Nov 43, Numbering System for Federal Accounts Relating to Individual Persons. PRINCIPAL PURPOSE: To update your records and provide a means for your Reserve participation. Use of Social Security Number is necessary to make positive identification of you and your record. ROUTINE USE. To place you in the Ready Reserve or provide for your retention in a ready status. Information provided may be furnished to any DOD component including the Department of the Air Force at base, major command, and HQ USAF' levels, and upon request, to other Federal, State, and local agencies in the pursuit of their official duties. DISCLOSURE IS VOLUNTARY: Failure to provide the information will preclude your consideration for any ready reserve assignment and may lead to your discharge from the Air Reserve Forces. NAME (Last — first — middle) GRADE RESIDENCE ADDRESS (Street No, Street, City, State, Zip Code) 1y-00 b o o , \ N ; ( Co\let ) A31%, 1 "IS 4o Ready Reserve consists of Unit, Mobilization Augmentee Program, Ready Reinforcement Personnel Section, and other point - gaining activities not authorized pay. � 1 agree to be a member of the Ready Reserve until S %.3 DATE - SEE NOTE BELOW 1 I certify that as a member of the Ready Reserve until that date, I am and will remain immediately available for presidential mobilization and for any active duty including active duty for training. If I lose my assignment for a reason other than medical or administrative disqualification before the expiration of this agreement, I will be retained in the Ready Reserve and assigned to the Ready Reinforcement Personnel Section where I will continue to be available for mobilization if the President declares a national emergency. I further certify that I understand that I will not be released from this agreement upon my own application unless all of the three following conditions have been met: 1. There has been a substantial change in my status or circumstances, other than change in reserve assignment. 2. I have requested, prior to the date of an alert or notice of mobilization or the date of orders to active duty, either a. transfer to the Standby Reserve, or b. transfer to the Retired Reserve, or c. discharge from the Air Force. 3. That above request has been approved. THIS AGREEMENT B ECOMES EFFECTIVE UPON MY SIGNING IT, BELOW. SIGNATURE OF AIR FORCE REPRESENTATIVE SIGNATURE OF MEMBER DATE SIGNED 1 NOTE: The date inserted in the second sentence of this agreement (above) must be one of the following, whichever is appropriate. For officers (including warrant officers) either: (a) 3 or more years from the date the agreement is signed; or (b) the date of the signer's eligibility for transfer to the Retired Reserve For enlisted members the date must be one or more years from the date the agreement is signed. SQ'KE OF BRAZOS 1p ►QM1 f ^ ; . 0 COUNTY c� � JAKE CANGLOSE OFFICE OF R. HARRY STITELER COUNTY DIRECTOR AND CHAIRMAN TEXAS ASM UNIVERSITY DIRECTOR E.E. BURNS CIVIL DEFENSE & EMERGENCY PLANNING GEORGE L. HUEBNER COUNTY DEPUTY DIRECTOR COUNTY COURTHOUSE COLLEGE STATION DIRECTOR ERNEST R. CLARK BRYAN, TEXAS 77801 NORTH BARDELL BRYAN DIRECTOR COLLEGE STATION DEPUTY DIRECTOR F21, 1980 cc Atoe.,,,■ 614...si 10.., c TO: Department of the Air Force ARPC Hq. Air Reserve Personnel Center Denver, Colorado 80280 �iL THROUGH: Mr. Frank Cox, State Coordinator( "- Texas Division of Disaster Emergee Services 5805 North Lamar Blvd. Box 4087 Austin, Texas 78773 Dear Mr. Cox: The attached Air Force forms 1288 and 231 are being for- warded for your consideration regarding a MOBDES assignment request`vf Capt. Maberly. We have need of his services to assist us in our Emergency Planning Operations. As you know our office operates on a limited budget and our MOBDES Officers have performed a vital and out- standing service in our Emergency Planning Program. I sincerely hope his assignment can be approved. Your assistance in processing this application through the proper Federal Channels will be sincerely appreciated. ) l