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USAF Combat Action Medal
Replacement Recognition Application Form

INSTRUCTIONS:

1. Complete this form in full. ( Click here to email amerwar@amervets.com if you have any technical problems sending this Application Form after you have completed it )

2. Click the button at the bottom of this completed form to email it to The War Library, along with a copy of your or the veteran's DD-214, DVB (Data Verification Brief) or other pre-arranged military document(s) to the address below.

Do Not Hilite, Underline, Circle, Colorize
Or Mark In Any Way The DD-214
Or Other Military Document Photocopy
You Will Be Sending.

Recipient's LAST Name (as it appears on the Report of Separation):
FIRST Name (as it appears on the Report of Separation):

MIDDLE name (as it appears on the Report of Separation):
Title (Must appear on military documentation):Jr Sr II III IV

Is this veteran currently living, deceased or KIA:
  LIVING
  DECEASED
  KILLED IN ACTION

Rank Title (Please Do Not Abbreviate):

Paygrade
Enlisted
Warrant
Officer

I have not moved. My current address info is on file from a previous application

Address:
City:
State:
ZipCode:
Phone (NO SPACES OR DASHES):

Your full and complete contact email address:

SERVICE NUMBER:
(Do Not enter any alphabet letters. Numbers only.)
★ Enter the veteran's 1st FOUR DIGITS ONLY  ☛ 
★ Enter the 2nd FOUR (or remaining) DIGITS ONLY   ☛ 

Combat Theater:

CHARGE or DEBIT CARD applicants:

-- My current Card information is already on file from a previous Application

If your Card information is not on file, please Complete the following...

Your Name as it appears on your charge or check debit card:

Payment Method
    Check Debit
    Visa
    MasterCard
    American Express
    Discover
    Diners Club
    Carte Blanche

Card number:
Expiration Date
Card Verification Number (CVV Code) (See below)
American Express: 4 digits on front of card
All other cards, 3 digits on back

After printing this form for mailing, please sign here ... or click the button below to email:

Personnel Branch
Processing and Delivery

Style Admin Shipping Total
Full Color .PDF (Printable) $7.50 Emailed $7.50
Published Document only (Full Color)

Includes FREE full-size medal and ribbon.		 $14.00 $13.43 USPS $27.43

Would you like to track your package through the United States Post Office after it has been shipped (for twenty [.20] cents extra)?

  • Yes, add 20 cents to my total
  • No, I don't want to track my package

    • Your Application Form is now complete. After clicking the button below to send this Form you will soon receive a confirmation email containing final instructions on which items, if any, are needed to fulfill your request. Your DD-214 can be mailed or emailed. Non-personalized items such as hardwear may be exchanged or returned within ten days of delivery.

    Records Chief (REC-AMW)
    The American War Library
    817 East Via Carmelitos
    Virginia Building 319
    Long Beach CA 90805-7549
    Phone: 1-562-422-4100 (Pacific Time Zone)

    LINK: Policy Statements On Display Recognitions and Hardwear
    Name-personalized items that are produced uniquely for a recipient may not be exchanged or returned. However, although typographical errors are very rare, there is no time limit on requesting corrections to errors.

    Print a copy for yourself before clicking the bar below..