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APPLICATION FOR VOLUNTARY RETIREMENT DATE For use of …

For use of this form, see AR 635-200; the proponent agency is MILPERCEN. 12. DATE 18. TOTAL SERVICE FOR BASIC PAY PURPOSES (Item 16 + 17) 16. TOTAL ACTIVE SERVICE CREDITABLE FOR RETIREMENT (Do not include time lost) MEDAL OF HONOR SOLDIERS MEDAL DISTINGUISHED SERVICE CROSS 15. TOTAL TIME LOST (If no time lost, enter …

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