Enlisted Personnel Retirement (AR 615-395)

[Enlisted Personnel Retirement (AR 615-395)]
[From the U.S. Government Publishing Office, www.gpo.gov]

NON-CIRCULATING
( ENLISTED PERSONNEL
RETIREMENT
(AR 615-395)
WAR DEPARTMENT
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WAR DEPARTMENT TECHNICAL MANUAL
JANUARY 19 45
'«A« STATE EHLLE3E FOR TOHIDi
LIBRARY
TM 12-238 c i
TECHNICAL MANUAL
ENLISTED PERSONNEL RETIREMENT (AR 615-395)
Changes 1
No.l {
TM 12-238, 1 January 1945, is changed as follows :
Pages 5 and 15, second note under box “War Department Orders” in column “Enlisted Man,” change to read: “WD orders entitle soldier to transportation to place selected as permanent home within the United States and its possessions within 1 year after the date designated as the official termination of the war or 1 year after the date of re-
[AG 300.7 (13 Aug 45)]
By order of the Secretary of War :
WAR DEPARTMENT
Washington 25, D. C., 17 January 1946 tirement, whichever is later; including transportation for dependents of enlisted persons of the first three grades and transportation of household effects, within authorized allowances, for enlisted persons of the first four grades. “See AR 55-120 and 55-160.”
All references to WD AGO Form 30-S in figures 1, 5, and 12 are rescinded. (See AR 35-5560, 2 July 1945.)
Add chapter 3, following chapter 2.
Official :
EDWARD F. WITSELL
Major General
Acting The Adjutant General
DWIGHT D. EISENHOWER Chief of Staff
Distribution :
AAF (5); AGE (5); ASF (2); Def Comd (5); AAF Comd (2); Arm & Sv Bd (1); S Div ASF (1); Tech Sv (2); SvC (5) ; FC (1); BU (2); GH (2); SH (2); CH (2); Gen & Sp Sv Sch (2); A (2); CHQ (2) ; D (1); B (1) ; R (1) ; Bn (1); C (1); AF (2). NO OVERSEAS DISTRIBUTION.
Refer to FM 21-6 for explanation of distribution formula.
II. S. GOVERNMENT PRINTING OFFICE: 1946
AGO2870A—Jan. 678050°—46
wa STATE COUEBE FUR Han <£"/ 2 ' *Z4>
library
17 Jan 46
C 1
TM 12-238
9-10

LI
FOR WOfcR*
CHAPTER 3 PROCEDURE FOR ISSUANCE OF TRAVEL ORDERS
9. Enlisted persons desiring retirement furlough.
a. If an enlisted person being retired has chosen a place to live at the time of filling out WD AGO Form 49, request will be made oil his behalf by the personnel section of the military installation with retirement authority to The Adjutant General (Enlisted Branch, Military Personnel Division, AGO, Munitions Building, Washington 25, D. C.) for permission to grant transportation to the enlisted person (and dependents and household goods if authorized; par. 11) from his last permanent duty station to his selected home. This request will accompany WD AGO Form 49 and may be included in its letter of transmittal. When The Adjutant General has checked the service of the enlisted person and returned copy 2 of Form 49 (in cases under sec. I, AR 615-395) or dispatched the required TWX (in cases under sec. II, AR 615-395), the request for transportation authority will be returned approved, quoting proper allotment number. Upon receipt of the approved request the installation will issue travel orders designating the enlisted persons last permanent duty station and the address selected as his home. Orders will contain a statement that travel is in connection with retirement of the enlisted person and that upon expiration of his retirement furlough he will report for retirement to (military installation near his home selected for retirement). War Department Special Orders will then omit reference to allotment number when final retirement order is issued.
b. If the enlisted person has not chosen a place to live and desires to find a place while on retirement furlough, he will designate the military installation where retirement is desired and proceed on his furlough. When the enlisted person has decided where his home will be, he will make a request to The Adjutant General, through the installation where he is to be retired, for transportation (including transportation of dependents and household goods if authorized; par. 11) from his last permanent duty station to his home. The
installation will forward the request (or a TWX if necessary) to The Adjutant General and, upon receipt of approval with allotment number, will issue travel orders designating the last permanent duty station of the enlisted person and the address selected as his home. Orders will include a statement that travel is in connection with retirement of the enlisted person and that upon expiration of his retirement furlough he will report for retirement to (military installation selected for retirement). War Department Special Orders will omit reference to allotment number when final retirement order is issued.
c. If the enlisted person desires to avail himself of the year allowed in which to select his home, the military installation selected for retirement will, upon receipt of War Department Special Orders directing his retirement, issue travel orders for the enlisted person (and dependents and household goods if authorized; par. 11) from his last permanent duty station to a place to be designated by him within 1 year after the date designated as the official termination of war or 1 year after the date of retirement, whichever is later, place not yet selected. War Department Special Orders effecting retirement will contain allotment number for the transportation.
10. Enlisted persons not desiring retirement furlough.
a. If an enlisted person not desiring retirement furlough has chosen a place to live prior to the date of retirement, upon receipt of War Department Special Orders effecting retirement supplementary orders will be issued by the military installation with retirement authority, authorizing transportation of the enlisted person (and dependents and household goods if authorized; par. 11) from his last permanent duty station to his selected home.
b. If the enlisted person desires to avail him-self of the year allowed in which to select his home, the military installation with retirement au
AGO 2S70A
25
TM 12-238
10-13
thority will, upon receipt of War Department Special Orders directing his retirement, issue orders for transportation of the enlisted person (and dependents and household goods if authorized; par. 11) from his last permanent duty station to a place to be designated by him within 1 year after the date designated as the official termination of the war or 1 year after the date of retirement, whichever is later, place not yet selected.
11. Regulations governing transportation.
a. Retired enlisted personnel. See paragraph 18a and 6, AR 55-120, as amended.
ft. Dependents of retired enlisted personnel. See paragraph 8a (1), AR 55-120, as amended. For time limit within which travel may be performed, see paragraph 8/ (1), AR 55-120, as amended.
c. Authorized baggage (household goods). See paragraph 14a (12) (a), AR 5-160, as amended. For time limit within which shipment
17 Jan 46
C 1
may be made, see paragraph 14* (1), AR 55-160, as amended.
12. Transportation of dependents and household goods while on furlough. An enlisted person on retirement furlough may have his dependents and authorized baggage (household goods) transported to his selected home at Government expense when authorized by the regulations cited in paragraph 11. If retirement orders have not been issued, he will obtain such transportation by presenting to the transportation officer travel orders showing his last permanent duty station and the address selected as his home.
13. Regular Army enlisted personnel retired for length of service after 20 to 29 years’ service. The procedures prescribed in chapter 1 and this chapter will be followed in processing the retirement of enlisted persons under the provisions of Public Law 190—79th Congress, approved 6 October 1945 (sec. VIII, WD Cir. 310,1945).
26
AGO 2870A
TM 12-238
C 2
TECHNICAL MANUAL
ENLISTED PERSONNEL RETIREMENT (AR 615-395)
Changes
No. 2
WAR DEPARTMENT Washington 25, D. C., 1 June 1946.
TM 12-238, 1 January 1945, is changed as follows:
All references to WD AGO Form 53 are changed to read WD AGO Form 53-94. Remove pages 23 and 24 and substitute page 2 3 and revised page 24 herewith.
Add chapter 4 following chapter 3.
[AG 300.5 (14 May 46)]
By order of the Secretary of War :
Official: DWIGHT D. EISENHOWER
EDWARD F. WITSELL
Major General The Adjutant General
Chief of Staff
Distribution:
AAF (5); AGF (5); ASF (2); Def Comd (5 ); AAF Comd (2); Arm & Sv Bd (1); S Div ASF (1); Tech Sv (2); SvG (5); FC (1); BU (2); GH (2); SH (2); CH (2); Gen & Sp Sv Sch (2); A (2); CHQ (2); D (1); B (1); R (1); Bn (1); G (1); AF (2). No oversea distribution.
Refer to FM 21-6 for explanation of distribution formula.
AGO 8755A—May 692787*—48
1 Jan 45
TM 12-238
ALLOTMENT DISCONTINUANCE, WD AGO FORM 30-S (WD Cir. 297, 1944)
-----------------------------A-------------------------------------------------------------—-------------1
INSTRUCTIONS; THJ^^ X BE PREPARED FOR EACH Pp< OR RELEASED FROM ACTIVE
___ ~.,n .JTO BE FORWARDED EACH SHEET.
TO TYPIST: use^ as.
/ A&AW'
TAG ALLOTMENT DISC9HTIHUANCE
RETIRED * ^*11 notice upon discharge or release from active duty No. A ff "1
LAST NAME — FIRST NAMK — MIDDLE INmAt ARMY SERIAL NUMBER PATE OF SEPARATION SC STATION ™ I
DOE JOHN J. 1 APR 18% R 1 965 422 JO Nov 1944 | B
(NO E .TRY HERE) PERMANENT ADORES. FOR MARANO PURPOSE. I ।
"±°? ‘““V" ^eT.vEDATE finaldeouot,ON 122 S Main St., San Bernadino, Cal
MENT <0 MONTH AND YEAR MONTH OF ----------- 7
* ----------- FAMILY ALLOWANCE APPLICATION VETERANS ADMINISTRATION NUMBER H S E| "“I
-----------NUMBER. IF IN SERVICE RECORD ----------- (NO ENTRY HERE)
_____________________________________X- N-
• ----------- NAME AND LOCATION OF ORGANIZATION EFFECTING DISCHARGE OR RELEASE B
D 12.55 1 Jun 41 Oct 44 ====== 1269 SCSI CAMP HAAN CAL.
5 ----------- ENTER NAMES OF “E” ALLOTTEES. IF IN SERVICE RECORD ‘ B
p; 10.00 1 Dec 42 Oct 44 = Mr. M.L. DOE 9 1
-----------------------------------------=====
F HHH I I
* ----------- TYPED NAME. GRADE AND TITLE OF OFFICER EFFECTING DISCONTINUANCE “ B
B ---- - ' - L.J. CAMPBELL, CAPT, AGD, PERSONNEL OFFICER 9 |
-------- I (no signature necessary)
W. D.. A. G. O.
FORM NO. 30-8 71 H B
1 JULY 1*44 TO: THE ADJUTANT GENERAL’S OFFICE. WASHINGTON 25. D. C. JI B
(7 PARTS) 12.55 1 Jun 41 Oct 44 — " —-
E 5 10.00 1 Dec 42 Oct 44
F $
B 5
ALLOTMENT DSSCONT^UANCE
UPON DISCHARGE OR RELEASE FROM ACTIVE DUTY
R 1 965 422

No. A
JO Nor 1944
122 S Main St., San Bernaiino, Cal
1269 6CSU CAMP HAAN CAL,
M.L. DOE
CAMPBELL, CAPT, AGD, PERSONNEL OFFICER
FILE COPY
NOTE 1: An Allotment Discontinuance Document (WD AGO 50-S) is prepared and distributed for each enlisted person being retired even though no allotments are recorded in the service record.
