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AIR FORCE DISCHARGE REVIEW BOARD HEARING RECORD
NAME OF SERVICE MEMBER (LAST, FIRST MIDDLE INITIAL)
GRADE
AFSNISSAN
HEARING DATE
05 NOV 2003
CASE NUMBER
FD-2003-00354
Case heard at Washington, D.C.
1 I ORDER APPOINTING THE BOARD
2 1 APPLICATION FOR REVIEW OF DISCHARGE
3 ( LETTER OF NOTIFlCATlON
4 1 BRIEF OF PERSONNEL FILE
COUNSEL'S RELEASE TO THE BOARD
ADDITlONAL EXHlBITS SUBMITTED AT TlME 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:
SAFMRBR
550 C STREET WEST, SUITE 40
RANDOLPH AFB, TX 78 1 504742
I
AFHQ FORM 0-2077, JAN 00
I FROM:
I
(EF-V2)
SECRETARY OF THE AIR FORCE PERSONNEL COUNCIL
AIR FORCE DISCHARGE REVIEW BOARD
1535 COMMAND DR, EE WING, 3RD FLOOR
ANDREWS AFB, MD 20762-7002
Previous edition will be used
Copies of the documents to be forwarded to the separation authority in support of this
recommendation are attached. The commander exercising special court-martial jurisdiction or a
higher authority will decide whether you will be discharged or retained in the Air Force. If you
are discharged, you will be ineligible for reenlistment in the Air Force and probably any other
branch of the military.
3. You have the right to consult counsel. Military legal counsel has been obtained to assist you.
ea Defense Counsel,
I have made an appointment for you to consult
Bldg 323C, R M 302, Phone 4-3939, at 1500 hrs on / I JULY l975 Instead of the appointed
counsel, you may have another, if the lawyer you request is in the active military service and is
reasonably available as determined according to AFI 5 1-201. In addition to military counsel, you
have the right to employ civilian counsel. The Air Force does not pay expenses incident to the
employment of civilian counsel. Civilian counsel, if employed, must be readily available.
4. You have the right to submit statements in your own behalf. Any statements you want the
separation authority to consider must reach me by& 3iJ? ct /drGnless you request and receive an
extension for good cause shown. I will send them to the separation authority.
5. If you fail to consult counsel or to submit statements in your own behalf, your failure will
constitute a waiver of your right to do so.
6. You have been scheduled for a medical examination. You must report to the 55th Medical
Group, Physical Exam Section at 0700 hrs/Part I and 15 15 hrs/Part I1 on 6 July 1995 for the
examination.
7. Any personal information you hrnish in rebuttal is covered by the Privacy Act Statement as
explained in AFI 36-3208, attachment 2. A copy of AFI 36-3208 is available for your use in the
unit orderly room.
8. Execute the acknowledgment provided and return to me immediately.
.........................................................
Attachments:
Atch 1-1, Article 15, 16 June 1995
Atch 1-2, LOC, 18 May 1995
Atch 1-3, LOR, 16 May 1995
Atch 1-4, LOC, 15 May 1995
Atch 1-5, LOR, 13 December 1994
Atch 1-6, LOR, 15 November 1993
Commander, HQ Squadron
,..-..-..-.-..-..-.-------------------------------------J
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