REQUESTOR’S INFORMATION

Vital Records DD214/Veteran ID Request Form

Lisa Brown, Oakland County Clerk ? 1200 N. Telegraph Rd., Pontiac, MI 48341 ? 248-858-0571

SAVE TIME ? GO ONLINE ? clerkrod

REQUESTOR'S INFORMATION

Name:

Daytime Phone:

Relationship to person on DD214:

Address:

City, State, Zip:

Signature:

Must be signed to process request

Date:

**All mail requests must be accompanied by a copy of requestor's valid driver license or state ID.**

Fees: DD214 ? One copy FREE, Additional copies $1.00 ~No checks~

DD214 INFORMATION

Number of copies requested:

Full Name as it Appears on DD214:

Service Number:

Branch of Service:

Discharge Date:

Date of Birth:

Fees: Veteran ID Card $10.00 ~No checks~

REQUEST VETERAN ID CARD (No mail orders ? must obtain card in person)

Yes:

No:

For office use only: File # ____________ Clerk's Initials ______ I.D. Verification: DL____ State ID____ Other____

Rev. 10/14

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