2: Transmit forms in accordance with Circular 297, W.D. 1944.
Figure It.
AGO 8735A
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24
AGO 8755A
*1
(The material on this page is rescinded.)
1 Jun 46 C 2
WAS STATE SSLLESE FO* LIO^ A13V
CHAPTER 4
ENLISTED RECORD AND REPORT OF RETIREMENT
TM 12-238 14-16
14. Records fo be used. Effective upon receipt of WD AGO Form 53—94. This record will be prepared for all enlisted personnel being retired regardless of the law under which retirement is being directed.
15. When prepared.
a. The form will be prepared at the time the soldier is retired.
b. The forms contain spaces for all items deemed appropriate; therefore, no additional entries will be made thereon unless specifically authorized by the War Department.
16. Preparation.
a. The following is an item by item description of entries to be made on the Enlisted Record and Report of Retirement. They are arranged in numerical order. Entries will adhere as closely as possible to instructions presented in order to insure uniformity in execution of the forms.
b. All entries on this form are to apply to current period of active service except items numbered 36, 37, 38, and 42. If no entries are applicable, enter “none” or “not available,” whichever is appropriate. Specific clarification of certain items follows:
ITEMS
Item I. The name will be typed in the sequence indicated. There will be two typewriter spaces between the last name and first name and between the first name and middle initial.
Item 2. Enter Army serial number.
Item 3. Enter grade held at time of retirement.
Item 4. Enter arm or service of the last tactical or administrative and tactical unit, or a similar element to which he was assigned.
Item 5. NG, RA, RAR, ERC, or AUS. See front cover of Service Record. Selective Service (SS) will not be used for this purpose.
Item 6. Enter the last tactical or administrative and tactical unit, or similar element to which he was assigned for duty. See WD Retirement Order for last assignment if other than place at which retired.
Item 7. Enter date retired from the service. In cases in which an enlisted individual is delivered to a Veterans Administration facility, other institution, or home, for retirement under provisions of AR 600-500 and AR 615-395, the date of retirement will be the date indicated in Special Orders.
Item 8. Place of retirement will be the military installation at which the soldier is retired.
Item 9. Enter street or RFD number, city, county, and State. Enter country only if other than the United States. Indicate by “X” in pertinent box if address is temporary or permanent.
Item 10. Enter date of birth.
Item 11.
Item 12.
Item 13.
Item 14.
Item 15.
Item 16.
Enter city (or county), and State of birth. Enter country only if other than the United States.
If same as item 9, enter “See 9.” If other than 9, enter street or RFD number, city and State. Enter country only if other than the United States.
See Service Record.
Item 17. Enter dependents as shown on WD AGO Form 20. (See par. 34&, TM 12-425.)
Item 18. Indicate if white or negro. If other thai. white or negro, specify nationality, under “other.” For example, “Chinese,” “Japanese,” “Hawaiian,” “American Indian,” “Filipino,” etc.
Item 19. Indicate if single or married at time of retirement from the service.
Item 20. Indicate whichever is applicable.
Item 21. Civilian occupation will be the main civilian occupation taken from WD AGO Form 100, if available, or from item 13, WD AGO Form 20 if WD AGO Form 100 is not executed. The corresponding code from the Dictionary of Occupation Titles will be shown to the right of the description.
Item 22. Enter the date on which enlisted man was enlisted
Item 23.
Item 24.
Item 25.
Item 26.
Item 27.
Item 28.
or inducted into current tour of duty.
Enter place of induction as shown on page 1 of Service Record, vr place of enlistment as shown on page 2 of Service Record.
Indicate whichever is applicable.
(Fill in for Selective Service registrants only. See page 1 of the Service Record. For personnel enlisted enter “Not applicable.”
Home address shown on page 2 of Service Record.
If same as item 9, enter “See 9.”
Military occupational specialty will be the same as the MOS entered on WD AGO Form 20; the number will follow the title.
Item 29. Enter items of special proficiency as shown in Service Record or on WD AGO Form 20. Example: Expert Infantryman, Combat Infantryman, Pilot, etc.
Item 30. Enter battles or campaigns as authorized by War Department General Orders.
Item 31. Decorations or citations and authority far each. Authorities for service medals need not be entered.
Item 32. Enter date wounded and theater.
Item 33. See WD AGO Form 8-117 (Immunization Register) (old MD Form 81), or page 1 of Service Record.
AGO 8755A
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TM 12-238
16-17
Item 34. Enter date of departure, destination, and date of arrival for each movement between theaters and between a theater and the United States.
Item 35. Enter length of current period of active duty as represented by continental service and foreign service. (See AR 35-1490.) (Total length of longevity service will be entered in item 42.)
Item 36. Enter prior active Federal service in Army, Navy, Marine Corps, and Coast Guard under each heading as it pertains to enlisted, warrant, or commissioned service.
Item 37. Enter total active Federal service (35 and 36).
Item 38. Highest active or inactive grade held during entire Army service either enlisted, warrant, or commissioned service.
Item 39. Enter reason and authority for retirement in manner indicated, applicable to the individual being retired. Following is an example of reason and authority for retirement: Retirement—30 years’ service, section I, AR 615-395, paragraph 22, WD SO 99, 31 May 1946.
Item 40. See Service Record or WD AGO Form 20.
Item 41. See Service Record or WD AGO Form 20.
Item 42. Compute total length of active and inactive service as authorized for longevity pay purposes.
Item 43. Enter total amount due soldier at time of retirement. See Service Record and AR 35-2600.
Item. 44. Indicate if transportation is to be taken prior to or upon retirement showing special orders and headquarters authorizing transportation. If transportation is to be taken at a later date, show the soldier’s last permanent duty station.
^Item *46 J Indicate kind of insurance and how paid.
Item 47. For date of discontinuance of allotments, see AR 35-5520.
Item 48. Enter date 1 month after date entered in item 47. Item 49. The amount of premium due each month.
Item 50. Enter intention of veteran in regard to continuing his insurance, authorizing deductions from his retired pay or his intention to pay premiums on cash basis or discontinuance of all of his insurance.
Item 51. Right thumbprint to appear on original and final indorsement copy only. Impression to be entered from side of form.
Item 52. This space is for completion of above items or entry of other items specified in War Department directives. The following entries will be made when applicable:
1. Discharge lapel button issued.
2. Double time. Indicate years, months, and days of service credited as double time as indicated on approved WD AGO Form 49.
3. In cases in which an enlisted individual is delivered to a Veterans Administration facility, or other institution or home for retirement under provisions of AR 600-500, a statement will be entered to show the name of the installation preparing the retirement papers as “retirement papers prepared at Tilton General Hospital, Ft. Dix, N. J.”
4. In cases in which an enlisted man is retired and transferred to the E. R. G. on the same order, entry will be made as follows:
“Transferred to ERG.”
c. The personnel officer and the person being retired will sign the original in ink. The final in
1 Jun 46
C 2
dorsement copy, the service command copy, and the Veterans Administration copies (parts 2, 3, 4, and 5) will be signed by the personnel officer and the person being retired. An indelible pencil may be used in signing part 2, sufficient pressure being applied to make legible copies of the signature on parts 3, 4, and 5. There is no objection to the signatures appearing on parts 6, 7, and 8, but they are not required on these parts.
d. The face of the form will be signed by the commanding officer, or an officer of field grade, of the installation at which the enlisted man is retired.
17. Distribution. Copies of the form will be distributed at the time of retirement in accordance with the following instructions:
a. Original to person retired.
b. Final indorsement copy. Affixed to inside back cover of Service Record. This is to serve as the final indorsement to the Service Record as called for by TM 12-230.
c. Service command copy. (1) For retirements in continental United States. To: Headquarters of service command in which individual is retired. (If retired in the Military District of Washington, forward copy to Third Service Command.) After completion of processing by the service command machine records unit, the copy of the retirement form is forwarded to the headquarters of the service command or department in which address shown in item 9 is located, or retained by the headquarters of the service command in which the individual is retired if the address shown in item 9 is not located in a service command or department.
(2) For retirements outside continental United States. To: Headquarters of service command in United States or department in which address shown in item 9 is located or to The Adjutant General, Washington 25, D. C., Attention: Machine Records Branch in those cases where the address shown in item 9 is not located in a service command or department.
d. Veterans Administration headquarters copy. To: Veterans Administration, 346 Broadway, New York 13, N. Y.
e. Veterans Administration regional office copy. To: Regional office serving address shown in item 9 except as noted in paragraph 18.
f. Board of Registration copy. To: State director of Selective Service for State shown in item 26 when available, otherwise item 27. The entire
28
AGO 3755A
1 Jun 46
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TM 12-238
17-18
days accumulation of No. 6 copies for each State director to be mailed in an envelope or container.
g. Reemployment committeeman copy. To: En-isted men upon retirement for presentation to whichever local board he desires to contact.
h. Veterans employment representative copy. To: Appropriate Veteran Employment Representative, Veterans Employment Service, for the State shown in item 12.
18. Address. The mailing address of State directors of Selective Service are shown in AR 615— 360. In cases in which the enlisted person is retired
for physical disability, the Veterans Administration regional office copy will be sent to the Veterans Administration area office accompanied by the clinical records, unless the enlisted person is transferred directly to a Veterans facility, in which event they will be sent to that facility. Veterans Administration office addresses are contained in AR 615— 361. The lastest addresses of Veterans Administration regional offices are contained in current War Department circulars. Since these addresses are subject to frequent changes, personnel using this manual should check carefully to be sure that any amendments to these circulars are not overlooked.
V. I. GOVERNMENT PRINTINS OFFICE: I94S
AGO 87S5A
29
Hil STATE COLLEGE FOR Hau
LI SR ARY
!j - 2. "7 - <7
WAR DEPARTMENT TECHNICAL MANUAL
TM 12-238
ENLISTED PERSONNEL
RETIREMENT
(AR 615-395)
WAR DEPARTMENT • JANUARY 1945
United States Government Printing Office Washington • 1945
WAR DEPARTMENT
Washington 25, D. C., 1 January 1945
TM 12-238, Enlisted Personnel, Retirement (AR 615-395), is published for the information, guidance, and compliance of all concerned.
[AG 300.7 (1 Jan 45).]
