Figure 2:  Sample of completed 13081 (Replaces R6-6915)  Form, Change of Record Request

CHANGE OF RECORD REQUEST DATE
       9/23/80

  RE:     Rexford T. Harrington
 
IN RESPONSE TO YOUR REQUEST TO CHANGE YOUR MILITARY RECORDS:

 X 
 The Privacy Act of 1974 prohibits this Center from amending military records as you have requested.  The military service department which created the record is the legal custodian and must consider your request for an amendment.
 
    
   
 Your request has been forwarded to the military service department checked below.  That office will respond directly.  Please address any further correspondence to that office.
 
    
 X 
 Please submit your request for an amendment to the address checked below.  It may further support your request if you are able to include the following with your request:
 
        
   
 Certified copy of record of birth or baptism.
   
 Original certificate of naturalization.
 X 
 Certified copy of court order showing    Change in sex                                             .
   
 
 
    
   
  Although we are not amending your records, we are adding the new/corrected name to the files for future cross reference.
 
   
  This Center may consider the administrative correction of the name, date of birth, or service number on one of the military documents, if there is evidence to support the fact that an administrative error was made on the document in question.  Please furnish a photocopy of a discharge certificate, certificate in lieu of lost or destroyed discharge, or any other statement of certificate of service issued by the appropriate officials to help support your claim.
 
   
  This office does not amend records or discharge certificates, or issue a new discharge certificate in a person's new name when change in name occurred after discharge.  When proof of name is required, it is suggested that the court order, naturalization certificate, or other legal evidence be presented with the discharge certificate.
 
   
  The enclosed DD Form 215 shows correction(s) to the report of separation and should be filed with that document.
 
   
  Please send the original discharge certificate to this Center for review so that any necessary administrative corrections can be made.
 
   
 
 

 

 

 

   
ARMY - U.S. Army Reserve Personnel Center
ATTN: ARPC-VSE-VS
9700 Page Avenue
St. Louis, MO 63132-5200
   
AIR FORCE - Air Force Personnel Center
ATTN:                    
550 C Street West
Randolph AFB, TX 78150-6001
 
 X 
MARINE CORPS - Commandant of the Marine Corps (MMSB-10)
Headquarters, U.S. Marine Corps
2008 Elliot RD., Suite 225
Quantico, VA 22134-5030
 
   
COAST GUARD - Commander, Military Personnel Command MPC-S-3
2100 2nd Street, SW
Washington, DC 20593-0001
 
   
NAVY - Bureau of Naval Personnel (Attn: PERS-313D) Washington, DC 20370-3130
 
Mr. Rexford T. Herrington
1311 Midwest Avenue
Maize City, IA 50300
 Date:      10/14/80                  
   Signed                               
For the Chief,
 
Army Reference Branch
 
Air Force Reference Branch
X
Navy Reference Branch
 
Records Reconstruction Branch
NATIONAL PERSONNEL RECORDS CENTER
(Military Personnel Records)
9700 Page Avenue
St. Louis, MO 63132-5100
NATIONAL ARCHIVES AND RECORDS ADMINISTRATIONNA FORM 13081 (REV. 2-96)