UNITED STATES MARINE CORPS - Camp Lejeune
_____________
Date
MEMORANDUM
From: _______________________________________________________________
To: Combat Camera, G-3/5, Marine Corps Installations-East, Marine Corps Base Camp Lejeune
Subj: CERTIFICATION OF HEIGHT/WEIGHT AND BODY FAT PERCENTAGE IN THE
CASE OF: ______________________________________________________
Ref: (a) MCO P1070.12K
(b) MARADMIN 463/01
(c) MARADMIN 003/09
1. The following information is hereby certified true and is submitted for display in SNM/SNO’s official photograph, per reference (a), (b), and (c):
LAST NAME: ____________________________________
FIRST NAME/MI: ____________________________________
RANK: ____________________________________
PRIMARY MOS: ____________________________________
EDIPI: ____________________________________
HT/WT: ____________________________________
BODY FAT %: ____________________________________
BILLET ASSIGNMENT/UNIT: ____________________________________
NAME/RANK AND COMMAND TITLE OF CERTIFYING OFFICIAL: (1stSgt, CO, BN SgtMaj, XO, BN CO) __________________________________________________________
2. Point of contact is the undersigned at (910) ____________
__________________________
Certifying Official
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