By order of the Secretary of War :
Official :
J. A. ULIO
Major General
The Adjutant General
G. C. MARSHALL
Chief of Staff
Distribution :
AAF (5); AGF (5) ; ASF (5) ; AAF C (2) ; Arm & Sv Bd (2) ; Def C (5) ; Tech Sv (2);SvC (5) ; MDW (5); PC&S (1);GH (2); SH (2); Conv Ctr (2); Gen & Sp Sv Sch (2) ; A (2); CHQ (2) : D (1); B (1); R (1); SBn (1); Bn (1);C (1); AF (2).
Oversea distribution will not be made.
For explanation of symbols, see FM 21-6.
II
CONTENTS
Page FOREWORD............................................................................ iv
CHAPTER 1. RETIREMENT OF ENLISTED PERSONNEL FOR LENGTH OF
SERVICE, AFTER 30 YEARS’ SERVICE,................................ 1
Determination of Service Prior to Retirement for 30 Years’ Service—Flow
Chart............................................................... 2
Preparation and Disposition of Retirement Forms—Flow Chart............ 2
Granting Retirement Furlough, Preparation and Disposition of Letter of
Merit—Flow Chart.................................................... 2
Transfer of Service Records and Allied Papers, Including Retirement and
Furlough Forms to Military Installation Selected for Retirement—Flow
Chart.............................................................. 4
Issuance of War Department Orders and Certificate of The Adjutant
General—Flow Chart.................................................. 4
• Completion and Disposition of Retirement Forms—Flow Chart........... 4
Distribution of Retirement Forms, Basic Separation Forms and Service
Record—Flow Chart................................................... 4
Report of Physical Examination of Enlisted Personnel Prior to Discharge,
Release from Active Duty, or Retirement, WD AGO Form 38—Illustration. 6
Tax Instructions—Illustration......................................... 7
Employees Withholding (Tax) Exemption Certificate, Form W-4—Illustration ................................................................. 7
Letter of Merit—Illustration.......................................... 8
CHAPTER 2. RETIREMENT FOR DISABILITY AFTER 20 YEARS’ SERVICE 9
Transfer to a General Hospital Through a Station Hospital if Necessary—
Flow Chart......................................................... 10
Determination of Length of Service and Preparation of Physical Examina-
tion Prior to Board Meeting—Flow Chart............................. 10
Determination of Retirement for Disability and Granting Retirement
Furlough—Flow Chart................................................ 12
Transfer to Military Installation Selected for Retirement—Flow Chart. 12
Issuance and Disposition of Retirement Orders and Forms-—Flow Chart. . . 14
Preparation and Disposition of Basic Separation Forms—Flow Chart..... 14
Forwarding Required Forms to The Adjutant General—Flow Chart......... 14
Time Schedule for Processing Retirement for Disability of Enlisted Men,
Section II, AR 615-395—Schedule................................. 16,17
Application for Retirement, WD AGO Form 49—Illustration.............. 18
Furlough Form, WD AGO Form 31—Illustration........................... 19
Physical Examination of Enlisted Personnel Prior to Retirement for Dis-
ability, AR 615-395, Section II, WD AGO Form 38-5—Illustration. . . 20
Report of Board of Medical Officers, WD AGO Form 38-5—Illustration . . 21
Record of Payment of Retired Enlisted Men, WD AGO Form 50—Illustra-
tion.............................................................. 22
Signature Card SF 1099—Illustration............................... 22
Allotment Discontinuance, WD AGO Form 30-S—Illustration.............. 23
Report of Separation, WD AGO Form 5*3—Illustration................... 24
III
FOREWORD
1. PURPOSE.
This manual is based on the provisions of AR 615— 395. It shows in detail the administrative procedures necessary to accomplish retirement of enlisted personnel.
2. SCOPE.
a. This includes simplifying and eliminating the number of required forms, expediting verification of length of service, and presenting complete and accurate instructions and illustrations of necessary actions.
b. The reduction of paper work is evidenced by the substitution of 3 basic retirement forms for 13 forms and supporting papers. The consolidation and elimi-
nation of other forms is presented graphically as follows:
« Old New
Retirement forms 13 5
Medical forms 5 2
Fiscal forms 5 2
Personnel forms, including WD Orders, Letters
of Merit, Certificate of The Adjutant General. 8 6
Total 31 15

Signatures and copies have been correspondingly reduced. Forms have been redesigned for use in the standard typewriter and to allow ample space for entries.
IV
1 Jan 45
TM 12-238
1
CHAPTER 1 RETIREMENT OF ENLISTED PERSONNEL FOR LENGTH OF SERVICE, AFTER 30 YEARS’ SERVICE
1. The objectives in the basic procedure for retirement of an enlisted man after completion of 30 years’ service are to provide—
a. The enlisted man with a retirement furlough of up to 120 days.
b. The personnel officer preparing the retirement forms with adequate instructions.
c. The Adjutant General with properly executed forms necessary to issue retirement orders.
d. The Finance Officer, U. S. Army, with properly accomplished forms so that he may place the retired soldier on the retirement pay roll promptly.
e. Authority to the commanding officer of the post, camp, or station at which a permanent party enlisted
man about to be retired is located to arrange for storage and/or, packing and crating of household goods of the enlisted man about to be retired if necessary and if requested for a period not to exceed 6 months.
2. The soldier selects the military installation at which he wishes to be retired. The necessary transfer of status and forms will be made so that he may be readily retired at such a point.
3. See figures 1 through 4 for the procedure to be followed and the forms used in accomplishing the above objectives.
1
TM 12-238 ' 1 Jan 45
FIG. 1 RETIREMENT
< FOR LENGTH OF SERVICE
nnpilucllT ORGANIZATION OF SOLDIER
DOCUMENT ENLISTED MAN
PERSONNEL SECTION
SECTION I DETERMINATION OF SERVICE PRIOR TO RETIREMENT FOR THIRTY YEARS OF SERVICE
APPLICATION FOR RETIREMENT ' P AG0 49 i I'. AG° 49 L
TO AGO 49 tfiy—-------------A' L 2 AGO M |““
\ AGO 49 F
- If soldier requests retirement for - Signs original only and forwards for
service, prepares application for re- approval.
tirement. z .
- Enters request for retirement furlough on Form 49.
- Forwards two copies to The Adjutant
. General five months prior to date sol-
dier wishes to be retired for thirty years service so that a furlough up to 120 days may be granted if approved.
ENVELOPE |
\ ■ W-4, INSTRUCTIONS |
■ - Receives envelope containing approved
application for retirement and necessary ■ blank retirement forms.
SECTION £ PREPARATION AND DISPOSITION OF RETIREMENT FORMS
APPLICATION FOR RETIREMENT I PtF 'AG°?9 Files in *uspense „
TO AGO 49 I |\_....A.G0 90 "^ service record.
M r. SF 1099 I w-™
RECORD OF PAY OF RETIRED UNLISTED dAN|Ha^U | I W-4 frJL
WD AGO 50 1J 12 AGO 0191 Il AGO 0191 |
SIGNATURE CARD M I1 AGO 0191 I |2 *60 0191 |
S.F. 1099 Up I
■I TAX INSTRUCTIONS I TAX INSTRUCTIONS I
EMPLOYEES WITHOLDING TAX EXEMPTION I
CERTIFICATE W-4 (TREASURY DEPT.) J
- Prepares retirement Forms omitting dates
REPORT OF ADDRESS CARDS, WD AGO 0191 and order numbers. ' Kee?s tax instructions for information.
- Gives address cards, W D AGO 0191 to ' Ho,ds address cards for future use.
" TAX INSTRUCTIONS - G^veTUx instructions to soldier.
- Files retirement forms with service record.
SECTION 3 GRANTING RETIREMENT FURLOUGH, PREPARATION AND DISPOSITION OF LETTER OF MERIT
FURLOUGH FORM F AGO 31
WD AGO 31 12 AGO 31 BHHWIIIII
L AGO 31 |
- If form 49 indorsed by the TAG states soldier is eligible for furlough he will •
be yranted a furlough not in excess of
120 days. The furlough will terminate *
on the last day of the month in which he will be retired.
I
f AGO 31 I
- Files with service records. AGO 31
- Keeps
- Soldier is granted retirement furlough.
LETTER OF MERIT
- Receives letter of merit with appropriate cermony.
- Keeps letter.
2
1 Jan 45
TM 12-238
ENLISTED MEN
SECTION I AR 615-3 9 S
COMPANY COMMANDING OFFICER
REGIMENTAL COMMANDING OFFICER
THE ADJUTANT GENERAL
- Approves by signing original and forward inq.
- Approves Dy signing original and forwarding. - Use or Air Mail authorized.
NOTE
Before soldier departs on furlough, the Personnel officer will advise the soldier he must report in person to the military installation selected for retirement to take a final physical examination within 72 hours of his retirement date.
If he goes on sick call while on furlough, he will report this fact by wire to TAG so that orders may be modified.
If he does not report to installation selected for retirement on date of termination of furlough, he will not be complying with W.D. orders and will forfeit right to government transportation.
AGO 31 | —Mfc
AGO 31 I
5 I rF
AGO 31
- Approved by signing.
- Authority is contained in Form 49 from TAG-
Forwards copy two of Form 31 to TAG without delay.
AGO 49 2
AGO 49
- Confirms or amends statement of service on application for retirement by checking in:
I. Correspondence file
2. 201 file
3. Archives
4. High point, North Carolina
5. Navy, Marine Corps, and other service legally credited towards retirement.
ENVELOPE 49,50,1099,0191 W-4, INSTRUCTIONS
- If soldier has thirty years or more of service for retirement mails required retirement .forms and Copy 2 of Form 49 with correct statement of service credited for retirement shown on reverse side thereof, and no. of days furlough authorized..
- Checks and returns statement of service normally *within fifteen (15) days.
- Use of Air Mail authorized .If soldier does not have thirty years of service credited for retirement,returns Copy 2 Form 49 with correct statement of service credited shown on reverse side thereof. Does not forward other retirement forms.
2
AGO 31
U^es to determine date of retirement and military installation at which soldier will be retired.
LETTER OF MERIT |
LETTER OF MERIT
- On receipt of Form 31, prepares letter of merit in recognition of service.
- Presents letter with appropriate ceremony prior to soldiers departure on fur lough.
3
5 AGO 99 I || AGO 99 > R
1 I F 1—
AGO 99 I I, AGO 99
TM 12-238
1 Jan 45
FIG. 1 (CONT’D)
RETIREMENT
FOR LENGTH OF SERVICE
RECORD JACKET
FORM
KO ORDERS |
SECTION 5-
ISSUANCE OF WAR DEPARTMENT ORDERS AND CERTIFICATE OF THE ADJUTANT GENERAL
AAR DEPARTMENT ORDERS
SECTION 6.
