Questions About This Form? Use Email

Phone: 1-562-422-4100

Military Installation Service
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 photocopy of the required document(s) described on the Operation's Information Page, or you can Print and mail this form and the required documents to the Library's mailing address below.

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

ARMY INSTALLATION

OTHER ARMY INSTALLATION NOT LISTED ABOVE:

Recipient's LAST Name:
FIRST Name:
MIDDLE name:
Title (Must appear on military documentation):Jr Sr II III IV

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

Service Branch:

Rank Title (Please Do Not Abbreviate):

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:

  • Enter the veteran's FIRST FOUR DIGITS ONLY (Do Not enter any alphabet letters. Numbers only.) 
  • Enter the SECOND FOUR (or remaining) DIGITS ONLY  

    • Date Arrived at Installation

    Date Departed Installation

    If you are sending a Check or Money Order please indicate:

    • I will mail a Check along with my application and documentation
    • I will mail a Money Order along with my application and documentation

    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:

    International shipping cost (U.S. veteran living outside the United States, please add the shipping cost you were quoted...

    TOTAL ADMIN PROCESSING/DELIVERY:

    I want to purchase the Full Color...

  • PDF emailed (full color, printable) ($7.50) (No shipping fee)
  • Document shipped ($24.50)...
       Document only with wallet card ($30.50)
  • Document shipped in Bond Enclosure ($29.50)... with wallet card ($35.50)
  • I do not want the Display Recognition. I am requesting the hardware items listed below (medal, badge, ribbon or patch) if they are available for this award. (Shipping cost applies to non-certificate requests.)

    (The shipping totals above include the USPS - Priority Mail shipping fee)

    Would you like a published copy of My Military Medal Last Will And Testament?

  • Yes, please include a Medal Will for a male heir of my medals and add $4.00 to my total
  • Yes, please include a Medal Will for a female heir of my medals and add $4.00 to my total
  • No, I will obtain the free jpg copy

    • Would you like to track your package using the internet 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

    • Click Here if you are a Prior Applicant who's DD-214 is on file
    New Applicants Click Here

    Your Application Form is now complete. After clicking the grey-bar 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 hardware may be exchanged or returned within ten days of delivery. Name-Personalized items such as Certificates that are produced uniquely for a recipient may not be exchanged or returned.)

    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
    LINK: Policy Statements On Display Recognitions and Hardwear

    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.

    I have read and understand the Certificate Return/Exchange Policy printed above.

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