I 
I NAME OF SERVICE MEMBER (LASI, FIRST MIDDLE INIHAL) 

AIR FORCE DISCHARGE REVIEW BOARD HEARING RECORD 

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/  1  1  ORDER AI'I'OWTING  THE HOARD 
1  2  1  APPLICA'I'LON FOR REVIEW C)F DISCHARGE 

LETTER OF NUI'IFICATION 

I'EKSONAL  AI'I'I-:ARi\NCE 

Advise applicant of the decision of the Board. the right lo a personal appearance withlwithout  counsel, and the right to submit an 
application to the AFBCMR. 

Names and votes will  be  made available to the applicant at the applicant's  request. 

X -. Upgrade of discharge, change of reason & authority, and change of reenlistment  code are denied. 

INDORSEMENT 

1  w o n t  

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9.  TYPE OF  REVIEW REQUESTED (X o n e )  

CONDUCT A RECORD REVIEW OF M Y  DISCHARGE BASED ON MY MILITARY PERSONNEL FILE AND ANY ADDITIONAL  DOCUMENTATION 
SUBMIRED BY  ME.  I AND/OR  Icounsel/representafivel  WILL  NOT APPEAR  BEFORE THE BOARD. 
I AND/OR /counsel/represenrar;vel WlSH TO APPEAR  AT A  HEARING AT NO EXPENSE TO THE GOVERNMENT BEFORE THE BOARD IN THE 
WASHINGTON. D.C.  METROPOLITAN AREA. 
I AND/OR  (counseVrepresentative) WlSH TO APPEAR AT A  HEARING AT NO EXPENSE TO THE GOVERNMENT  BEFORE A TRAVELING PANEL CLOSEST TO 
(NOTE:  The Navy Discharge Review Board does not have a rraveling panel  I 
(enter city and slate1 

10.a.  COUNSELIREPRESENTATIVE llf any) NAME (Last, First, Middle lnirial) AND ADDRESS  b-  T 

See Item  10 of the insrructions about  counsel/representative.) 

E NUMBER IInclude Area  Codel 

11.  APPLICANT MUST SIGN IN ITEM 13.a.  BELOW.  If the record in question is that of a deceased or incompetent person,  LEGAL PROOF OF 

DEATH OR  INCOMPETENCY MUST ACCOMPANY THE APPLICATION.  If the aoolication is sisned bv other than the applicant.  indlcate 
the name (print1 
SPOUSE 

and relation.ship by marking a box  below. 
LEGAL REPRESENTATIVE 

NEXT OF KIN 

WIDOWER 

WIDOW 

12.a. CURRENT MAILING ADDRESS OF APPLICANT OR PERSON ABOVE 
. . . . - lk.~aLdf'L'lifk~~~'nL' 

~f MY~G~WLQR h P ~ ~ w s J - ,  

d.  FAX NUMBER Ilnclude Area  Codel 

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C . . . - . . - . . - . . - . - . . - - - - - - - - - - - - - - - - - - - - - - - - - a  
13.  CERTIFICATION. 

I make the foregoing statements,  as part of  my claim,  with full knowledge of the 
penalties involved for willfully  making a false statement or claim.  (U.S.  Code,  Title  18, Sections 2 8 7  
a n d   1001, provide  that a n  individual shall b e  fined under this title or imprisoned not more than 5 years, 
or  both.) 

,.%-  ~ S L G ~ ~ T Y ~ - . B E Q V ~ ~ E Q ~ A P R ~ ~ C ~ ~ ~ ~ ~  

~ e c m r ~ i n l i e a r  11 &el, 

b.  DATE SIGNED - REQUIRED 

(YYYYMMDDI 

bb FORM 2 9 3 , m ~ ~  
2004 

PREVIOUS EDITIONS ARE OBSOLETE. 

4- IELEPHClNE NUMEERUnrJude Area-vdel 

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CASE NUMBER 

(Do not  write in  this space.) 

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Page 1 of 4 Pages 

14. CONTINUATION OF ITEM 6, ISSUES (If applicable) 

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15. CONTINUATION OF ITEM 8,  SUPPORTING DOCUMENTS (If applicable) 

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16. REMARKS (If applicable) 

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MAIL COMPLETED APPI-ICATIONS TO APPROPRIATE  ADDRESS BELOW. 