COMPLETION AND DISPOSITION OF RETIREMENT FORMS
AGO W
SECTION 7.
COMPLETION OF BASIC SEPARA TI ON
SECTION 8.
DISPOSITION OF RETIREMENT FORMS, BASIC SEPARATION FORMS, AND SERVICE RECORD.
CERTIFICATE OF THE ADJUTANT GENERAL.
EMPLOYEES WITHHOLDING TAX
EXEMPTION CERTIFICATE W-4
ENVELOPE CONTAINING, -RETIREMENT FORMS -BASIC SEPARATION FORMS -SERVICE RECORD
38, Part I
53, Part I 30-S, Part I
24, service record.
- Completes retirement forms entering dates and War Department order numbers, and other entries required.
- Soldier signs required forms.
- Receives and checks service records, retirement forms and furlough form for completeness.
- Requests any incomplete data or necessary forms without delay.
- Picks up soldier on morning report on effective date of change.
- Receives Var Department orders directing retirement of soldier under section I, AR 615-395.
- Gives soldier one copy of the W.D. orders.
- These orders will be delivered in person and not in any other manner.
- Advises soldier to report address to service commander and TAG after he selects his home.
XAR DEPARTMENT ORDERS
SIGNATURE CARD SF IU99
RECORD JACKET 49,50,1099,W-4, 24,31.
APPLICATION FOR RETIREMENT WD AGO 49
RECORDS JACKET. CONTAINING
-SERVICE RECORD AND ALLIED PAPERS
-RETIREMENT FORMS
-FURLOUGH
- Checks for accuracy of name and serial no.
- Encloses part I, form 38 in service record.
RECORD OF PAYMENT OF RETIRED ENLISTED MAN WD AGO SO
envelope
49,50,1090,W-4 30-S, 53,24
- Transfer is accomplished by indorsement of the service record, s tatus attached unassigned.
- Service record and allied paper, retirement forms and furlough form are forwarded to military installation selected for retirement.
- Drops soldier from morning report on effective date of change.
FORMS.--SEE FOLLOWING SECTION 6 OF THIS MANUAL, UNDER RETIREMENT FOR DISABILITY
REPORT OF PHYSICAL EXAMINATION OF ENLISTED PERSONNEL PRIOR TO DISCHARGE, RELEASE FROM ACTIVE DUTY OR RETIREMENT WD AGO 38
- Forwards following forms to T*G - Retirement forms as follows:
WD AGO No's 49 and 50, SF 1099, W-4 - Basic separation forms as follows:
WD AGO No. ‘ WD AGO No. WD AGO No. WD AGO No. . properly completed.
- Extract from service record, WD AGO 25, Not Reau i red.
DOCUMENT ORIGINAL ORGANIZATION PERSONNEL SECTION MILITARY INSTALLATION SELECTED
PERSONNEL SECTION
SECTION N. TRANSFER OF SERVICE RECORDS AND ALLIED PAPERS INCLUDING RETIREMENT AND URLOUGH FCRMS TO MILITARY INSTALLATION
l»l HHl
4
1 Jan 45
TM 12-238
ENLISTED MEN
SECTION I, ARBI5-335
FOR RETIREMENT
ENLISTED MAN
THE ADJUTANT GENERAL
SURGEON
SELECTED FOR RETIREMENT-
NOTE I. Soldier will be paid at termination of furlough by Finance Officer servicing military installation selected for retirement. If soldier requests payment he will be paid while on furlough by military installation selected for retirement.
WAR DEPARTMENT
0* ORDERS
- Receives WD orders retiring soldier.
- WD orders entitles soldiers of the first four grades to transportation for himself, family, and household goods to any point within the United States within one year after retirement date. See AR 55-160 and AR 55-120.
- To live outside United States he must obtain approval of TAG, AR 615-395.
CERTIFICATE OF THE ADJUTANT
- Receives in recognition of long and meritorious service.
ENVELOPE 49,50,1099,W-4 30-S ,53,24
- Receives.
- Forwards required forms to Finance Office, U.S. Army.
CERTIFICATE OF THE ADJUTANT
- Prepares and forwards after retirement is accomplished.
5
wpj 1 WD ORDERS | ,
i WD ORDERS I
WAR DEPARTMENT p
ORDERS
- Prepares and issues war department orders in month prior to month he will be placed in retirement list.
1 AGO 38 I AGO 38
AGO 38 |J T
- Gives or directs physical examination be given.
- Prepares form 38.
- Part 2 serves as worksheet.
- Part 3 serves as lab slips.
- Signs copy I.
AFTER TWENTY YEARS SERVICE.
TM 12-238
1 Jan 45
REPORT OF PHYSICAL EXAMINATION OF ENLISTED PERSONNEL PRIOR TO DISCHARGE, RELEASE FROM ACTIVE DUTY, OR RETIREMENT, WD AGO FORM 38
(See WD Cir. 333, 1944)
6
—_____________________________________________________________________________
REPORT OF PHYSICAL EXAMINATION OF ENUSTED PERSONNEL %
fBIQB TO BISCHARGE, RELEASE FROM ACTIVE BUTY QU RETIREMENT. | fl
I LAST BAKE - FIRST KAKE - KIDDIE IBITIAt 2 ARKY SERIAL RUBBER TTrAOE-« RES IKEKT, ARK OR SERVICE---------- I
_ T , T , , 5235 Ord Dept Co.
Doe, John J. B 1 963 422 M Sgt Ft, Mi, J J
6 "m""! *mESS —————1 , COLOR I? ACE „ i~»X~ I. SYPHILIS II- REGISTER
122 So. Main St., San Bernadlno, Cal 1 f. w yEARS "• s/r? closed ih s/r? I
54 M YES OR RO YES OR Do“| ■
_________________________________STATEMENT AND MEDICAL HISTORY CF EXAMINEE_________________________________________
10 minn SUFFE"I"S Fro" “W”- injury dr disease khetke«.dr rot ikcurred id the [7/ ' „ „ I I
MILITARY SERVICE. IF YES, LIST THOSE CONDITIONS FIRST UNDER ITEM II. ts 0R 110
_______________________________________________________________________________________ No
H LIST ALL SI3NIFICANT DISEASES, WOUNDS, AKO INJURIES. STATE CIRCUMSTANCES UNDER WHICH i 2 3 u
WOUNDS OR INJURIES WERE INCURRED. ANSWER YES OR NO IN COLUMNS I TO H. ,
EFTS 2’ AMS 3* IMS 1* PD 5*
None
r- RECORD OF PHYSICAL EXAMINATION
12 PSYCHIATRIC DIAGNOSIS 23 TEETH - INDICATE RESTORABLE CARIOUS TEETH BY 0 NON-RESTORABLE CARIOUS TEETH 'by /, I
"ISSIWG NATURAL TEETH BY X: TEETH REPLACED BY DENTURE (HORIZONTAL LINE OVER) X AS
„ _ XXX AND TEETH REPLACED BY FIXED BRIDGE (OVAL TO INCLUDE ABUTMENTS) AS (A I 6~)
-formal right examines left —
13 BFUBOLOOICAL OIADKOSIS
8 7 6 8 U 3 2 I X23US6X8 I
Normal 88 xf u 13 12 11 10 a 9 10 11 12 13 u 15 il
l» EYE ABBORHALITl ES 2B KOUTH ABD DUH ABBORHALITl ES 3» DEBTAL PROTHESIS: SERVICEABILITY---
None Normal Good.
IB EAR, NOSE, THROAT ABNORMALITIES 25 MUSCULOSKELETAL DEFECTS — TZ 7---------------------------------- I
HBBLULUBBLLtlAL DEFECTS 3S UHCORRECTED- V I S I OH - CORRECTED
RIOBT EVE LEFT EYE RICKY EYE LEFT EYE I
None j(or,a
Tg--------------------------------------—-------------------------------------- 70/ 15 K/ 12 20/ 18 20/ 18 I
2S »>”"'>«■ VISCERA HEARING-------------- I
Trr~_ 1 RIGHT EAR LEFT EAR* I
Normal Normal ip £4
17 VARICOSE VEINS ~ 11 C Akb I 0 VASM11 AB m---------------------------Lli_______
if CARDIOVASCULAR SYSTEM 37 HEIGHT (UCUS) WEIGHT (W/M? I
None Normal 7 2 180
18 HEm* 28 PULSE 38 ENTER SPECIAL TESTS
„ SITTING IMMEDIATELY AFTER I TWO MINUTES
None fih. exercise after exercise
____________________________________________________102___________ 04 None
19 HEMORRHOIDS 29___________BLOOP PRESSURE___________ 39 BLOOD FOR SEROLOGY HAS BEEN SENT TO U.S.P.H.S.
-SYSTOLIC H DIASTOLIC
None__________________________________________120_________| 90 No
20 „„ „ —l™'8________________________FTpim K«Lr.g^.»a!tiTjfdWfeg/je.T3,?
Normal S6P/aV|F?YC I *Lf,UMM' SUGAR MICRO SC0PIC6* CMOItJon: YES OR io YES OR NO I
41 ,E,t>E*L ”iE‘iEi--------------------1 W------------------L-g" '■ 1MT °F'""J A ■ —
---mEASE INCURRED IN LINE (>F DUTYJ___
None Normal connt.o;.-' | ns or .0 |
22 FEET CHEST X-RAY “ ———————- — y(JlJR Op||||O|| 00E3 iHDIVIDUAL MEET
_ _ PHYSICAL AND MENTAL STANDARDS FOR DIS-
Normal Normal charge?_____________________
_______________________________________ IF ROT, STATE WHY YES OR RO
ENTER REMARKS OR OTHER DEFECTS (COHUHt 0! BiCi) 33 ENDOCRINE SYSTEM ' yeg I
Normal
DATE OF EXAMINATION LOCATION TYPED NAME AND GRADE SIGNATURE-----------------------------
30 Nov 1944 Carap Haan, ”
9 y Calif. [Major L. J. Tieman, MO________________
i* pxrot ro itxiUL it 3trmrioi ctrrtt «• ucontD vBiuTi71fii.inKT sttrrct ' disTributionb
r IBCOBM Oi tnsrtD mot TO nrtiicf n militiby sttuct r ptisnr hysich DtrtcTs IMCLOsro WITR
3* iGOBBYiTtn BY .YLITiBY SBBYYCB „„ IIDlClrn
W.D..A.O.O. FORM NO. »S. 1^ <--------------------------------------------............
