Free Standard Form 180 (Rev - Federal


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Date: November 13, 2008
File Format: PDF
State: Federal
Category: Government
Author: Mary Wills
Word Count: 2,384 Words, 15,323 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.archives.gov/research/order/standard-form-180.pdf

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INSTRUCTION AND INFORMATION SHEET FOR SF 180, REQUEST PERTAINING TO MILITARY RECORDS
1. General Information. The Standard Form 180, Request Pertaining to Military Records (SF180) is used to request information from military records. Certain identifying information is necessary to determine the location of an individual's record of military service. Please try to answer each item on the SF 180. If you do not have and cannot obtain the information for an item, show "NA," meaning the information is "not available." Include as much of the requested information as you can. To determine where to mail this request see Page 2 of the SF180 for record locations and facility addresses. Online requests may be submitted to the National Personnel Records Center (NPRC) by a veteran or deceased veteran's next of kin using eVetRecs at http://www.archives.gov/veterans/evetrecs/. 2. Personnel records and Service Treatment Records (STR). Personnel records of military members who were discharged, retired, or died in service less than 62 years ago and STR's are in the legal custody of the military service department and are administered in accordance with rules issued by the Department of Defense and the Department of Homeland Security (DHS, Coast Guard). STR's of persons on active duty are generally kept at the local servicing clinic, and usually are available from the Department of Veterans Affairs approximately 40 days after the last day of active duty. (See item 3, Archival Records, if the military member was discharged, retired or died in service over 62 years ago.) a. Release of information: Release of information is subject to restrictions imposed by the military services consistent with Department of Defense regulations and the provisions of the Freedom of Information Act (FOIA) and the Privacy Act of 1974. The service member (either past or present) or the member's legal guardian has access to almost any information contained in that member's own record. An authorization signature, of the service member or the member's legal guardian, is needed in Section III of the SF180. Others requesting information from military personnel records and/or STR's must have the release authorization in Section III of the SF 180 signed by the member or legal guardian. If the appropriate signature cannot be obtained, only limited types of information can be provided. If the former member is deceased, surviving next of kin may, under certain circumstances, be entitled to greater access to a deceased veteran's records than a member of the general public. The next of kin may be any of the following: unremarried surviving spouse, father, mother, son, daughter, sister, or brother. Requesters must provide proof of death, such as a copy of a death certificate, letter from funeral home or obituary. b. Fees for records: There is no charge for most services provided to service members or next of kin of deceased veterans. A nominal fee is charged for certain types of service. In most instances service fees cannot be determined in advance. If your request involves a service fee, you will be notified as soon as that determination is made. 3. Archival Records. Personnel records of military members who were discharged, retired, or died in service 62 or more years ago have been transferred to the legal custody of NARA and are referred to as "archival" records. a. Release of Information: Archival records are open to the public. The Privacy Act of 1974 does not apply to archival records, therefore, written authorization from the veteran or next of kin is not required. However, in order to protect the privacy of the veteran, his/her family, and third parties named in the records, the personal privacy exemption of the Freedom of Information Act (5 U.S.C. 552 (b) (6)) may still apply and preclude the release of some information. b. Fees for Archival Records: Access to archival records is granted by offering copies of the records for a fee (44 U.S.C. 2116 (c)). You will be notified if there is a charge for photocopies of documents contained in the record you are requesting. 4. Where reply may be sent. The reply may be sent to the service member or any other address designated by the service member or other authorized requester. 5. Definitions and abbreviations. DISCHARGED -- the individual has no current military status; SERVICE TREATMENT RECORD (STR) -- The chronology of medical, mental health and dental care received by service members during the course of their military career (does not include records of treatment while hospitalized); TDRL ­ Temporary Disability Retired List. 6. Service completed before World War I. National Archives Trust Fund (NATF) forms must be used to request these records. Obtain the forms by e-mail from [email protected] or write to the Code 6 address on page 2 of the SF 180.
PRIVACY ACT OF 1974 COMPLIANCE INFORMATION The following information is provided in accordance with 5 U.S.C. 552a(e)(3) and applies to this form. Authority for collection of the information is 44 U.S.C. 2907, 3101, and 3103, and Public Law 104-134 (April 26, 1996), as amended in title 31, section 7701. Disclosure of the information is voluntary. If the requested information is not provided, it may delay servicing your inquiry because the facility servicing the service member's record may not have all of the information needed to locate it. The purpose of the information on this form is to assist the facility servicing the records (see the address list) in locating the correct military service record(s) or information to answer your inquiry. This form is then retained as a record of disclosure. The form may also be disclosed to Department of Defense components, the Department of Veterans Affairs, the Department of Homeland Security (DHS, U.S. Coast Guard), or the National Archives and Records Administration when the original custodian of the military health and personnel records transfers all or part of those records to that agency. If the service member was a member of the National Guard, the form may also be disclosed to the Adjutant General of the appropriate state, District of Columbia, or Puerto Rico, where he or she served. PAPERWORK REDUCTION ACT PUBLIC BURDEN STATEMENT Public burden reporting for this collection of information is estimated to be five minutes per request, including time for reviewing instructions and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of the collection of information, including suggestions for reducing this burden, to National Archives and Records Administration (NHP), 8601 Adelphi Road, College Park, MD 20740-6001. DO NOT SEND COMPLETED FORMS TO THIS ADDRESS. SEND COMPLETED FORMS AS INDICATED IN THE ADDRESS LIST ON PAGE 2 OF THE SF 180.

