Application for Voluntary Retirement

Collects the service and contact details needed to process a public servant's or service member's voluntary retirement request.

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Full Name of Applicant

First Name

Last Name

Officer's Name

First Name

Last Name

Rank

Current Grade (Pay Grade)

Phone Number

E-mail

Start Date of Military Service

End Date of Military Service

Active Federal Service

Address

Street Address

City

State / Province

ZIP / Postal Code

Reason for Retirement

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