- holds r
- Forwards to board of medical officers at ,
time of board meetings. ,
- If form 51 or LOD find- _
i.ngs not received and LOD status undetermined initiates LOD proceedings.
md 55 [ HD 55
_ beviews If so wishes. - Receives clinical rec- - Files on ward or ap-
ords. propriate location.
- Forwards to ward through - Forwards to board of
__________________chief of service. medical officers at
| 1 AGO 49 w H |
P ago 49 T ~ K
U p "1. ” L AGO 49
I AGO 49 U I J
- Determines length of _ , .... service and uses form
- prepares for. 4? within 72 „ a5 , basis for re.
7 Ply to the hospital by
- Soldier signs applicat.on as Tky „ithip seven /
acknowledgement of his st.- of recei t of form J
tus,and request for furlough if retired. - Obtains signature of C.O. detachment of patients or station complement. - Forwards through C.O. to
TAG. See note 2-
Pr______A£°_31 ___IjmX To So 1 d' er
i i 2 ■ F
AGO 31 Si ^■■■■aai ■■■■■■■
• Pending receipt of TUX from TAG may grant soldier approximately ten day furjough If C.O. of hospital approves. ---------------------
—------------------------------------------------------------------------
I1 AGO 38-5 n---r
o . l I 0 A°0 38-( - Sends TWX stating serv-
- Receives AGO 38-5 ™---ice credited for re-
‘ i?™ 7s ,ir'',arins U p Tafr n 'e8rs-
item 7, 38-5. ■ Tl ---------——------U 3 AG0 38^5 months, and days, grade <
Fl •«. I I U l~H ~ *n which he will be j-e-
AGO 38-b__■ I AG0 3g_g | tired, maximum number
IT Ago 38-5 ■ I A 5 AG0 38"5 I of days furlough au-
rx----------------r Ahh I thorjzed and name of
H AGO 38-5___________ Forwards to chief of soldier.
U 4 service. . Directs physical ex-
AG0 38-5 ~ Gee no*e _______ amination be given sol- .
I P ago 38-5 "I dier ®nd form 38-5 be
r-x----- A------L be completed within 72__________
- Initiates form 38-5 com- AGO 38-5 | hours after receipt. F AGO 51 | j
pleting item 1-7 and for- W*. 3 1| - Uses copy 4, 38-5 as ।-——----- 5
wards within 48 hours after MMB w,.; I worksheet. . -------11
receipt of TWX. AGO 38-5 I . (ote I. I AGO 38-5 fc
k—IJ | 2 AGO 38-5 I - Receives ’ 11 ra-
- Forwards to Board of 'll
Medical officers with- k 1^ AGO 38-5
In 48 hours together M HHMb ______________________I
with 51 and clinical ■ F
records. ■ - »e«lve»
- Acts as automatic re- ■ ” Uses as a basis for
ouest for board meet- ■ conducting retirement
jng. ■ board meeting within
four
11
1 Jan 45
TM 12-238
FIG. 5 (CONT'D)
RETIREMENT
FOR DISABILITY AFTER TWENTY
DOCUMENT
HOSPITAL WITH RETIREMENT AUTHORITY
BOARD OF MEDICAL OFFICERS REGISTRAR
SECTION 3 DETERMINATION OF RETIREMENT FOR DISABILITY AND GRANTING RETIREMENT FURLOUGH
REPORT OF INVESTIGATION .WD AGO 51 (IF INDICATED)
CLINICAL RECORDS NO 55
REPORT OF FINDINGS OF A BOARD OF MEDICAL OFFICERS WD AGO 38-5 (BACK)
। <—ag° 51
I, MD 55 x\
% 1 AGO 38-5 I \
J p AGO 38-5
\[3 W
AGO 38-5 ’
AGO 51
MD 55
AGO 38-5
2 AGO 38-5
3 AGO 38-5
RECOMMENDATION TO TAG BY TSGO (IF INDICATED)
FURLOUGH FORM WD AGO 31
- A board of medical officers will not oe convened until the end of required definite treatment in an army hospital.
- Prepares report of findings of a board of medical officers, using cooy 3 form 38-5 as board work sheet.
- The report wi11 show:
I. Findings
a. Diagnosis - only of its incapacitating conditions
o. Line of duty - status for each condition
c. Disability - degree, duration and nature
I. Whether patient is (or is not) incapacitated for future service
2. If incapacitated the cause thereof
3. Approximate date that incapacity or i g inated
4. Whether or not the disability was incurred in line of duty and whether it is permanent
2. Recommendations
a. Soldier is to be retired
b. Other disposition recommended
- Types up report of ooard findings on back of form 38-5, using copy 3, form 38-5 as work sheet.
- If board has a secretary directs that secretary prepare form 38-5.
- Obtains or has secretary obtain signature of board members required on original form 38-5.
- Forwards to C.O. within 24 hours of board meeting.
- Files clinical records or has records
- Files cooy 3, worksheet, form 38-5.
- Requests soldier and explains his
to appear status to
before the ooard
- Requests soldier To state whether
sign form he wishes
38-5.
to be retired or not.
- The board will meet within _____
registrar has requested the soldier appear before the board.
four days after the
SECTION U TRANSFER TO MILITARY INSTALLATION SELECTED FOR RETIREMENT.
APPLICATION FOk RETIREMENT WD AGO 49
TWX FROM TAC
SERVICE RECORD WD AGO ?4
NOTE 2
The soldier will be advised that if taken sick while on furlough he will report to an army hospital and advise the TAG by wire he is on sick call at a specified hospital so that War Department orders may be modified accordingly.
The soldier will ue advised he must report to to installation he selects at termination of furlough unless condition above applies or he will not be complying with W.D. orders and will forfeit transportation privileges.
12
TM 12-238
1 Jan 45
ENLISTED MEN
TEARS SERVICE SECTION B AR 615-395
HOSPITAL WITH RETIREMENT AUTHORITY
COMMANDING OFFICER
PERSONNEL SECTION
MILITARY INSTALLATION SELECTED FOR RETIREMENT
PERSONNEL SECTION
THE SURGEON GENERAL
THE ADJUTANT GENERAL
NORMALLY SENT TO TAG UNLESS SOLDIER DOES NOT WISH TO BE RETIRED
AGO 51
AGO 38-5
AGO 38-5 2
- Reviews and approves proceedings of board of medical officers by signing original form 38-5
- If commanding officer approves retirement recommendation forwards proceedings directly to TSGO
- May request board to reconsider
- Receives
- If approved retirement recommendation uses TWX as basi s for grant ing furlough if soldier wishes furlough
- If commanding officer approves recommendation other than retirement does not forward retirement case to TSGO but accomplishes other rec-ommendat ion
- If C.O. approves retire-, ment forwards proceeding to TAG, unless soldier has stated he does not wish to be retired, in which case proceedings are forwarded through TSGO to TAG.
n F AGO 31
I
AGO 31 |l
AGO 31

AGO 51
If necessary requests additional data by air mail or TWX.
AGO 38-5
AGO 31
- Holds case at TSGO.
RECOMMENDATION
|J RECOMMENDATION
If soldier does not wish to be retired receives and reviews proceedings.
- Orders other disposition as assignment deemed aooroor i ate.
1 1 AGO 51 1
1 1 1 AGO 38-5
Ml2 AGO 31 r
U r
RECOMMENDATION j L_ ■
'W Mm bW ^M^M ^Mm
- Receives proceedings from hospital or TSGO.
- If necessary requests information from hospital.
- Accepts recommendations of TSGO.
- Uses as a basis to prepare War Department orders to retire sol-
- Makes recommendations to TAG.
- Forwards to TAG normally within three days.
- On authority of TWX from TAG and request of soldier, grants furlough to soldier of up to 120 days starting within the third day after the board meeting. The fur lough wi11 terminate on the last day of the month in which the
If soldier does not wish retirement furlough he will be g iven with hospital approval a convalescent furlough terminating on the end of the first month in which retirement can be accom-plished.
- Forwards for use in preparation of form 50.
TWX-TAG
SERVICE RECORD
- Forwards to use in preparation of form 50.
- Indorses service record and forwards with above forms wi thout. delay.
- Droos soldier on morning report on effective date of change.
by indorsement of the service record noting sect ion II, AR 6 15-395, states attached unassi gned.
621720 0 - 44-2
A
NOTE I
While soldier is on retirement furlough, if he requests payment, and at termination of fur1ough, soldier will be paid by finance officer serving the military installation selected for retirement.
L_ AGO 31 |
J3 AGO 99 |
TAX-TAG |
SERVICE I RECORD 1
- Receives
- Requests if not received .
- Picks up soldier on morning report on effective date of change.
13
|g
«
TM 12-238 1 Jan 45
HG. 5 (CONT’D) RETIREMENT |
FOR DISABILITY AFTER TWENTY YEARS
MILITARY INSTALLATION SELECTED FOR RETIREMENT
DOCUMENT —_______________________________________________________________________________________________
PERSONNEL SECTION FINANCE OFFICE
SECTION 5- ISSUANCE ANO DISPOSITION OF RETIREMENT ORDERS AND FORMS. ~
WAR DEPARTMENT ORDERS r 03103 U ■
1 2 WO ORDERS W
SIGNATURE CARD M I SF 1099 | %
SF 1099 4 I AGO 50 I
I1 AGO 0191
RECORD OF PAYMENT OF'RETIRED ENLISTED MEN F
WD AG0-50 4 *80 0191
- Receives during month inwhich furlough
REPORT OF ADDRESS CARDS . Form |099.
WD AGO 0191 - Prepares WD AGO Form 50 using copy 3. Form
49 and TWX from TAG as oasis for entries required.
- Gives one copy of 'War Department papers to sold ier.
- Gives address cards to soldier.
- Advises soldier to report his address to Service Commander and TAG after he selects his home.
SECTION 8. PREPARATION AND DISPOSITION OF BASIC SEPARATION FORMS.
INFORMATION FOR SOLDIERS GOING BACK TO m 2|-i»
CIVILIAN LIFE WD PAMPHLET 21-4
REPORT 'OF SEPARATION 4 ______~ 8ives to soldier.
AGO 53 I AGO 53 I
I 2 AGO 53
U [1 AGO 53
1J n~'
Vr«' ______________________________________________ I
I, AGO 53 | B
- Prepares and distributes Form 53.
ALLOTMENT DISCONTINUANCE ________ 11 AGO 30-S |
WD AGO 30-S 12 AGO 30-S 12 AGO 30-S
M 13 AGO 30-S ________ I3 AGO 30-S
U IA AGO 30-3 U 19 AGO 30-S
U [5 AGO 30-S rV U | 5 AGO 30-S
U I 6 AGO 30-S I8
U p | j, AGO 30-S
1, AGO 30-S f
- Prepares Form 30-S. " prward! ln accordance with AR 35-5560,
- Encloses copy I in service records. 1944.
