Almy et al v. United States Department of Defense et al

Filing 38

AMENDED COMPLAINT for Declaratory and Injunctive Relief for Violations of the United States Constitution and Administrative Procedures Act against Department of the Air Force, Department of the Navy, Michael B. Donley, Robert M. Gates, Ray Mabus, United States Department of Defense. Filed byJason D. Knight, Anthony J. Loverde, Michael D. Almy. (Attachments: # 1 Exhibit 1, # 2 Exhibit 2, # 3 Exhibit 3, # 4 Exhibit 4, # 5 Exhibit 5)(Woodmansee, Mark) (Filed on 5/4/2011)

. EXHIBIT 4

CAUTION: NOT TO BE USED FOR
IDENTIFICATION PURPOSES

ANY ALTERATIONS IN SHADED AREAS
RENDER FORM VOID

THIS IS AN IMPORTANT RECORD.
SAFEGUARD IT.

CERTIFICATE OF RELEASE OR DISCHARGE FROM ACTIVE DUTY
bciALSECURITY:NUMBEff'"

2. DEPARTMENT, COMPONENT AND BRANCH

NAVY-USNR

R:E6ACTED '.'

'

""X

'" 5. DATE OFR~~l~Trrr;vYMMDD)
7a. PLACE OF ENTRY INTO ACTIVE DUTY

b. HOME OF RECORD AT TIM E OF ENTRY (City and state, or complele address if known)
REDACTED

MOUNT PLEASANT, SC
Ba. LAST DUTY ASSIGNMENT AND MAJOR COMMAND

b. STATION WHERE SEPARATED

NMPS NORFOLK VA

PERSUPPDETNAVSTAsAN DIEGO CA

9. COMMAND TO WHICH TRANSFERRED

10. SGLI COVERAGE
NONE
AMOUNT: REDACTED

N/A
11. PRIMARY SPECIALTY (Ust number, titie and years and months in
specialty. Ust additional specialty numbers and til/os involving perfods of
one or more yearS.)

CTI-OOOO.XX
X

X
X
X

YEAR(S)

12. RECORD OF SERVICE

MONTH(S)

DAY(S)

a. DATE ENTERED AD THIS PERIOD

\---------_._-

c.

b. SEPARATION DATE TIllS PERIOD

d. TOTAL PRIOR ACl1VE THIS PERIOD
NET ACTIVE SERVICE SERVICE

r::'~"I'~'·~~i9Iilli~

e, TOTAL PRIOR INACTIVE SERVICE
f. FOREIGN SERVICE

X
X

g. SEA SERVICE

_

h. EFFECl1VE DATE OF PAY GRADE

13. DECORATIONS, MEDALS, BADGES, CITATIONS AND CAMPAIGN
RIBBONS AWARDED OR AUTHORIZED (AJJPeriodsofservice)

14. MILITARY EDUCAnON (Course Itlle, {lumber 01 Weeks, and month and

ARMED FORCES RESERVE MEDAL W/"M" DEVICE;
NATIONAL DEFENSE SERVICE MEDAL; NAVY AND
MARINE CORPS ACHIEVEMENT MEDAL; NAVY GOOD
CONDUCT MEDAL; NAVY RIFLE SHARPSHOOTER
RIBBON, NAVY PISTOL MARKSMANSlllP RIBBON, SEA
SERVICE DEPLOYMENT RIBBON. CONT BLK.18. ?DC

NONE. XX
X
X
X

yoar completed)

X

X,

15a. MEMBER CONTRIBUTED TO POST-VIETNAM ERA VETERANS' EDUCATIONAL ASSISTANCE PROGRAM
b. HIGH SCHOOL GRADUATE OR EQUIVALENT
16. DAYS ACCRUED LEAVE
PAID NONE

17. MEMBER WAS PROVIDED COMPLETE DENTAL EXAMINATION AND ALL APPROPRIATE
DENTAL SERVICES AND TREATMENT WITHIN 90 DAYS PRIOR TO SEPARATION

NO

NO