Phone: 1-562-422-4100 (Pacific Time Zone)
Email Questions

Iraq Combat Campaign Service
Replacement Recognition Application Form

INSTRUCTIONS:

    1. Complete this form in full.
    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 (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 Mail or Email.

    I am selecting ONLY ONE campaign credit certificate
    I am selecting MORE THAN ONE campaign credit certificate

  • March 19 to May 1, 2003: Liberation of Iraq -- Yes No
  • May 2, 2003 to June 28, 2004: Transition of Iraq -- Yes No
  • June 29, 2004 to Dec. 15, 2005: Iraqi Governance -- Yes No
  • Dec 16 2005 to Jan 09 2007: National Resolution -- Yes No
  • Jan 10 2007 to Dec 31 2008: Iraqi Sruge -- Yes No
  • Jan 01 2009 to Date To Be Determined: Iraqi Sovereignty -- Yes No

    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

    Service Branch:

    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):


    Full and complete contact email address:


    SERVICE NUMBER:

  • Enter the veteran's FIRST FOUR DIGITS ONLY (Do Not Enter any Alpha characters. Digits only.) 
  • Enter the SECOND FOUR (or remaining) DIGITS ONLY  

  • Date First Tour Began In Iraq
    Date Final Tour Ended In Iraq


    If you are sending a check or USPS money order please indicate:

    • I will mail a check along with my application and documentation. The Library will receive my envelope within 10 days from today.
    • I will mail a USPS money order along with my application and documentation. The Library will receive my envelope within 10 days from today.

    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:
    (USPS Priority Mail shipping fee is included in the totals)

    I want to purchase the Full Color...

  • PDF emailed ($7.50) (No shipping fee)
  • Document shipped ($22.45)... with wallet card ($28.95)
  • Document shipped in Bond Enclosure ($27.45)... with wallet card ($33.45)

  • Would you like an archive (black&white) copy of the Certificate you are applying for to be mailed from the Records Chief directly to your Commanding Officer -or- to your Employer -or- to your School Administrator for inclusion into your permanent personnel file jacket?
    (Fee: $3.50)

  • No.
  • Yes, please mail an embossed, B&W copy of my Certificate to the following person and address:
  • Official's name
    Official's Title
    Official's Agency Name (name of unit, vessel, office, school, etc.)
    Address
    City, State, Zip


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

  • No, I will obtain the free jpg copy

  • Yes, please include a Medal Will for a MALE heir of my Awards and add $4.00 to my total
  • Yes, please include a Medal Will for a FEMALE heir of my Awards and add $4.00 to my total

  • Would you like to track your package through the United States Post Office after it has been shipped (for seventy-five [.75] cents extra)?

  • No, I don't want to track my package
  • Yes, add 75 cents to my total

  • Ignore this final Question if you will EMAIL or have previously EMAILED a copy your DD-214...

    Would you like your mailed DD-214 scanned by The War Library and integrated into your 201A Award Report that will be emailed to you when your requested item(s) are sent to you? The scanning fee is $3.00 (a one-time fee)

  • Yes, add a one-time $3.00 to my total to Scan and Integrate my DD-214 into my Award Report (Form 201-A)
  • No, I will accept my Award Report without my DD-214 appearing in my Award Report (Form 201-A)


  • 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 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. 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 (Pacific Time Zone)
    Policy Statements On Display Recognitions and Hardwear
    Personalized items shipped or emailed with a name and SN/PSN number cannot be returned or refunded. 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..