- Forwards copies 2-6 through finance officer. e ------------------
FINAL PAYMENT ROLL - F» lem copy 7. I WO 371 |
*D 371 [j----------------k p j
ns---—----------WO 371 I—__K r
12 WD 371 F
WD 37. I - Processes in accordance with estaolished
F procedure.
- Mustering out pay is not paid to retired
_ x , soldiers.
- Prepares payment roll.
PAY
P/rr TO SOLDIER
- Pays soldier in accordance with estaolised A
SECTION 7. FORWARDING REQUIRED FORMS TO THE ADJUTANT GENERAL, procedbre. ■
LI SF 1099
| AtS0~5O
U I1 AGO 30-S TlW
TJ 11 AGO 53
H SERVICE rik
‘3»«£H»n &> J Fs I Z7 State Selective
f J 5^^53|*HIt
I, AGO 53
- States Selective Service Distributes copies 4, 5, 6.
।---------------k Office of Special
■■■■■■■■ilHHHBHNBHIHHIBBHI ■■■■■■■■■■■■■■MHMHHnKHH 2 ISettlement Accounts
F? ~~ T New York City
3 AGO 30-S fk
II [T fc^^^Army War Bond Office
P_____AGQ 30-S._Chicago, 111.
M 5 AGO 30-S A „ ,
W e Newark, N. J.
I, AGO 30-S M
- Takes steps to cancel allotments and allowances
_[ ...'' I
- Receives bay.
SF 1099 pLp—I SF 1099 |
I AG0 50 pwk J
11^ 7 I tG0 30~S *!■< AS° 50
U I A90 53 |
M SERVICE I “ Uses to place soldier
L RECORD on retirement pay roll
in month following re-t i r erne n t.
- These forms will be Receives. forwarded through TAG
- Forwards SFI099 and WO AGO 50 to to Finance officer Finance Office. u s> Arniy.
15
TM 12-238
FIG. 6
1 Jan 45
TIME
PROCESSING RETIREMENTS FOR DISABILITY
ACTION TAKEN DY AFTER ADMISSION AFTER REQUEST FOR BOARD MEETING
THIRD DAY THIRD DAY FOURTH DAY
PERSONNEL SECTION - Obtains service record and Allied papers. - Prepares and forwards Form >19 to TAG. - If necessary initiates request for line of duty determination.
THE ADJUTANT GENERAL
COMMANDING OFFICER, DETACHMENT OF PATIENTS OR STATION COMPLEMENT - Signs Form 99
. COMMANDING OFFICER OR HIS DESIGNEE - Signs Form 99
REGISTRAR - Has requested physical examination given soldier and Form 38-5 completed. - Types up Form 38-5 from worksheet, Copy 9. - Sends Form 38-5,clinlcal reports, and Form 51, if required,to board meeting. - Types ud Form 38-5 from worksheet, board proceedings. - Obtains signature of board members on part I, Form 38-5, board proceedings.
CHIEF OF SERVICE - Completes physical examination and completes Form 38-5. - Signs Form 38-5 before board meeting.
BOARD OF MEDICAL OFFICERS • - Receive, required records. - Conducts board meeting. - Prepares Form 38-5 worksheet,
SOLDIER - Signs Form 99 - Signs Form 38-5
THE SURGEON GENERAL
THE SCHEDULES ON THIS CHART THE BOARD MEETING WILL NOT DEFINITIVE TREATMENT
16
1 Jan 45
TM 12-238
SCHEDULE
OF ENLISTED MEN, SECTION D, AR 615-395
AFTER BOARD MEETING IN A HOSPITAL WITH RETIREMENT AUTHORITY AFTER RECEIPT OF RETIREMENT CASE AFTER RECEIPT FORM 49
FIRST DAY SECOND DAY THIRD DAY
SECOND DAY SEVENTH DAY
- Prepares and issues furlough Form 31. - Transfers soldier to military installation selected for retirement. - Forwards service records, application for retirement. - Forwards Service Records, Application for Retirement part 3, and Form 31 to military installation selected for.retirement. - Received TWX from TAG.
- Having checked service send, TWX to hospital stating service, number days furlough, and retirement grade.
- Signs Form 31
- Approved board proceedings by signing part 1, Form 38-5.

- Signs part 1 Form 38-5 board proceedings.
- Signs furlough Form 31. - Takes furlough if desired.
- Approves or disapprove, retirement of soldier and forwards proceeding to TAG.
REPRESENT MAXIMUM INTERVALS. BE REQUESTED PRIOR TO END OF IN AN ARMY HOSPITAL.
17
B TM 12—238 ] Jan 45
I APPLICATION FOR RETIREMENT (WD AGO FORM 49)
I
I ---------------------------------------------------------------------------------------------------------------------------1
APPLICATION FOR RETIREMENT "] ■
■ _____________________*« 616-305 _____■
g *AKE ’ FHIST ,AHE ' HI00LE INITIAL 2. ARMY SERIAL HUMBER 3. GRADE *. DATE MD PLACE OF APPLICATION I I
| X Of, / Doe, John J. R 1 963 422 M Sgt 1 Aug 1944. Tilton General Hosp. I “I
I X /_________________________________________ Ft. Dix, N. J.
ORGANIZATION ASSIGNED, ARM OR SERVICE (Show company, battalion and regiment if applicable. If unaaai&ed ao atate)
I 3235th Ord. Depot Co., Ft. Dix, N. J.
ft* TERMS OF MILITARY SERVICE (Show all Army, Navy or Narine Corpa aervice credited for retirement and foreign aervice credited for double time TIME
■ under AR 615-395) LOST
I GRADE AT BITES DATES AS 31 DSC 44 SFRYICF ,U"DE'
S ORGANIZATION DISCHARGED FROM AMD DISCHARGE OR ’-------------------------------- 107
■ NO. PliCnAKbt OR FROM TO CREDITED / r- Dave}
I BRANCH OF SERVICE OTHER THAN U.S. ARMY RELIEF FROM ------———------------------1? ------------------------------------------------- Y }
8 _________________________________________________ACTIVE DUTY DAY MONTH YEAR DAY MONTH YEAR YEARS MONTHS DAYS
! 1 Btry A, 26th FA Pfc 10 Jul. 10 9 Jul 1} 3 0 0 0
I 2 MGC. 118 Inf. Sgt 5 Nov. 17 4 Nov. 18 1 0 0 0
I 3 Co A, 5th Inf. Pfc 11 Sept 20 10 Sept 23 3 0 0 0
| 4 Co A, 5th Inf. Cp 11 Sept 23 10 Sept 26 3 0 0 0
5 Co B, 5th Inf.. Sgt 11 Sept 26 10 Sept 2g 3 0 0 0
’ 6 Eq. let Sq., 11th Cav Sgt 11 Sept 29 10 Sept 32 3 0 0 G
7 Tr B, 11th Cav Sgt 11 Sept 32 10 Sept 35 3 0 0 0
8 Tr B, 11th Cav Sgt 11 Sept 35 10 Sept 38 3 0 0 0
9 3235th Ord. Depot Co. M Sgt 11 Sept 58 10 Sept 41 3 0 0 0
10 3235th Ord. Depot Co. M Sgt 11 Sept 41 1 Aug 44 3 10 17 5
LIST SEKVICE AS AH OFFICER HERE
11 Co C, 118th Inf 2nd. Lt 4 Nov 18 May 19 0 6 4 0
_J__________________________________________________________ ____________ / A\
7. TIME LOST UNDER AM 107 DURING CURRENT ENLISTMENT ------------------------------------------------X 40 X
3 Days_____________________________________________________________ TOT‘U 28 16 21 3 X. .
8. REMARKS (Indicate higheat grade held aa officer) CONVERTED TO on I---------------------/
yearSt- months- days 29 4 21
2nd. Lt. -Double time for service in Cuba. 24 Aug 1911 to 25 Aug 1912- one year.
______________________________________________________________________________, ______________________________________________________________
9. GRADES HELD OURIMS CURRENT ENLISTMENT AHO DATES OF PROMOTIONS THERETO____ 10. I DESIRE 12Q PAYS RFTIrAifhT FIIRIIMIGH
__________DA TE OF PROMOTION AMD GRADE DATE OF PROHOTIOH AHO GRADE____ ADDRESS WHILE OH FURLOUGH I c/o Mr. M. L. Doe
, 122 So. Main St. I I
San Bernadino, Calif. I l/A
_________________________________________________________________________________________________________________________J
H. SOLDIER IS TO BE RETIRED 12. YEARS OF SERVICE IS. MILITARY IHSTALLATIOH AT WHICH RETIREMERT IS IM. SISHATURE OF SOLDIER TTCV
UHOER AR SIS-196 COMPLETED DESIRED . - /‘\r
(s.ctio„ no.) £j. 2^ Camp Haan, Calif.
15.APPROVAL BY COMPANY OR DETACHMENT C.O. 16.APPR0VAL BY REGIMENTAL OR STATION C.O. ~ 17, APPROVAL BY THE ADJUTANT GEHERRL
DATE 1 Aug 1944________________________DATE 2 Aug 1944___________________________DATE___ \
SIGHATURE, . SIRHATURE . -------------------------—--------------------------------------1
^P/ P7 /T, y y RETIREMENT____APPROVED.
S-’d.f.cS.ri''_______________________________________________ RETIREMENT FURLOUGH APPROVED FOR_______________________________OAYS.'^^^
TYPED NAME, GRADE AHO OROAHIZATIOW TYPED NAME, DRAX AHO ORGANIZATION Iy J/w
H.A. PRESS JOHN TURNBULL
Cof^t'ofCpatientB________________________Cmman^Ag^Tilton General
v | ADJUTANT GENERAL
M.D.,A. G.O. FORM NO. 48 THIS FORM SUPERSEDES W.B..A.G.O. FORM NO. »•, 1925 WHICH IS NOT TO 8E
8 August 19»« U3E0 AFTE" «CEIPT OF THIS FORM.
Figure 7. Model preparation of application for retirement.
18
19
1 Jan 45 TM 12-238
FURLOUGH FORM, WD AGO FORM 31
.. - Ttr-
Thia form supersedes W. D., A. G. O. Form 11* I T"R T T^ZJTJ
No. 81, 2 July 1943, which will not be used w 1 1 i
after receipt of this revision.