i r ,,\ ,lake Cang1ose'"� County Director and Chairman Brazos County Civil Defense f APPLICATION FOR RESERVE ASSIGNMENT (If more space is needed for any Item, attach additional sheets indicat . (THIS FORM IS SUBJECT TO THE PRIVACY ACT OF 1974) !ng applicable item numbed AUTHORITY: 10 V.S.C. Section 275, Personnel Record; EO 9397, 22 Nov 43. Numbering System for Federal Accounts Relating to Individual Persona. PRINCIPAL PURPOSE(S): Request for ready reserve assignment must contain current personal information to complete processing. Use of Social Security Number is necessary to make positive identification of th• individual and records. ROUTINE USES: Provides personal data and information concerning your requested assignment. Information contained hereon may be disclosed to any DOD component including the Department of the Air Force at base, major command, and HQ USAF levels, and upon request, to other Federal, State, and focal agencies in the pursuit of their official duties. It may be used for other lawful purposes including law enforcement and litigation. DISCLOSURE 1S VOLUNTARY: Individuate choosing not to eubmit necessary documentation will not be eligible for ready reserve assignment. INSTRUCTIONS Complete application in trirlicats. Attach three completed copies of DD Form 1644 and a Certificate of Availability of Federal Employee as required. TD :Department of the Air Force I. LAST NAME - FIRST NAME - MIDDLE INITIAL ARP( Ma\oc,ki Ea>w.Iii C - Hq .Air Reserve Personnel Center 2. DATE OF BIRTH 3. RESAF GRADE 4. DATE OF RESAF Denver, Colorado 80280 )9'45 4P ` e /GRADE };2- S. ADDRESS AND TELEPHONE NUMBER (11 different from 6. SSAN 7. PRIMARY AFSC pennant address. indicate both) ' 6% ADDITIONAL ADDITIONAL AFSC'S 9. DATE AND TERM OF APPOINTMENT r rtAT; 6N OR ENLISTMENT - „gy'c 1 d1 i0 /od /10 10. DRAWING DISABILITY COMPENSATION (If yea, state percent) {� 6q3 -30(03 laftES EJNO 0 11. AERONAUTICAL RATING (Indicate if on flying status. If requested assignment will authorize flying duty, indicate flying experience by type aircraft and hours in each, date and type of instrument card now held, and date of fast physical examination.). 12. CIVILIAN EDUCATION (Indicate years completed, 13. CIVILIAN EXPERIENCE an chronological order ahowfnglateat experience major subject and degree. If any) J Brat, indicate pertinent experience to include employera, positions held and 1 Amyl €6.A. CLolJomics \9b`� duration.), TRr+nu c t� ca NOlYltcs 03,5 A.SS;STANT pr o-* , „„ Dt Cf G Cj4Ai. "'T M U« �. V- 0411e. ' e U. PA -S. MtAtk ton* \q-►�' \qlg { Aau, �h•� E, NdNGt 19i($ 14. MILITARY SCHOOLS ATTENDED (Indicate date, 15, MILITARY EXPERIENCE (Indicate position title, level of command, DAFSC course nuatber or title, and location) hdgheat grade and duration. List only experience that directly substantiates J G �� your qualification• for sss /g requested.), 1 w ecycS 10 1r. t1; 51e Co v1t1bctr Crc.,. CC rN m a $atY. .A-C. 1 ).1 C, Prni k %e"v-, C T j 1'i -” t � L RSG s w eckS • M a+-cr► 16. PRESENT ASSIGNMENT AND ATTACHMENT 17. ASSIGNMENT DESIRED (Indicate unit If any preferred, training/pay category (Indicate unit and training/pay category) or description of type of training desired) (to act;Je U / P ©( -a\c% 1' Cio, Cs.e t c R.e.scrJCs Asst.County She Division Officer • a.Coordinator Shelter Inspections b.Radiological Instrument Inspections c.Coordinator Shelter & Radiological Monitoring Plans 1 CERTIFY THAT THE DATA CONTAINED HEREIN IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. 1 ALSO ACKNOWL - EDGE THAT UPON MY ASSIGNMENT TO THE READY RESERVE 1 AM RESPONSIBLE TO NOTIFY MY EMPLOYER OF MY READY RESERVE STATUS AND THAT AS A READY RESERVIST I SHALL BE SUBJECT TO. INVOLUNTARY ORDER TO ACTIVE DUTY IN TIME OF WAR OR NATIONAL EMERGENCY DECLARED BY THE CONGRESS, A NATIONAL EMERGENCY DECLARED BY THE PRESIDENT. OR WHEN OTHERWISE AUTHORIZED BY LAW. DATE SIGNATURE OF APPLICANT \ti DeD4rfment of the Air Force P.