Dd Form 2266 - Hometown News Release Information
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1HOMETOWN NEWS RELEASE INFORMATION
1.
PAO CODE
FOR RELEASING PUBLIC AFFAIRS OFFICE USE ONLY
PRINT OR TYPE - SEND ORIGINAL ONLY
2. YOUR SOCIAL SECURITY NUMBER
(For identification only)
PRIVACY ACT STATEMENT
AUTHORITY: 5 U.S.C. 301, 10 U.S.C. 8012 and 8034, and EO 9397.
PRINCIPAL PURPOSE: To prepare news stories and news releases for distribution and publication by civilian news media to recognize the achievements of Army and Air
Force members. In accordance with the 1974 Privacy Act, you are hereby informed that your Social Security Number on this form is required for identification use only.
ROUTINE USE: Information may be disclosed to civilian news media representatives. Once published, information is considered "Public Domain."
DISCLOSURE : Information collected on this form is released over your signature and is voluntary. If you have no objection to the information being released to hometown
audiences, sign your name below. Failure to provide the information may mean little or no public news release material can be produced, thus
denying the individual public recognition for personal achievements.
5. RANK
6. PAY GRADE
7.
FIRST NAME, MIDDLE INITIAL,
LAST NAME
8. SEX
3. BRANCH OF SERVICE
4.
STATUS
ARMY
ACTIVE
9.
EVENT
(Example: Arrival; Promoted to Sergeant; Received Commendation Medal, etc.- Citation Needed)
AIR FORCE
RESERVE
NAVY
NATIONAL
GUARD
MARINE CORPS
COAST GUARD
CIVILIAN
10. YOUR LIVING PARENTS, STEPPARENTS, GUARDIANS, AUNT/UNCLE/GRANDPARENTS OR ADULT SIBLINGS
a.(1) FIRST NAME, MIDDLE INITIAL, LAST NAME
(2) RELATIONSHIP TO YOU
(3) ADDRESS (Number and Street)
(4) CITY
(5) STATE
(6) ZIP CODE
b.(1) FIRST NAME, MIDDLE INITIAL, LAST NAME
(2) RELATIONSHIP TO YOU
(3) ADDRESS (Number and Street)
(4) CITY
(5) STATE
(6) ZIP CODE
11. SPOUSE’S NAME
(First, Middle Initial, Last)
12. SPOUSE’S LIVING FATHER
a. FIRST NAME, MIDDLE INITIAL, LAST NAME
b. ADDRESS (Number and Street)
c. CITY
d. STATE
e. ZIP CODE
13. SPOUSE’S LIVING MOTHER
a. FIRST NAME, MIDDLE INITIAL, LAST NAME
b. ADDRESS (Number and Street)
c. CITY
d. STATE
e. ZIP CODE
14.a. YOUR PRESENT UNIT OF ASSIGNMENT
b. POST OR BASE (Not APO)
c. CITY
d. STATE OR
(Do not abbreviate)
COUNTRY
15. DUTY MOS OR AFSC
16. PRESENT JOB TITLE
17. TOTAL YEARS
(Full Title - Do not abbreviate)
MILITARY SERVICE
18.a. HIGH SCHOOL GRADUATED FROM
b. YEAR GRADUATED
c. CITY
d. STATE
e. ZIP CODE
19. COLLEGES GRADUATED FROM
a. COMPLETE NAME
b. DEGREE c. YEAR GRADUATED
d. CITY
e. STATE
f. ZIP CODE
20.
REMARKS
(Continue on back if necessary)
21. SIGNATURE OF PERSON LISTED ABOVE
22. DATE
23. DUTY PHONE
(Authorizing release of this information)
(YYMMDD)
(DSN or area code)
DD FORM 2266, JUN 95 (EG)
Designed using Perform Pro, WHS/DIOR, Jun 95
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