LAST NAME-FIRST NAME-MIDDLE INITIAL SERIAL NO. GRADE
Doe John J._____________________________Pl-96^-^-22 M Sgt
ORGANIZATION AND STATION LAST PAID TO INCLUDE (DATE)
3235 Ora. Depot Co.; Ft.DiXjN.J^l July 1944 I
IS AUTHORIZED TO BE ABSENT NO. DAYS PARTIAL PAYMENTS SINCE ABOVE DATE
from!^ Aug 19^-4to3Q Nov 19^ 101?________________$____________________
ADDRESS WHILE ON FURLOUGH _
122 So. Main St. San Bernadino, Calif. Retirement
_______________________________ ’_________ Furlough
FURLOUGH GRANTED UNDER ARMY REGULATIONS 615-275, PARAGRAPH I |
TYPED NAME. GRADE AND ORGANIZATION ’ I APPROVED
E, A. Press, Capt. M. C. ' A • J’ ■
C.O., Det. of Patients (signature)
To Deport to Camp Haan, ORIGINAL Cal. ? J 0 Nov. 19W®-hio2«
~T*.................................... .......... —I J
{Note. The military installation selected for retirement will be typed on this form and one copy forwarded to
The Adjutant General.)
Figure 8. Model preparation of WD AGO Form 31.
TM 12-238
1 Jan 45
PHYSICAL EXAMINATION OF ENLISTED PERSONNEL PRIOR TO RETIREMENT FOR DISABILITY, WD AGO FORM 38-5
^TEMS 1 • *7 —
COMPLETED by PERSONNEL SECTrn.r
PHYSICAL EXAMINATION OF ENLISTED PERSONNEL PRIOR TO RETIREMENT FOR DISABILITY AR 615-395, SECTION II
*. 1.41 ■ wit, rIK3T NAME. MIDDLE INITIAL —— — Doe,. John J, 2. ARMY SERIAL RO. B 1 963 122 3. GRADE M Sgt' ». RESIHERT, 1H OB SERVICE 3235th Ord Depot Co.
«. nnwt.i ADDRESS FDR MAILING PURPOSES 122 So. Main St., San Bernadino, Calif, c/o M. M. L. Doe III TEAR! 51 7. TEARS, MOR CREDITED F 26-4 TMS ARD DATS OF SERVICE R^RETIREMENT Ur... I to -21
OF EXAMINEE
In Sept. *1+3 as a result of routine physical examination prior to overseas duty, was turned, down because of hypertension. Admitted to Station Hospital. Ft. Dix, N.J., < 3 July 'll and complained at that time of mild vertigo. Previous to then had not been hospitalized. Examination revealed the following positive findings: mild pallor, slight cervical vein distension, some Increase in the anterior posterior d iemeter of the chest, Blood pressure measures 170.76. Systolic murmur heard equally well over the (Cont)
9. PSYCHIATRIC DIAGNOSIS Normal 10. NEUROLOGICAL DIAGNOSIS Normal RIGHT EXAMINEES RIGHT LEFT
05 *> « 11 io 9 , „ u G „ Q tB 15
None 21. MOUTH ANO GUM ABNORMALITIES Artificial upper denture Lower Teeth Good 31. DENTAL PROTMESIS: SERVICEABILITY Good
None 22. MUSCULOSKELETAL DEFECTS formal >2. URCORBECTEO . „SIM . CORRECTED
RIGHT ETE LEFT EVE 20 20 RIGHT EYE LEFT EYE
Normal 23. ABDOMINAL VISCERA Normal HEARING
RIGHT EAR 14 LEFT EAR 13
None 2N. CARDIOVASCULAR SVSTEM Systolic murmur at mitral and aortic areas. Base pf * 3». HEIGHT (INCHES) .71 WEIGHT (POUNDS)
None 2B- PULSE 38. SPECIAL TESTS WBC-and Hgb. normal
SITTING IMMEOIATELT AFTER Two MINUTES FXERCISE AFTER EXERCISE •88 120 80-
t6. HEMORRHOIDS None 2B- BLOOD PRESSURE LABORATORY PROCEDURE
158 DIASTOLIC '65 KAHN Neg. WASSERMAN Positive
Small penile scar near meatus-chancre 1920. 27- URINALYSIS 37. IN TOUR OPINION WILL WOUND, INJURY OR UNTIMELY DISEASE RESULT IN; DISABILITY? DEATH?
1.022 ALBUMIN Neg. Neg. MICROSCOPIC Normal
CONDITION: YES OR NO YES OR NO
Yee
IB. VENEREAL DISEASES None 28. LUNGS Breath sounds distant; no rales. 38. IN YOUR OPINION WAS WOUND, INJURY OR DISEASE INCURRED IN LINE OF OUTY?
CONDITION: 21 and 26 YES OR NO Yee
Normal 29. CHEST X-RAT 'Exaggerated bisonchovffBcular markings. 9. IN YOUR OPINION DOES INDIVIDUAL MEEY PHYSICAL AND MENYAL STANDARDS FOR RETIREMENT FOR DISABILITY?
IF NOT, STATE WHY YES OR NO
EBTES REMARKS OS OTHER DEFECTS fC.nU,,. k...) *heart elightly widened.X-Bay. of heart enowe calcification pf aorta. 30. ENDOCRINE ST STEM Normal Yes
DATE OF EXAMINATION LOCATION 6 Aug. 1911 TGH-Ft.Dlx,N.J. TPEO NAME ANO GRADE J.C. Treitman Capt. MC SIGNATURE (3ifn oritinol only)
Clir C£Ve»4£ HITH BOAED PROCEEDINGS.
riLe- PMtT 3-*OKXSHEET For
PAKT A-POKE SHEET FOR PHYSICAL EXAMINATION.
Figure 9. Model preparation of WD AGO Form 38-5 (front).
20
1 Jan 45
TM 12-238
PHYSICAL EXAMINATION OF ENLISTED PERSONNEL PRIOR TO RETIREMENT FOR DISABILITY, WD AGO FORM 38-5 REPORT OF BOARD OF MEDICAL OFFICERS
USE THIS SPACE FDR A CONTINUATION OF REMARKS OR OTHER DEFECTS FROM REVERSE SIDE.
8. entire proceedings radiating to the left axitalla and up the vessels of the peck. The base of the heart is slightly widened. X-ray of the heart shows a palcified. area in the aorta. The aorta knob is preminent. He had, palpitation and, mild dyspnea on slight exertion.
______________________________________REPORT OF BOARD OF MEDICAL OFFICERS____________________________
I. FINDINGS: Board oat undtr prorialona of Section II, At 615-393, Ro.lraoont for Pliability (ENTER BELOW)
.. OI.MODID f..l, M 2^ John J. Doe, R1 ^22 „ Qis.HLiTr
(1) Arteriosclerosis, coronary moderate, permanent, has cause undetermined.
(2) Arteriosclerosis, aorta, ascending portion, cause undetermined.
(?) Arterial hypertension, moderate, manifested, by blood pressure of 170 and. a diastolic pressure of 80, Cause undetermined.
b. LINE OF DUTY STATUS FOR EACH CONDITION aaCRAVATFP „lwn ,.,nJ INCIDENT INCURRED IN 777 777
BY ACTIVE WHILE TO ENTERING TO PRIVATE OWN OF
DATE OF ONSET MTE “KI “ °" H,S?6")WCT
••«*«’« i»ju«e —-----------------r------------------------------------------------r————--------------
VES NO YES NO YES NO YES NO YES NO YES NO YES NO
id Sept 19U5 5 July 1944 X X X X X~ “ X X
Sept 19^5 X XXX XXX
(»> Sept 1943 X XXX XXX
C. DISABILITY, DEGREE, DURATION AHD MATURE (ENTEK BELOW)_______________________
(1) IS THE PATIENT INCAPACITATED FOR FUTURE ACTIVE SERVICEtjvES t InO 1(2) IF INCAPACITATED STATE THE CAUSE THEREOF.
Arteriosclerosis, coronary, moderate, permanent cause undetermined.
2. RECOMMENDATIONS (ENTER BELOW)
a. SOLDI EP IS TO BE RETIPFP| YES,|N0 b. IF NOT TO BE RETIRED STATE OTHER DISPOSITION RECOMMENDED HERE None
PRESIDENT'S SIGNATURE (Sign Original only) RECORDER'S SIGNATURE (Sifn Ordinal. only) THIRD MEMBER'S SIGNATURE (Not Raquirad)
TYPED NAME AND GRADE Russel L. Hiatt, Major, MC TYPED NAME AND GRADE Alter Weiss, Captain MC TYPED NAME AND GRADE (Raquirad) Arnold Treitman, Capt. MC
1 AGREE TO BE RETIRED’ |yES X I"0 APPROVAL OF COMMANDING OFFICER OF HOSPITAL WITH RETIREMENT AUTHORITY
SIGNATURE OF SOLDIER ttpco >me mo John Turnbull Colonel MC, Commanding Tilton General Hospital oLE '*ITIAL 2- *«MY SERIAL HUMBER 3. GRADE-- B
Doe, John J.____________________________________| R 1 963 422 | M Sgt
RETI,mE*T MY CHECKS in .*(,». to bo forwerded to 5. pURTE^RARK (Act of
122 So' Main S^.y San Beradino,- Calif. Second. Lieut.
■£a\ 6- RETIRED UNDER ARSIS-39517. SERVICE CREDITED FDR RETIREMENT IS. FOREIGN SERVICE CREDITED FOR DOUILE TIME B
■>/. (Section Ho.) (Veer. - Hon th. ■ Dey.) (Y.er, - ttontb. - Doro)
• II___________ 26- 4 - 21_________________ 1-0-0 _____________________________
9. LAST SERVED AS (Grach - Company - Regiment) |0, DATE RETIRED
M Sgt, 5235th Ord. Depot Co. 30 Nov. 1944
... Ft. D1x, N. ,T._______________ _____________________________L________
II. PLACE OF RETIREMENT I2. SPECIAL ORDER DIRECTING RETIREMENT
PAR. NO. 27___, M.o.,S.O. NO. 182 ।
___gamp Ham, Calif.______________________ °>TE ^0 Nov. 1944________________________ B
13. SERVICE AS A COMMISSIONED OFFICER (Dote. .nd Gr.de.)' ------------- ■
2nd. Lt., 4 Nov. 1918 to 7 May 1919 \
___________INSURANCE DEDUCTIONS TO BE MADE FROM SOLDIER'S RETIREMENT P»Y___________
IN. CLASS GOV'T LIFE INSURANCE ||5. CLASS "K" MAT. SERVICE LIFE INSURANCE 116. CLASS •£■ COMMERCIAL LIFE INS./ ”■*■* — vlCT •c>"$f'£C \
* None________________ » None ♦ None / 9.9 ________________________J
17. REMARKS --------------------------------------/ O _ z-. V
------------------ ------------------------------------ ___________________________________________________________________________________AFFIDAVIT OF CITIZENSHIP OF THE UNITED STATES OF AMERICA U. DATE OF BIRTH___________________________________________________________________19. PLACE OF BIRTH-—-——