I 

A R M Y  

Army Review Boards Agency 
Support Division, St. Louis 
9700 Page Avenue 
St.  Louis,  MO  6 3  132-5200 
(See http:llarba.arrny.pentagon.rnil) 

AIR  FORCE 

Air  Force Review Boards Agency 
SAFIMRBR 
550-C Street West,  Suite 40 
Randolph  AFB,  TX  781 50-4742 

I 
DD FORM 293, MAR 2004 

I 

I 

-  I 

N A V Y  A N D  M A R I N E  CORPS 

Naval Council of  Personnel Boards 
7 2 0  Kennon Street,  S.E. 
Room 309 (NDRB) 
Washington  Navy Yard.  DC  20374-5023 

COASTGUARD 

U.S. Coast Guard 
Commandant  (G-WPM) 
2100 Second Street,  S.W. Room 5500 
Washington,  DC  20593 

I 
Page 2 of  4 Pages 

DEPARTMENT OF THE AIR FORCE 

HEADQUARTERS 27TH FIGHTER WING  (ACC) 

CANNON AIR FORCE BASE NEW MEXICO 

FROM:  27 CRS CC 

SUBJ:  Letter of Notification  (Board Hearing) 

1.  I  am recommending your  discharge from the  United  States  Air Force for 
Failure  in Alcohol Abuse Rehabilitation,  according  to AFR 39-10,  under the 
provisions  of  paragraph  5-32.  If  my  recommendation  is  approved,  your 
service will be characterized as General or Honorable.  1 am recommending that 
your  service  be characterized  as General.  Copies  of  the documents  to be 
forwarded  to  the separation  authority  to support  this  recommendation are 
attached. 

2.  My reasons for this action are that: 

a.  On 8 Mar 93,  you failed alcohol abuse rehabilitation, as evidenced by 
AF Form 2731, Substance Abuse Reorientation and Treatment Program Disposition, 
dated 8 Mar 93 (Atch la). 

b.  On  23 Jan 93,  you were drunk and disorderly at or near the main gate 
of Cannon Air Force Base,  New Mexico,  as evidenced by AF Form 3545, Incident 
Report, dated 23 Jan 93, and an Article 15, dated 5 Feb 93 (Atch lb). 

3 .   This action could result in your  separation  with a General Discharge.  I 
am  recommending  that  you  receive  a  General  Discharge.  The  Commander 
exercising  SPCM  jurisdiction  or  higher  authority  will  make  the  final 
decision  in this matter.  If you are  discharged,  you will be ineligible for 
reenlistment in the Air Force. 

4.  You have the right to: 

a.  Consult legal counsel. 

b.  Present your case to an administrative discharge board. 

c.  Be represented by legal counsel at a board hearing. 

d.  Submit  statements in your own behalf in  addition to,  or in lieu of, 

the board hearing. 

e.  Waive  the above rights.  You must consult legal counsel before making 

a decision to waive any of your rights. 

5.  You completed a medical examination on 3 Mar 93. 

6.  Military  legal  counsel  has been obtained to assist you.  I have made an 
appointment for you to consult the Area Defense Counsel on  z3 h9A.e f3  at 
) \ ! i 5 &   .  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 AFR  111-1.  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. 

7.  Confer  with  your counsel  and  reply,  in  writing,  within  7 workdays, 
specifying  the  rights  you  choose  to  exercise.  The  statement  must  be 
signed  in the presence of  your counsel who also  will sign it.  If you waive 
your right to  a  hearing  before  an administrative discharge board,  you may 
submit  written statements in  your own behalf.  I will send the statements to 
authority  with  the  case  file  to  be  considered  with 
the 
this recommendation.  If you fail to respond,  your failure  will constitute a 
waiver of the right to the board hearing. 

discharge 

8.  Any  personal  information you  furnish in  rebuttal  is  covered by  the 
Privacy  Act  Statement  as  explained  in  AFR  39-10,  attachment 6.  A  copy 
of AFR 39-10 is available for your  use  in the orderly room. 

9.  You must immediately report to the Separation section,  Bldg 600, Rm 2037, 
to  pick  up  the  final  outprocessing  checklist.  This  checklist  will  be 
completed NLT  4 & 

returned to the Separation Section. 

10.  Execute the attached acknowledgement and return it to me immediately. 

L.-..-..-..-..-..-.----------------------------: 

Commander, 2 7 CRS 

Atch 
Supporting Documents