° TOARPC FROM: Brazos County Civil Defense` Hq.Air Reserve Personnel Center County Courthouse Denver, Colorado :80280-- Tt Bryan, Texas 77801 'APPROVED 1 'DISAPPROVED REMARKS H DATE T ^ N ME AND T SIGNATURE ^ / aF7c A Can ITLE Jose Feb.21,198) County Civil Defense Director c./ ( `�� TO: F ROM: �- --'� ni APPROVED (Furnish assignment data) n DISAPPROVED I. AUTHORIZED 2. FUNCTIONAL CODE 3. TRAINING /PAY CATEGORY A. GRADE 9. AFSC 4. UNIT OR TYPE OF ASSIGNMENT 5. RESERVE SECTION CODE 6. DUTY POSITION NUMBER 'UNIT )MA , (MA (RSO)I IRD 1 IOTHE R(spec) 7. ASSIGNMENT LOCATION 8. PAS 3. UNII OF Ali ACHmE IT tO. UOA PAS Z o REMARKS N U l " Z W W C4 O 0 z DATE TYPED NAME AND TITLE SIGNATURE NOTE: Do not include assignment data in succeeding indorsements except to correct original data. TO: FROM: ' ' APPROVED ( 'DISAPPROVED REMARKS S 1- DATE TYPED NAME AND TITLE SIGNATURE TO: FROM: _i APPROVED ' 'DISAPPROVED REMARKS O O DATE TYPED NAME AND TITLE SIGNATURE • READY RESERVE SERVICE AGREEMENT PRIVACY ACT STATEMENT. AUTHORITY: Title 10, USC Section 269, Ready Reserve: placement in; transfer from; and EO 9397, 22 Nov 43, Numbering System for Federal Accounts Relating to Individual Persons. PRINCIPAL PURPOSE: To update your records and provide a means for your Reserve participation. Use of Social Security Number is necessary to make positive identification of you and your record. ROUTINE USE. To place you in the Ready Reserve or provide for your retention in a ready status. Information provided may be furnished to any DOD component including the Department of the Air Force at base, major command, and HQ USAF levels, and upon request, to other Federal, State, and local agencies in the pursuit of their official duties. DISCLOSURE IS VOLUNTARY: Failure to provide the information will preclude your consideration for any ready reserve assignment and may lead to your discharge from the Air Reserve Forces. NAME (Last — first — middle) GRADE SSAN 1 (Abe 1 Edw; N baPre11 6.44P - RESIDENCE ADDRESS (Street No, Street, City, State, Zip Code) \ I tOrM i ;k Co \le C ST aT � a 14 1 .- crxA,s •1 - 1$�t� Ready Reserve consists of Unit, Mobilization Augmentee Program, Ready Reinforcement Personnel Section, and other point - gaining activities not authorized pay. I agree to be a member of the Ready Reserve until `- - DATE - SEE NOTE BELOW 1 I certify that as a member of the Ready Reserve until that date, I am and will remain immediately available for presidential mobilization and for any active duty including active duty for training. If I lose my assignment for a reason other than medical or administrative disqualification before the expiration of this agreement, I will be retained in the Ready Reserve and assigned to the Ready Reinforcement Personnel Section where I will continue to be available for mobilization if the President declares a national emergency. I further certify that I understand that I will not be released from this agreement upon my own application unless all of the three following conditions have been met: 1. There has been a substantial change in my status or circumstances, other than change in reserve assignment. 2. I have requested, prior to the date of an alert or notice of mobilization or the date of orders to active duty, either a. transfer to the Standby Reserve, or b. transfer to the Retired Reserve, or c. discharge from the Air Force. 3. That above request has been approved. THIS AGREEMENT BECOMES EFFECTIVE UPON MY SIGNING IT, BELOW. SIGNATURE OF AIR FORCE REPRESENTATIVE SIGNATURE OF MEMBER DATE SIGNED gleLAA'A t • S 1 NOTE: The date inserted in the second sentence of this agreement (above) must be one of the following, whichever is appropriate. For officers (including warrant officers) either: (a) 3 or more years from the date the agreement is signed; or (b) the date of the signer's eligibility for transfer to the Retired Reserve For enlisted members the date must be one or more years from the date the agreement is signed. . APPLICATION FOR RESERVE ASSIGNMENT (If more apace i• needed for any item, attach additional sheets