1 Apr. 1890 Reading, Pa.
20. DATE OF AFFIDAVIT 21. PUCE OF AFFIDAVIT -------------
30 Nov. 1944 Camp Haan, Calif.
22. I SMEAR, OR AFFIRM, I AM A CITIZEN —x
OF THE UNITED STATES OF AMERICA. /\ 2 Z1 / )
|F—VI—yX— a-n . ____________________
/ / /_____Z Signature of bet ibid soldier " ' ____
/ ____________ 1 CERTIFY THE FQ^eAoiHG IS CORRECT
‘<’4. V*M- TYPED H^NE, GRADE AND ORGANISATION OF OFFICER 2N. SIGNATURE OF PERSONNEL OFFICER OR CO
L,J" CaJnPtell> Capt. AGD. fl /)
L Personnel Adjutant, Cp.Haan,Calj
AtX. THE SPACE BELOW FOR USE OF THE ADJUTANTGENER/L
26. SERVICE AND GRADES HELD SIX MONTHS PRIOR TO RETIREMENT FOR DISABILITY
8RA0£ TO I ^GRAIIE^^ FROM- T.L-’-X-—
----- ----..J.QHN..J.t.12CE.... ........------------------------ -----------------------R.le..94>422.________________________ ■
(PaW . nun.) (U.nsfiaElumL.,)
----------122-So.-Maift-Stsi------------------------------------
San Bemadino, CafT*> >2 0 JU >
TO TYPIST : USEZ^Z FIGURES.
SPtCOISKT-PATO.-CILHAN FANFOLD X \ZZX ZfZX
ZZX ZZ ZX TAG ALLOTMENT DISCONTINUANCE L
_______RETIRED NOTICE UPON DISCHARGE OR RELEASE FROM ACTIVE DUTY No. A I
LAST NAME — FIRST NAME — MIDDLE INITIAL ARMY SERIAL NUMBER DATE OF SEPARATION SC STATION
DOE JOHN J. 1 APR I89C R 1 963 4'22 JO Nov 1944
AlLowIXJeQR ^oTMgXyNQW^EFFggT (NO E ™Y HERE> PE'’MANENT ADDRESS ™" “*“-'NO PURPOSE
allot- amount effective date f.nal oeouct.on :- 122 S Main St., San Bernadino, Cal
MENT_____(1)_____ MONTH AND YEAR MONTH OF ----------
* FAMILY ALLOWANCE APPLICATION VETERANS ADMINISTRATION NUMBER 1
------------------------------------------------------ NUMBER. IF IN SERVICE RECORD ----------------------------------------------------- (NO ENTRY HERE) ---------------------------------------------------------------------------------------------------------- X- _N-_ *........................................................................................................ NAME AND LOCATION OF ORGANIZATION EFFECTING DISCHARGE OR RELEASE
D 12.J5 1 Jun 41 Oct 44 ......... 1269 SCSU CAMP HAAN CAL.
* ENTER NAMES OF “E” ALLOTTEES. IF IN SERVICE RECORD
£ 10.00 1 Dec 42 Oct 44 ----------------- .. —I Mr. M.L. DOE ~|
F $ ----------- L
> ------------TYPED NAME. GRADE AND TITLE OF OFFICER EFFECTING DISCONTINUANCE
B ----------------- - L.J. CAMPBELL, CAPT, AGD, PERSONNEL OFFICER
(NO SIGNATURE NECESSARY). W. D., A. G. O. FORM NO. 30-S J\
1 JULY 1944 1 ro' THE ADJUTANT GENERAL’S OFFICE. WASHINGTON 25. D. C. L
(7 PARTS) (FOLDCD ANO INMCRTCD IN THI SKRVICE RECORD IN CASES OF ENLISTED PERSONNEL) I
(7 PARTS) 17 PINE ST.. NEW YORK S. N. Y. //
JULY 1944 t«e )* «t«PPed m of the date specified. Appropriate credits will be taken in the next succeeding month’s voucher io GOVERNMENT INSURANCE u))
payment of refunds due the allotter of the U. S. Government for allotment payment* made subsequent to the effective ALLOTMENT DIVISION c<\
(7 PARTS) date of this notice of discontinuance. GOVERNMENT INSURANCE ALLOTMENT DIVISION nmrr nr CFrnai arrn runrr arr/uiMvc fl ))
________________________________ OFFICE OF SPECIAL SETTLEMENT ACCOUNTS 17 pine NEWYORK 5 NY D PARTS) )■
1 JULY 1944 TO; OFFICE OF DEPENDENCY BENEFITS, CLASS E ALLOTMENT DIVISION, NEWARK 2. NEW JERSEY (7 PARTS)
F? JULY°i9^S TO: <>EF|CE OF DEPENDENCY BENEFITS. CLASS F ALLOWANCE DIVISION. NEWARK 2. NEW JERSEY (7 PARTS) I Qi
1 JULY 1944 _ //
(7 PARTS) FILE COPY [j
NOTE 1: An Allotment Discontinuance Document (WD AGO JO-S) is prepared, and. distributed for each enlisted person being retired even though no allotments are recorded in the service record.
2; Transmit forms in accordance with Circular 297, W.D. 1944.
Figure 12.
23
TM 12-238 1 Jan45
REPORT OF SEPARATION, WD AGO FORM S3
REPORT OF SEPARATION r
1. LAST NAME - FIRST NAME - MIDDLE INITIAL 2. ARMY SERIAL NO. I 3. GRADE 4. ARM OR SERVICE S. COMPONENT- ' ■
Doe, John. J____________________________ B 1 963 422 [ M/Sgt Orel BA
3. ORGANIZATION 7. DATE OF SEFARAT,ON a. PLACE OF SEPARATION ~|
3233 Ord. Depot Co______________________________________ jo Nov 44 Camp Haan, California ■
3. PERMANENT ADDRESS FOR MAILING PURPOSES 10. DATE OF BIRTH----- !L PLACE OF BIRTH----------------------------------
122 So Main St San Bernardino California 1 Apr 1890 Beading Pa “I
12. ADDRESS FROM WHICH EMPLOYMENT WILL BE SOUGHT ' !3. COLOR EVES I 14. COLOR HAIR 15. HEICHT-I IS. WEIGHT-H? NO. MPEM,. |
See 9 Blue [ Brown 6'_____________________________________________________________________________________[ 180 lbs. None
—----------RACE------1». MARITAL STATUS__________________ 20. U. S. CITIZEN 21. CIVILIAN OCCUPATION ------------------------ I
•tWTE NEGRO OTHER {Specify) SINGLE I MARRIED I OTHER {Specify> YES[ NO
* I I______________x I I____________________________________X I None _____________________________________________________________
'_________militaryhistory —
22. DATE OF INDUCTION 23. DATE OF ENLISTMENT 24. DATE OF ENTRY INTO ACTIVE SERVICE 25. PLACE OF ENTRY INTO SERVICE -----------------~~ ""I
11 Sept 41 11 Sept 41 Fort Dix NJ ,
SSERVICEE b Z7.LOC.LS.S.BO.RO HO. 23. COUNTY ANO STATE 23. HOME ADDRESS AT TIME OF ENTRY INTO SERVICE-'-
data F|YES ["% _______________ See 9 -.
30. MILITARY OCCUPATION 31. SPEC. SER. NO. 32. MILITARY QUALIFICATION AND DATE (i.C., «/>. inf.. marksmanship, «C.) ~ .
Chief Clerk 052 None
33. BATTLES and CAMPAIGN^ (G.O. 75, 29 October 1943) ~ ~—
None —
34. DECORATIONS AND CITATIONS —————————————— -----------------------------------------------------
Good. Conduct Medal American Defense Service Medal
35. WOUNDS RECEIVED IN ACTION ~ ---
None
—----------i—--LATEST IMMUNIZATION DATES_ 37. SERVICE OUTSIDE CONTINENTAL U. S. AND RETURN
SMALLPOX TYPHOID TETANUS OTHER {Specify) DATE OF DEPARTURE DESTINATION DATE OF ARRIVAL
1 Jan 44 1 Mar 44 1 May 44 None
J8.____TOTAL LENGTH OF SERVICE__ 39. HIGHEST GRADE HELD
CONTINENTAL SERVICE FOREIGN SERVICE *
YEARS | MONTHS I DAYS YEARS I MONTHS 1 DAYS M
3 | 3 |20 | | M/bgt
40. PRIOR SERVICE ------------------------------------------------------------------
United States Army - 21 Years
4L REASON AND AUTHORITY FOR SEPARATION ” TW. TYPE OF SEPARATION 42. ChIra'.Jek AT SEPARATION-
Retirement Par 2? SO 182 WD 30 Nov 44 "“u| t“"c~e l"™£ Excellent
43. SERVICE SCHOOLS ATTENDED ---------------------------- 44. EDUCATION lYaarfi
None GRAMMAR I HIGH SCHOOL I COLLEGE I I;'
------------------------------------------------------------------------------------------------------------ 8 I 3 I
fS-. LONGEVITY _FOR PAY PURPOSES I 46. MUSTERING OUT PAY- 47. SOLDIER DEPOSITS 48. TRAVEL PAY 49. TOTAL AMOUNT. NAME OF DISBURSING OFFICER
YEAR? MONTHS DAYS TOTAL THIS PAYMENT
24 I 2 I 20 , None |,___________________________3,010.00 , None $3,242.00
Z__________I N S U R A N CE NOTICE ‘ *
IMPORTANT - » N°T PAID WHEN UUE °R W>THIN THIBTT-ONE DAYS THEREAFTER, INSURANCE WILL LAPSE. MAKE CHECKS OR MONET ORDERS PAYABLE TO THE TREASURER
-------THE U. s. AND FORWARD TO COLLECTIONS SUBDIVISION, VETERANS ADMINISTRATION, WASHINGTON 25. D. C. .gO^-KIND OF INSURANCE .51 ■ .HOW PAID _ 52. EFFECTIVE DATE OF ALLOTMENT 53. DATE OF HEXT PREMIUM DUE 54. PREMIUM DUE EACH 55. INTENTION OF VETERAN TO NAT. SERV. I U. S. GOVT. NONE ALLOTMENT DIRECT TO VX DISCONTINUANCE {Ont month after 52) MONTH_[ToNTINUE «