Military Retiree Information

1. Service:* -- please make a selection -- Air Force Army Coast Guard Marine Corps National Guard Navy
2. Title:* -- please make a selection -- Admiral Captain Chief Chief Master Sergeant Chief Warrant Officer Colonel Commander Corporal General Lieutenant Lieutenant Colonel Lieutenant Commander Lieutenant General Major Major General Master Chief Master Sergeant Petty Officer Senior Chief Senior Master Sergeant Staff Sergeant Technical Sergeant -- Other --
3. Other:
4. Rank Abbreviation:*
   e.g., MSgt, NC1, Lt Col, CSCM
5. Warfare Designator:
   e.g., (SW/AW) (for the Navy only)
6. First Name:*
7. Middle Initial:
8. Last Name:*
9. Address Line 1:
10. Address Line 2:
11. City:
12. State: -- please make a selection --AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaF.S. MicronesiaFloridaGeorgiaGuam HawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingNot in USA
13. ZIP or Postal Code:
14. Comments:

Retirement Date

1. Retirement Date:* (mm-dd-yyyy)
2. Ceremony Date: (mm-dd-yyyy)

Forwarding Address

1. Full Name:*
2. Address Line 1:*
3. Address Line 2:
4. City:*
5. State: -- please make a selection --AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaF.S. MicronesiaFloridaGeorgiaGuam HawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingNot in USA
6. ZIP or Postal Code:*