See back for Instructions and

APPLICATION FOR RETIRED PAY BENEFITS Privacy Act Statement.

1. TO 2. DATE OF BIRTH (YYYYMMDD) 3. DATE RETIRED PAY TO

BEGIN (YYYYMMDD)

4. HIGHEST MILITARY PAYGRADE HELD

5. APPLICANT NAME (Last, First, Middle Initial) 6a. SERVICE NUMBER (If applicable) b. SOCIAL SECURITY NUMBER

7a. PRESENT HOME ADDRESS (Street, Apt No., City, State, ZIP Code) 8. PRESENT ASSIGNMENT

b. HOME TELEPHONE NUMBER ( )

SERVICE BEFORE 1 JULY 1949
9. 10. 11. APPROXIMATE DATES OF SERVICE 12. ACTIVE DUTY
ARMED FORCE GRADE OR a. FROM b. TO a. FROM b. TO
AND COMPONENT RATING DAY MONTH YEAR DAY MONTH YEAR DAY MONTH YEAR DAY MONTH YEAR

SERVICE AFTER 30 JUNE 1949

13. RETIREMENT YEAR 14. 15. 16. ACTIVE DUTY 17.
a. FROM b. TO ARMED FORCE GRADE OR a. FROM b. TO RETIREMENT
DAY MONTH YEAR DAY MONTH YEAR AND COMPONENT RATING DAY MONTH YEAR DAY MONTH YEAR POINTS EARNED

18. SIGNATURE 19. DATE SIGNED (YYYYMMDD)

DD FORM 108, JUL 2002 PREVIOUS EDITION IS OBSOLETE.

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 PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 1331; EO 9397, November 1943 (SSN).

PRINCIPAL PURPOSE(S): Used by members and former members of the Reserve Components to apply for retired pay at age
60. Application is reviewed to determine eligibility.

ROUTINE USE(S): Information provided by the member is used to:

a. Identify the individual and his/her service record.
b. Determine eligibility for retired pay under 10 U.S.C. 1331.
c. Determine effective date that retired pay can and will commence.

DISCLOSURE: Voluntary; however, unless this form is completed, the individual will not receive retired pay.

INSTRUCTIONS
GENERAL. This form is to be submitted in one copy ITEM 8. Enter the complete designation of your present
(duplicate for Naval personnel). Entries must be organization. If you are presently a member of a National
typewritten or hand printed. Brief instructions for making Guard organization, give name of state. If not a member of
entries are provided below in numerical order. Submission a reserve organization, enter "none."
of official statements of service is not required. If all
information required is not readily available, prepare form NOTE: Primary purpose of Items 9 through 17 is to enable
to the best of your ability. reviewing authority to verify service which may not be of
NOTE: Primary purpose of Items 9 through 17 is to enable record.
reviewing authority to verify service which may not be of
record. ITEM 9. Enter the Armed Force and component for periods
of service covered in Item 11. Example: "Army, USAR",
ITEM 1. Addresses of Headquarters of Armed Forces for "Navy, USNR." All enlisted service will include organization
purpose of forwarding application for retired pay are listed to which you were assigned. For National Guard service,
below. Application will be addressed to the Armed Force include name of state.
in which you are presently (or were last) a member.
ITEM 10. Enter the highest grade or rating held during each
ARMY: Commander period of service shown in Item 11.
United States Army Reserve Personnel Center
9700 Page Boulevard, St. Louis, MO 63132-5200 ITEM 11. Enter approximate dates of each individual period
of service. Example: 2 May 1936 to 1 May 1939; 20 Oct
NAVY: Commander 1942 to 15 Nov 1946.
Navy Personnel Command (PERS-912)
5720 Integrity Drive ITEM 12. Enter inclusive dates of all periods of active duty
Millington, TN 38055 performed during each individual period of service indicated
in Item 11.
AIR FORCE: United States Air Force Military Personnel
Center (AFPMPR) ITEM 13. Enter inclusive dates of each individual year of
Building 499C service performed after 30 June 1949. Example: If you
Randolph Air Force Base, TX 78148-9997 were a member of a reserve component on 1 July 1949,
your retirement year will be from 1 July 1949 to 30 June
MARINE CORPS: Commandant 1950, your second year will be 1 July 1950 to 30 June
United States Marine Corps 1951, etc. If you were not a reservist on 1 July 1949 or
(Code MMSR-5) have had a break in service since that time, your retirement
Washington, DC 20380-0001 year will begin on the date of acquiring an active status in a
reserve component and end one year later. Example: 15
COAST GUARD: Commandant Sep 1956 to 14 Sep 1957.
United States Coast Guard (SP-4)
Washington, DC 20593-0001 ITEM 14. Enter the Armed Force and component in which
you served during each year as shown in Item 13. All
enlisted service will also include the organization to which
ITEM 2. Enter correct date of birth (proof of date of birth you were assigned during the year specified, and, in the
may be required before final action is taken on application.) case of National Guard service, name of state.
ITEM 3. Enter date you desire retired pay to begin (cannot ITEM 15. Enter highest grade or rating held during each year
be before age 60). of service shown in Item 13.
ITEM 4. Enter highest grade or rating held in Armed ITEM 16. Enter inclusive dates of all periods of active duty,
Forces. including active duty for training, performed during the year
or years indicated in item 13.
ITEM 5. Enter your name in the order indicated.
ITEM 17. Enter the total retirement points earned for each
ITEM 6a. Enter service (serial) number. If you have been a period shown in Item 13. This total to include points earned
member of more than one Armed Force, enter the service through drills, correspondence courses, active duty,
number of each, i.e. "2 532 430 ARMY" and "603-1-91 membership, etc.
NAVY."
ITEM 18. Place your signature in this space. Signature
ITEM 6b. Enter your Social Security Number. appearing therein must coincide with the name shown in
Item 4.
ITEM 7. Enter your present home address and telephone
number. ITEM 19. Insert date application is prepared.

DD FORM 108 (BACK), JUL 2002