Standard Form 180 (Rev. 09/08) (Page 1) Prescribed by NARA (36 CFR 1228.168(b))

Authorized for local reproduction Previous edition unusable

OMB No. 3095-0029 Expires 10/31/2011

REQUEST PERTAINING TO MILITARY RECORDS
* Requests from veterans or deceased veteran's next-of-kin may be submitted online by using eVetRecs at http://www.archives.gov/veterans/evetrecs/ * (To ensure the best possible service, please thoroughly review the accompanying instructions before filling out this form. Please print clearly or type.)

SECTION I - INFORMATION NEEDED TO LOCATE RECORDS (Furnish as much as possible.)
1. NAME USED DURING SERVICE (last, first, and middle) 5. SERVICE, PAST AND PRESENT BRANCH OF SERVICE
a. ACTIVE
COMPONENT

2. SOCIAL SECURITY NO.

3. DATE OF BIRTH

4. PLACE OF BIRTH

(For an effective records search, it is important that all service be shown below.) SERVICE NUMBER DATE ENTERED DATE RELEASED OFFICER ENLISTED

(If unknown, write "unknown")

b. RESERVE
COMPONENT

c. NATIONAL GUARD

6. IS THIS PERSON DECEASED? If "YES" enter the date of death. NO YES

7. IS (WAS) THIS PERSON RETIRED FROM MILITARY SERVICE? NO YES

SECTION II ­ INFORMATION AND/OR DOCUMENTS REQUESTED
1. CHECK THE ITEM(S) YOU WOULD LIKE TO REQUEST A COPY OF:

DD Form 214 or equivalent. This form contains information normally needed to verify military service. A copy may be sent to the veteran, the deceased veteran's next of kin, or other persons or organizations if authorized in Section III, below. NOTE: If more than one period of service was performed, even in the same branch, there may be more than one DD214. Check the appropriate box below to specify a deleted or undeleted copy. When was the DD Form(s) 214 issued? YEAR(S): UNDELETED: Ordinarily required to determine eligibility for benefits. Sensitive items, such as, the character of separation, authority for separation, reason for separation, reenlistment eligibility code, separation (SPD/SPN) code, and dates of time lost are usually shown. DELETED: The following items are deleted: authority for separation, reason for separation, reenlistment eligibility code, separation (SPD/SPN) code, and for separations after June 30, 1979, character of separation and dates of time lost. All Documents in Official Military Personnel File (OMPF) Medical Records (Includes Service Treatment Records (outpatient), inpatient and dental records.) If hospitalized, provide facility name and date for each admission: Other (Specify): 2. PURPOSE: (An explanation of the purpose of the request is strictly voluntary; however, such information may help to provide the best possible response and may result in a faster reply. Information provided will in no way be used to make a decision to deny the request.) Check appropriate box: Benefits Other, explain: Employment VA Loan Programs Medical Medals/Awards Genealogy Correction Personal

SECTION III - RETURN ADDRESS AND SIGNATURE
1. REQUESTER IS: (Signature Required in # 3 below of veteran, next of kin, legal guardian, authorized government agent or "other" authorized representative. If "other" authorized representative, provide copy of authorization letter.) Military service member or veteran identified in Section I, above Next of kin of deceased veteran (Must provide proof of death).
Show relationship:

Legal guardian (Must submit copy of court appointment.) Other (specify) 3. AUTHORIZATION SIGNATURE REQUIRED (See items 2a or 3a on accompanying instructions.) I declare (or certify, verify, or state) under penalty of perjury under the laws of the United States of America that the information in this Section III is true and correct. Signature Required - Do not print

(See item 2a on accompanying instructions.) 2. SEND INFORMATION/DOCUMENTS TO: (Please print or type. See item 4 on accompanying instructions.)

