John H. Gertz American Legion Post 310
                                100 Liberty Street Little Ferry, NJ 07643
                                   201-641-9774 Hall Rentals 201-807-0470
                                           Commander: Sophia L. Dmoch 
   

DD214 Request Form

  :
DD214 Request Form
                           

To begin the DD214 request process, please fill out the form below COMPLETELY and summit it    

 ANY QUESTIONS JUST CALL ME 917-416-9221

Victor Ruggiero
100 Liberty Street
Little Ferry, NJ 07643

 We will contact you shortly so that you may sign the official DD214 request form.

Todays Date:
First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Daytime Phone:
Social Security No.::
Service Number:
Branch of Service
When in Service : Status:
Officer/Enlisted:
City and State of Birth:
Month and Year Left Service MM/YYYY:
Email:
Comments: