Request Form For Michigan National Guard Records

Download a blank fillable Request Form For Michigan National Guard Records in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Request Form For Michigan National Guard Records with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

Archive Records

Request For

MICHIGAN NATIONAL GUARD JOINT

FORCE HEADQUARTERS

Michigan National Guard

3411 N. MARTIN LUTHER KING BLVD

Records

LANSING, MI 48906-2934

Phone: (517)481-8331 Fax: (517)481-8363

RESTRICTIONS ON RELEASE OF INFORMATION:

Information from records of retired/discharged military personnel

are released subject to restrictions imposed by military departments consistent with provisions in the Freedom of Information Act

of 1967 (Revised 1974) and the Privacy Act of 1974.

PLEASE PROVIDE ALL INFORMATION. INCOMPLETE FORMS WILL BE RETURNED.

SECTION 1 – INFORMATION REQUIRED TO LOCATE RECORDS

SOLDIER INFORMATION (Required to Locate Records)

PLEASE PRINT:

_______________________________________________________

NAME (Last, First, MI):

__________________ DATE OF BIRTH: _________________

SSN/SERVICE NUMBER(S):

MICHIGAN NATIONAL GUARD MEMBERSHIP:  ARMY

 AIR

 OFFICER

 ENLISTED

APPROXIMATE DATES OF SERVICE

FROM: _________________ TO: ___________________

IS THE INDIVIDUAL DECEASED:  YES  NO

IS THE INDIVIDUAL RETIRED:  YES  NO

SECTION II – REQUESTED INFORMATION

 NGB 22 and/or DD 214, also includes all pertinent service records including NGB 23B

discharge orders and any other required forms for proof of service.

 Medical Records

 Other: ________________________________________________________________

__________________________________________________________________________

SECTION III – REQUESTOR INFORMATION

 Individual

 Family Member

 Official Business

 Recruiter

__________________________

_________________________________________

Phone Number:

Name:

__________________________

_________________________________________

FAX:

Street Address

_____________________________

_________________________________________

E-Mail:

City, State, Zip

I understand by checking this box  and typing my initials here ___________ that my digital signature

in the signature field below is legally binding and certifies that I am indeed the person requesting the

records or an authorized representative thereof and I declare under penalty of perjury that the foregoing

in true and correct.

__________________________________

___________________

Signature

Date

Note: Family members do not have access to spouse, sibling, or parental records without permission from said family member and subsequent filling out of

the above form and proof of identity. Additionally in the case of a death of a service member or incapacitation proof of death or power of attorney will be

required to obtain the records of said individual. RECORDS ARE PROTECTED UNDER THE FEDERAL PRIVACY ACT.