indicat- . I :71 'S FORM 15 SUBJECT TO THE PRIVACY ACT OF 1971) Ina applicable item numbed r . ______ -- --- _ .. "Y: 10 U.S.C. Section 275, Personnel Record; EO 9397, 22 Nov 43, Numbering System for Federal Accounts Relating to Individual v , PURPOSE(S): Request for ready reserve assignment must contain current personal Information to complete proce•sing. Use of .. rity Number is necessary to make positive identification of the Individual and records. '- USES: Provides personal data and information concerning your requested ee•ignment. Information contained hereon may be disclosed - ., F'OD component including the Department of the Air Force at base, major command, and HQ USAF levels, end upon request, to other Ice .. eral, State, and local agentise In the pursuit of their official duties. It may be used for other lawful purposes Including law enforcement and litigation. DISCLOSURE IS VOLUNTARY: Individuals choosing not to submit necessary documentation will not be eligible for ready reserve assignment. INSTRUCTIONS Complete application in triplicate. Attach three completed copies of DD Form 1644 and a Certificate of Availability of Petit-tat Employee as required. Ig et Pe 10 0 eta Aplett°A)7 087 e A/ K Fof2.C.C, 1. LAST NAME - FIRST NAME - MIDDLE INITIAL Ai 12 p 1-4 I, R Ra 'Ave ° etc- soAl l+le/ C%e' Avreg. M �10 crly C —a.N ; N p. 2. GATE OF BIRTH S. REIAF GRADE 4. DATE OF RESAF I) etWie/4) CO /j_t - aO 8 6.1.8d ` t / i l l LF5 c A- P -T 4�i ADE l L S. A''7:2ESS AND TELEPHONE NUMBER (It different from 9. !SAN 7. PRIMARY AFSC ,,a . -sn ) - L14 1 kgeD OYY■ ■ N IK C-G ale- fie, S-rATI bNI- CexAS 8 S ADDIT� i 0 AL AFiC'f 9. OR DATE ENLISTMENT TERM OF APPOINTMENT V V O • a _ E /1 ). /bci (� / Q 10. DRAWING DISABILITY COMPENSATION(1f yes, state percent) 1 3 - t�-13 -20(›3 ny ONO 1O 11. AERONAUTICAL RATING (Indicate If on flying status. II requested assignment will authorise flying duty, indicate flying experience by ' type aircraft and hour* in each, date and type o inettument card now held. and date of last physical examination.) NONE 11., CIVILIAN EDUCATION (Indicate years completed. IS. CIVILIAN EXPERIENCE (In chronological order showing latest experience major subject end degree, II any) first, Indicate pertinent experience to include employers, posttlon• held, and T A mu. ®. A. E. co&Jo m t c Y4 4pt duration.), Z"AIMU M.S. GcoNoNllcs (9b5 f- SSISTaNT ProSc IA* r bi c, ECoN. ?f1M�t V.1i,,Voi, STute U. V. Mutli1 t4 \ Alt -kill I A a pivt. FI &APC.t %ill 14. MILITARY SCHOOLS ATTENDED (Indiana date. IS. MILITARY EXPERIENCE (Indicate position title, level of coevnand. DAPSC count number or title. and location) _ highest grade and duration. L/at only experience that directly subetentiarae M S L. L. N c K OFF c- St your quaflflutions for assignment requested) 14 wectt:S 10 .1 0.11. IMiss.l,. Ccwlb4,r Cr Corvlw. u�� --c � � L �C • SA.0 / \�?1F- ) Ga ere, iw 1 4. , . 4 c .7 ( Wetcs n Moo-c1.1 IS. PRE•IINT ASSIGNMENT AND ATTACHMENT 17. ASSIGNMENT DESIRED (Indicate unit If any preferred, traMry f/pay category -. (indicate unit and training/pay category) or description of type of training desired) IN 0,,ct U fcscr�ci Q r0., of C,,,, N t,S Cc,l c N . l r. ad, 4r 54 efT'k U f di1 %.J D r I Cti' co6leory lash. 5X eG7e/ / A/s re-e--- • /Z 4 D/b 4 -7t.e.44 /r r —, w•- / 'v $ re 7.-4" -- 1 . t! o i fat A le 67, PG7-e 4 GI- r - f-GI oLiAo -P tvt - ONt r Cri I CERTIFY THAT THE DATA CONTAINED HEREIN IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. 1 ALSO ACKNOWL - EDGE THAT UPON MY ASSIGNMENT TO THE READY RESERVE I AM RESPONSIBLE TO NOTIFY MY EMPLOYER OF My READY RESERVE STATUS AND THAT AS A READY RESERVIST 1 SHALL BE SUBJECT TO. INVOLUNTARY ORDER TO ACTIVE DUTY IN TIME OF WAR OR NATIONAL EMERGENCY DECLARED BY THE CONGRESS, A NATIONAL- EMERGENCY DECLARED BY THE PRESIDENT, OR WHEN OTHERWISE AUTHORIZED BY LAW. DATE � SIGNATURE OF APPLICANT 1— CIO DO AF FOR" 1288 PR[VIOu1 EDITION IS OBSOLETE DEC 77 • • C n \ Y VA� I To: aem1cr M fove• p F' 'rite- Ai& F kft FROM: \ \ \ /f9 Hi 12 �' es exlie P ve 6Ora eL d3 ►Z p„ 205 �'vu n� T y C i • i D ik)& i Leo /ea- - )a �0 -gv y • 77(10/ j APPROVED n DISAPPROVED REMARKS W .