Philippine Independence Medal
Replacement Recognition Application Form
1. Complete this form in full. ( Click here to email email@example.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 WD AGO 53-55, NAVPERS 53-55, NAV-MC or other pre-arranged military document(s) to the address below.
Charge card or Debit card applicants: To expedite shipment of your Recognition you may email this form today. Your Recognition will be prepared and awaiting the arrival of your WD AGO 53-55 or other, pre-arranged military document(s).
You will shortly receive a confirmation email/receipt acknowledging your application arrived, or should we have a question or require more information. Please ensure that you have entered a correct email address.
To email this form click the button below. To mail this form address your envelope to:
Print a copy for yourself before clicking the bar below..