Statement Of Service printable pdf download

Statement Of Service

Statement of Service

Full Name: _____________________________________________________________________

SSN: __________________________________________________________________________

Grade / Rank: __________________________________________________________________

Branch of Service: _______________________________________________________________

Please Check One:

[__] Officer

Student: GSN/SOM Year______ [__] Enlisted

Information for paperwork to be started:

DOB: ____/____/______

Active Duty Service Date: ____/____/______

End of Active Obligated Service Date: ____/____/______ (Officers: Indefinite)

Marital Status: _______________ Prior Service: [__] Yes or [__] No Period: ________________

Lost Time: _____________________________________________________________________

Pending UCMJ, Court Martial or Civil Actions: [__] Yes or [__] No _________________________

Duty Station Upon Graduation: (Four Year and PCSing Soldiers Only):

______________________________________________________________________________

Additional Information:

______________________________________________________________________________

Base Pay: ___________________ BAH: _______________________

BAS: _______________________ Other: _____________________

______________________________________________________________________________

Soldier Signature

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Statement Of Service