� DATE TYPED NAME AND TITLE SIGNATUR 1 3'/4ke cAA) q c os qFa" iOVA y c,v,� D cfr,dse TO: F ROM: Li APPROVED (Furnish assignment data) I DISAPPROVED 1. AUTHORIZED 2. FUNCTIONAL CODE 3. TRAINING /PAY CATEGORY A. GRADE 1 B. AFSC 4. UNIT OR TYPE OF ASSIGNMENT 5. RESERVE SECTION CODE 6. DUTY POSITION NUMBER IUNIT I IMA I IMA (RSO)I IRD I IOTHERespec. 7. ASSIGNMENT LOCATION 8. PAS 9. UNIT OF ATTACHMENT 10. UOA PAS C O REMARKS M V F w = N W N CC 0 A Z DATE TYPED NAME AND TITLE SIGNATURE • NOTE: Do not include assignment data in succeeding indorsements except to correct original data. T0: FROM: El APPROVED I I DISAPPROVED 0 REMARKS r DATE TYPED NAME AND TITLE SIGNATURE TO: FROM: El APPROVED { ( DISAPPROVED 0- REMARKS O DATE TYPED NAME AND TITLE SIGNATURE • U.S. Osysrnm.et PrIMIp OINsa If 711- /11-1.» 1 As • READY RESERVE SERVICE AGREEMENT PRIVAC ACT STATEMENT. AUTHORI Title lo, USC Se(1Lm 267, Ready R eserve: placement in; transfer from; and 1 I Ii) 939,' 22 N ov d3 Nu S ystem for Federal Ac coun t s R r ! to Individu P ersons. PRINCIPAL PURPOSE: To update your records and provide a means for your Reserve participation. Use of Social Security Number is necessary to make positive identification of you and your record. ROUTINE USE. To place you in the Ready Reserve or provide for your retention in a ready status. Information provided may be furnished to any DOD component including the Department of the Air Force at base, major command, and HQ USAF Levels, and upon request, to other Federal, State, and local agencies in the pursuit of their official duties. DISCLOSURE IS VOLUNTARY: Failure to provide the information will preclude your consideration for any ready reserve assignment and may lead to your discharge from the Air Reserve Forces. NAME (Lest — first — middle) GRADE SSAN Mabe d■; N boorrc G44P`r . RESIDENCE ADDRESS (Street No, Street, City, State, Zip Corte) VA-00 bOIM 1 N ;k G \tetc Sorct: N ) ( 4 1, 5 1 Ready Reserve consists of Unit, Mobilization Augmentee Program, Ready Reinforcement Personnel Section, and other point - gaining activities not authorized pay. A3 1 agree to be a member of the Ready Reserve until ,� 4�5 DATE - SEE NOTE BELOW 1 I certify that as a member of the Ready Reserve until that date, I am and will remain immediately available for presidential mobilization and for any active duty including active duty for training. If 1 lose my assignment for a reason other than medical or administrative disqualification before the expiration of this agreement, I will be retained in the Ready Reserve and assigned to the Ready Reinforcement Personnel Section where I will continue to be available for mobilization if the President declares a national emergency. I further certify that I understand that I will not be released from this agreement upon my own application unless all of the three following cI ndi have been met: 1. There has been a substa sal change ' my status or circumstances, other than change in reserve assignment. 4 2. 1 have rested, prior t• t. date of an alert or notice of mobilization or the date of orders to active duty, eithg+r a. tra fer to the .ndby Reserve, or b. trap fer to e Retired Reserve, or c. dischar,.- from the Air Force. 3. That ab• ie request has been approved. THIS AGREEMENT BECOMES EFFECTIVE UPON MY SIGNING IT, BELOW. SIGNATURE OF AIR FORCE REPRESENTATIVE SIGNATURE OF MEMBER DATE SIGNED geLLA 1. 1 `— 5 — �0 I NOTE: The date inserted in the second sentence of this agreement (above) must be one of the following, whichever is appropriate. For officers (including warrant officers) either: • (a) 3 or more years from the date the agreement is signed; or (b) the date of the signer's eligibility for transfer to the Retired Reserve For enlisted members the date must be one or more years from the date the agreement is signed. AF MAR 7. 231 REPLACES DD FORM 1644, JAN 68 WHICH IS OBSOLETE