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standard form 180 .pdf



Nombre del archivo original: standard-form-180.pdf
Título: Microsoft Word - SF180 Request Pertaining to Military Records May 2012 pg 2
Autor: mwills

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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. Incomplete information may delay response time.
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/military-service-records/.
2. Personnel Records/Military Human Resource Records/Official Military Personnel File (OMPF) and Medical Records/Service
Treatment Records (STR). Personnel records of military members who were discharged, retired, or died in service less than 62 years
ago and medical records 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, newspaper article (obituary) or death notice, coroner’s report of death; funeral
director’s signed statement of death, or verdict of coroner’s jury.
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.
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. For more
information see http://www.archives.gov/st-louis/archival-programs/military-personnel-archival/ompf-archival-requests.html.
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 inquire@nara.gov 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 207406001. 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. 5/12) (Page 1)
Prescribed by NARA (36 CFR 1228.168(b))

Authorized for local reproduction
Previous edition unusable

OMB No. 3095-0029 Expires 01/31/2015

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/military-service-records/*

(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

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 RELEASED
OFFICER
ENLISTED

BRANCH OF SERVICE

DATE ENTERED

(If unknown, write “unknown”)

a. ACTIVE
COMPONENT
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 ARE REQUESTING:

DD Form 214 or equivalent. When was the DD Form(s) 214 issued? YEAR(S): ___________________________________________________
If more than one period of service was performed, even in the same branch, there may be more than one DD214.
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. An UNDELETED DD214 is 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.
An undeleted copy will be sent unless you specify a deleted copy. Indicate here if you want a deleted copy of the DD Form 214 . .
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, Health (outpatient) and dental records.) If hospitalized (inpatient), the facility name and
date for each admission must be provided: _________________________________________________________________________________
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

Employment

VA Loan Programs

Medical

Genealogy

Correction

Personal

Other, explain:

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.) No signature required for Archival records.
Military service member or veteran identified in Section I, above
Next of kin of deceased veteran:
(Relationship)
MUST HAVE PROOF OF DEATH - See item 2a on instruction sheet.

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

Name

3. AUTHORIZATION SIGNATURE WHEN 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. No signature required for Archival records.

Signature Required - Do not print

Street
City

Legal guardian (Must submit copy of court appointment.)
Other (specify)

Apt.
State

Zip Code

(
)
Daytime phone

Date
(
)
Fax Number

Email address

*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. 5/12) (Page 2)
Prescribed by NARA (36 CFR 1228.168(b))

Authorized for local reproduction
Previous edition unusable

OMB No. 3095-0029 Expires 01/31/2015

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.
ADDRESS CODE
BRANCH

CURRENT STATUS OF SERVICE MEMBER

Personnel Record

Discharged, deceased, or retired before 5/1/1994

AIR
FORCE

COAST
GUARD

MARINE
CORPS

ARMY

NAVY

PHS

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
Active enlisted, officers
Former National Guard/USAR personnel

14
14
1
1

Medical or
Service
Treatment
Record

14
11
11

2

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

13
6
14
14
3
6
14
14
4
5
4
6
14
14
7
14
6
14
14
10
10

Public Health Service - Commissioned Corps officers only

12

14
11

14
11
11

11

14
11
11

ADDRESS LIST OF CUSTODIANS (BY CODE NUMBERS SHOWN ABOVE) – Where to write/send this form

1

2

3

4

5

Air Force Personnel Center
HQ AFPC/DPSIRP
550 C Street West, Suite 19
Randolph AFB, TX 78150-4721

6

National Archives & Records Administration
Old Military and Civil Records (NWCTB-Military)
Textual Services Division
700 Pennsylvania Ave., N.W.
Washington, DC 20408-0001

11

Department of Veterans Affairs
Records Management Center
P.O. Box 5020
St. Louis, MO 63115-5020

7

US Army Human Resources Command
ATTN: AHRC-PDR-V
1600 Spearhead Division Ave., Dept 420
Fort Knox, KY 40122-5402
askhrc.army@us.army.mil

12

Division of Commissioned Corps Officer Support
ATTN: Records Officer
1101 Wooton Parkway, Plaza Level, Suite 100
Rockville, MD 20852

8

Reserved.

13

Reserved.

Headquarters U.S. Marine Corps
Manpower Management Support Branch
(MMSB-10)
2008 Elliot Road
Quantico, VA 22134-5030

9

Reserved.

14

National Personnel Records Center
(Military Personnel Records)
1 Archives Dr.
St. Louis, MO 63138-1002

Marine Forces Reserve
4400 Dauphine St.
New Orleans, LA 70146-5400

10

Air Reserve Personnel Center
Records Management Branch
(DPTARA)
18420 E. Silver Creek Ave.
Bldg. 390 MS 68
Buckley AFB, CO 80011
Commander, Personnel Service Center
(PSD-MR) MS7200
US Coast Guard
4200 Wilson Blvd., Suite 1100
Arlington, VA 29598-7200
http://uscg.mil/psc/adm

Navy Personnel Command (PERS-312E)
5720 Integrity Drive
Millington, TN 38055-3120

eVetRecs!
http://www.archives.gov/veterans/military-service-records/


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