CAUTION: NOTTO BE USED FORIDENTIFICATION PURPOSES

THIS IS AN IMPORTANT RECORD,SAFEGUARD IT.

ANY ALTERATIONS IN SHADED AREASRENDER FORM VOID

EDTTION

CERTIFICATE OF RELEASE OR DISCHARGE FROM ACTIVE DUTYThis Report Contains Information Subject to the Privacy Acl ol 1974, As Amended.

1, NAME (Last, Fhst, Middte)KLAPHEKE, ASHLEY DANIELI,E

2. DEPARTMENT, COMPONENT AND BRANCHARMY/RA

3. SOC|AI603

SECURIT\42

NUMBER0060

4a. GRADE, RATE OR RANKSPC

b. PAYGRADE804

5. DATE OF BIRTH (YYYYMMDD)79900926

6. RESERVE OBLIGATION TERMINATION DATE(YYYYMMDD) 00000000

7a. PLACE OF ENTRY INTO ACTIVE DUTYMOI]NTAIN VIEW, CALIFORNIA

b. HOME OF RECORD AT TIME OF ENTRY (City and state, or complete address if known)

3014 DRIFTWOOD DRIVE APT24SAN JOSE CALIFORNIA 95128.0000

8a. LAST DUTY ASSIGNMENT AND MAJOR COMMANDOO2SINAV TRANS DET P1

b. STATION WHERE SEPARATEDSCHOFIELD BARRACKS, HI 96857

9. COMMAND TO WHICH TRANSFERREDN/A

10. SGLI COVERAGEI I NoNE

AMOUNT: $ 400, 000 . 001 1. PRIMARY SPECIALTY (List number, title and years and months in

specialty. List additional specialty numbers and titles involving periods ofone or more years.)

1sP1O AVTATTON OpS Sp - 2 yRS s MOS//NOTHTNGFOLLOWS

12. RECORD OF SERVICE YEAR(S) MONTH(S) DAY(S)

a. DATE ENTERED AD THIS PERIOD 2009 0 18b, SEPARATION DATE THIS PERIOD 20 12 03 05

c. NET ACTIVE SERVICE THIS PERIOD 00u2 09 18d. TOTAL PRIOR ACTIVE SERVICE 0000 00 00e. TOTAL PRIOR INACTIVE SERVICE 0000 00 00f. FOREIGN SERVICE OU!}U 06 1-4

o. SEA SERVICE 0000 00 00h. INITIAL ENTRY TRAINING OUUO 00 UU

i. EFFECTIVE DATE OF PAY GRADE 20 IL o/ U1

13. DECORATIONS, MEDALS, BADGES, CITATIONS AND CAMPAIGNRIBBONS AWARDED OR AUTHORIZED (Att periods of service)

NATIONAL DEFENSE SERVICE MEDAL//GLOBAL WARON TERRORISM SERV]CE MEDAL/ / TRAQ CAMPAIGNMEDAL W/ CAMPAIGN STAR//ARMY SERVICE RIBBON//OVERSEAS SERVICE R]BBON//BASIC AVIATIONBADGE//SHARPSHOOTER MARKSMANSHIP BADGE W/RIFLE BAR//NOTH]NG FOLLOWS

14. MILITARY EDUCATION (Course title, number of weeks, and month andyear completed)

AVIATION OPERATIONS SPECIALIST, 7 WEEKS,2OO9//COMBAT LIFE SAVERS CRS, 1 WEEK, 2OO9//DRIVERS TRAINING, 1 WEEK, 2011//NOTHINGFOLLOWS

15a. COMMISSIONED THROUGH SERVICE ACADEMY YES x NO

b. COMMISSIONED THROUGH ROTC SCHOLARSHIP f70 USC Sec. 2107b) YES x NO

c. ENLISTED UNDER LOAN REPAYMENT PROGRAM (70 USC Chap. 109) (lf Yes, years of commitmenf: NA ) I YES X NO

16. DAYSACCRUED LEAVEp419 13.5

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

YES NO

x18. REMARKS / / / / / / / / / / / / / I / / / / / / / / / / / I / / / / / / / / / / I / / / I / / / I / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 1 / 1 / / / / / / / /3LOCK 6, PERIOD OF DELAYED ENTRY PROGRAM:2008l.024-2009051-1//BLOCK 1: OTHER NAME(S) OFTECORD: PADILLA, ASHLEY DANIELLE//MEMBER HAS NOT COMPLETED F']RST FULL TERM OF SERVICE//AUTHORIZED SHOULDER SLEEVE INSIGNIA FOR FORMER WARTIME SERV]CEI/ ADDENDTIM TO BLOCK 13:]VERSEAS SERVICE BAR/ / ARMY LAPEL BUTTON//NOTHING FOLLOWS

The information contained herein is subject to computer matching within the Department of Defense or with any other affected Federal or non-Federal agency for verificationpurposes and to determine eliqibilitv for. and/or continued comoliance with. the requiremenls of a Federal benefit proqram.

19a. MAILING ADDRESS AFTER SEPARATION (tnctude ZtP Code)

9902 ROUNDSTONE TRACET-'\TTTA\/TT,T,El IZE'NTTITTTNV'/ AA"'1

b. NEAREST RELATIVE (Name and address - include ZIP Code)

DAV]D KLAPHEKE9902 ROUNDSTONE TRACET.ATTTc\/TT,T.E T{8"T\T'PTTrII(1/ AO))?

20. MEMBER REQUESTS COPY 6 BE SENT TO (specify state/tocatity) HI OFFICE OF VETERANS AFFAIRS I X YES NO

a. rytElTEEEEF_qUES-TS COPY 3 BE SENr rO rHE CENTRAL oFFlcE oF THE DEPARTMENT oF VETERANS AFFAIRS I v(WASHINGTON. DCI I ^ YES NO

21.a. MEMBER SIGNATUREESIGNED BY: KLAPHEKE.ASHLEY. DANIELLE. 13 84365l.7 ].

p. uAtE(YYYYMMDD)

20L20206

l2.a. OFFIGIAL AUTHORIZED TO SIGN (Typed name, srade, titte, signature)ISIGNED BY: CARTER.DONALD.R. 1131128327

)ONAT,D R CARTF,R. CHTFIF TRANSTTTON CEN

D. UAItr(YYYYMMDD)

20720206

SPECIAL ADDITIONAL INFORMATION (For use bv authorized aqencies onlv)

23. TYPE OF SEPARATION)]SCHARGE

24. CHARACTER OF SERVICE (tnctude upsrades)HONORABLE

25. SEPARATION AUTHORITY\R 635-200, PARA 5-8

26. SEPARATION CODE]DG

27, REENTRY CODE1

28. NARRATIVE REASON FOR SEPARATION]ARENTHOOD 'nrtifu this to lre CI true cooy of the orioinol,29. DATES OF TIME LOSTdONE

DURING THIS PERIOD (YYYYMMDD) 10. MEMBER REQUESTS COPJ 4' (tnitiatd ADK

PREVIOUS EDITION ISDD FORM 214, AUG 2OO9GENERATED BY TRANSPROC

MEMBER