Name Street City State Apt. Zip Code Date of this request Email address

( ) Daytime phone

*This form is available at http://www.archives.gov/research/order/standard-form-180.pdf on the National Archives and Records Administration (NARA) web site.*

RESET

Standard Form 180 (Rev. 09/08) (Page 2) Prescribed by NARA (36 CFR 1228.168(b))

Authorized for local reproduction Previous edition unusable

OMB No. 3095-0029 Expires 10/31/2011

LOCATION OF MILITARY RECORDS
The various categories of military service records are described in the chart below. For each category there is a code number which indicates the address at the bottom of the page to which this request should be sent. Please refer to the Instruction and Information Sheet accompanying this form as needed. BRANCH
ADDRESS CODE Service Personnel Treatment Record Record

CURRENT STATUS OF SERVICE MEMBER
Discharged, deceased, or retired before 5/1/1994 Discharged, deceased, or retired 5/1/1994 ­ 9/30/2004 Discharged, deceased, or retired on or after 10/1/2004 Active (including National Guard on active duty in the Air Force), TDRL, or general officers retired with pay Reserve, retired reserve in nonpay status, current National Guard officers not on active duty in the Air Force, or National Guard released from active duty in the Air Force Current National Guard enlisted not on active duty in the Air Force Discharge , deceased, or retired before 1/1/1898 Discharged, deceased, or retired 1/1/1898 ­ 3/31/1998 Discharged, deceased, or retired on or after 4/1/1998 Active, reserve, or TDRL Discharged, deceased, or retired before 1/1/1905 Discharged, deceased, or retired 1/1/1905 ­ 4/30/1994 Discharged, deceased, or retired 5/1/1994 ­ 12/31/1998 Discharged, deceased, or retired on or after 1/1/1999 Individual Ready Reserve Active, Selected Marine Corps Reserve, TDRL Discharged, deceased, or retired before 11/1/1912 (enlisted) or before 7/1/1917 (officer) Discharged, deceased, or retired 11/1/1912 ­ 10/15/1992 (enlisted) or 7/1/1917 ­ 10/15/1992 (officer) Discharged, deceased, or retired after 10/16/1992 Reserve; or active duty records of current National Guard members who performed service in the U.S. Army before 7/1/1972 Active enlisted (including National Guard on active duty in the U.S. Army) or TDRL enlisted Active officers (including National Guard on active duty in the U.S. Army) or TDRL officers Current National Guard enlisted and officer not on active duty in Army (including records of Army active duty performed after 6/30/1972) Discharged, deceased, or retired before 1/1/1886 (enlisted) or before 1/1/1903 (officer) Discharged, deceased, or retired 1/1/1886 ­ 1/30/1994 (enlisted) or 1/1/1903 ­ 1/30/1994 (officer) Discharged, deceased, or retired 1/31/1994 ­ 12/31/1994 Discharged, deceased, or retired on or after 1/1/1995 Active, reserve, or TDRL Public Health Service - Commissioned Corps officers only

AIR FORCE

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COAST GUARD

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MARINE CORPS

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ARMY

NAVY

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PHS

ADDRESS LIST OF CUSTODIANS (BY CODE NUMBERS SHOWN ABOVE) ­ Where to write/send this form
Air Force Personnel Center HQ AFPC/DPSSRP 550 C Street West, Suite 19 Randolph AFB, TX 78150-4721 Air Reserve Personnel Center /DSMR HQ ARPC/DPSSA/B 6760 E. Irvington Place, Suite 4600 Denver, CO 80280-4600 Commander, CGPC-adm-3 USCG Personnel Command 4200 Wilson Blvd., Suite 1100 Arlington, VA 22203-1804 Headquarters U.S. Marine Corps Personnel Management Support Branch (MMSB-10) 2008 Elliot Road Quantico, VA 22134-5030 Marine Corps Mobilization Command 15303 Andrews Road Kansas City, MO 64147-1207 National Archives & Records Administration Old Military and Civil Records (NWCTB-Military) Textual Services Division 700 Pennsylvania Ave., N.W. Washington, DC 20408-0001 U.S. Army Human Resources Command ATTN: AHRC-PAV-V 1 Reserve Way St. Louis, MO 63132-5200 U.S. Army Human Resources Command ATTN: AHRC-MSR 200 Stovall Street Alexandria, VA 22332-0444 Commander USAEREC ATTN: PCRE-F 8899 E. 56th St. Indianapolis, IN 46249-5301 Navy Personnel Command (PERS-312E) 5720 Integrity Drive Millington, TN 38055-3120 Department of Veterans Affairs Records Management Center P.O. Box 5020 St. Louis, MO 63115-5020 Division of Commissioned Corps Officer Support ATTN: Records Officer 1101 Wooton Parkway, Plaza Level, Suite 100 Rockville, MD 20852 The Adjutant General (of the appropriate state, DC, or Puerto Rico)

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National Personnel Records Center (Military Personnel Records) 9700 Page Ave. St. Louis, MO 63132-5100

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http://www.archives.gov/veterans/evetrecs/