NAME OF SERVICE MEMBER (LAST, FIRST MIDDLE INITIAL)
GRADE
AFSNISSAN
AIR FORCE DISCHARGE REVIEW BOARD HEARING RECORD
MEMBER SITTING
I
ISSUES
A92.2 1
INDEX NUMBER
HEARING DATE
19 Nov 2003
CASE NUMBER
FD-2003-00352
Case heard at Washington, D.C.
1 I ORDER APPOINTING THE BOARD
2 1 APPLICATION FOR REVIEW OF DISCHARGE
3 1 LETTER OF NOTIFICATION
4 1 BRIEF OF PERSONNEL FILE
COUNSEL'S RELEASE TO THE BOARD
ADDITIONAL EXHIBITS SUBMITTED AT TIME OF
PERSONAL APPEARANCE
TAPE RECORDING OF PERSONAL APPERANCE
Advise applicant of the decision of the Board, the right to a personal appearance witWwithout counsel, and the right to
submit an application to the AFBCMR
TO:
I
SAFlMRBR
550 C STREET WEST, SUITE 40
RANDOLPH AFB, TX 78150-4742
AFHQ FORM 0-2077, JAN 00
FROM:
SECRETARY OF THE AIR FORCE PERSONNEL COUNCIL
AIR FORCE DISCBARGE REVIEW BOARD
I535 COMMAND D R EE WING, 3RD FLOOR
ANDREWS AFB, MD 20162-7002
I
(EF-V2)
Previous edition will be used
1
0
/
CHARGE SHEET
I. PERSONAL DATA
2. SSN ....-..-..-....,
.----------
---
3. GRADE OR RANK
AlC
4. PAY GRADE
E-3
6. CURRENT SERVICE
a. INITIAL DATE
b. TERM
'
3 1st Services Squadron (USAFE)
Avian0 Air Base, Italv
7 . PAY PER MONTH
a. BASIC
b. SEAlFORElGN D U N
c. TOTAL
8 NATURE OF RESTRAINT OF ACCUSED
980701
9. DATEIS) IMPOSED
4 years
$1,171.50
$0.00
$1.171.50
None
N/A
lo. CHARGE I :
VIOLATION OF THE UCMJ, ARTICLE 112a
It. CHARGES AND SPECIFICATIONS
SPECIFICATION:
In that AIRMAN FIRST CLASS 1 -,.,---,.
occasions between on or about 31 December 1998 and on or about 6 February 2000, wrongfully use marijuana.
.----- 2, United States Air Force, did at or near Aviano Air Base. Italy, on divers
I - - - - - - - - - - - - - - - - - - - - - - - -
CHARGE 11:
VIOLATION OF THE UCMJ, ARTICLE 107
SPECIFICATION:
In that AIRMAN FIRST CLASS 1 - - - - - - - - - - -
20 May 1999, with intent to deceive. make to fieutenant &~lonel~::::::::::-:~:::-::::~
official statement, to wit: I have never used drugs-aerr~&&Iggt, or words to that e/fect, which statement was totally false, and
was then lcnown by the said Airman First Class :
- - - - - - - - - ' United States Air Force, did at or near Aviano Air Base, Italy, on or about
.------------------------
3 1 st Services Squadron commander, an
!o be so false.
, - - - - - - - - - - - - - - - - - - -
1 1 a. NAME OF ACCUSER @st, Firsf. MI)
, - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
d. SIGyAtQM nEACLU.SFR. ......... L-.l.. ...........
Ill. PREFERRAL
b. GRADE
Lt Col
c. ORGANIZATION OF ACCUSER
3 1st Services Squadron
e. DATE
m
AFFIDAVIT: Before me, the undersigned, authorized by law to administer oath in cases of this character. personally appeared the
above named accuser this
under oath that helshe is a person subject to the Uniform Code of Military Justice and that he/she either has personal knowledge of
or has investigated (he matters set forth therein and that the same are true to the best of hisher knowledge and belief.
, EX 2000 . and signed the foregoing charges and specifications
6R
day of
C-..........-..-..-I
oped Name of m c e r
I
I
Captain
Gr&
....................................
2 1 "* E:"l.*-- 11r:
-1138 l-l&UtGl
OrgMizobn of C@I
I I U
cer n--I
Assistant Staff Judge Advocate
OBicial Copoci@ to Administer Oath
(See R.C.M. 3076)- &st be commlssioncd oflcer)
I
I
DD Form 458, AUG 84 IEG)
EDITION OF 1 OCT 69 IS OBSOLETE.
Designed using Perform Pro, WHS/DIOR, Aug 9r
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