FOR RELEASING PUBLIC AFFAIRS OFFICE USE ONLY1. PAO CODE
HOMETOWN NEWS RELEASE INFORMATION
PRINT OR TYPE - SEND ORIGINAL ONLY
5. RANK 6. PAY GRADE 7. FIRST NAME, MIDDLE INITIAL, LAST NAME
2. YOUR SOCIAL SECURITY NUMBER (For identification only)
8. SEX
3. BRANCH OF SERVICE
9. EVENT (Example: Arrival; Promoted to Sergeant; Received Commendation Medal, etc.- Citation Needed)
a.(1) FIRST NAME, MIDDLE INITIAL, LAST NAME (2) RELATIONSHIP TO YOU
(3) ADDRESS (Number and Street) (4) CITY (5) STATE (6) ZIP CODE
14.a. YOUR PRESENT UNIT OF ASSIGNMENT
(Do not abbreviate)
b. POST OR BASE (Not APO) c. CITY d. STATE OR
COUNTRY
15. DUTY MOS OR AFSC 16. PRESENT JOB TITLE (Full Title - Do not abbreviate) 17. TOTAL YEARS
MILITARY SERVICE
18.a. HIGH SCHOOL GRADUATED FROM c. CITY d. STATE e. ZIP CODEb. YEAR GRADUATED
19. COLLEGES GRADUATED FROM
20. REMARKS (Continue on back if necessary)
21. SIGNATURE OF PERSON LISTED ABOVE (Authorizing release of this information) 22. DATE (YYMMDD) 23. DUTY PHONE
(DSN or area code)
DD FORM 2266, JUN 95
PRIVACY ACT STATEMENT
AUTHORITY: 5 U.S.C. 301, 10 U.S.C. 8012 and 8034, and EO 9397.
PRINCIPAL PURPOSE: To prepare news stories and news releases for distribution and publication by civilian news media to recognize the achievements of Army
and Air Force members. In accordance with the 1974 Privacy Act, you are hereby informed that your Social Security Number on this form is required for
identification use only.
ROUTINE USE: Information may be disclosed to civilian news media representatives. Once published, information is considered "Public Domain."
DISCLOSURE : Information collected on this form is released over your signature and is voluntary. If you have no objection to the information being released to
hometown audiences, sign your name below. Failure to provide the information may mean little or no public news release material can be produced, thus
denying the individual public recognition for personal achievements.
ARMY
AIR FORCE
NAVY
MARINE CORPS
COAST GUARD
4. STATUS
ACTIVE
RESERVE
NATIONAL
CIVILIAN
10. YOUR LIVING PARENTS, STEPPARENTS, GUARDIANS, AUNT/UNCLE/GRANDPARENTS OR ADULT SIBLINGS
b.(1) FIRST NAME, MIDDLE INITIAL, LAST NAME (2) RELATIONSHIP TO YOU
(3) ADDRESS (Number and Street) (4) CITY (5) STATE (6) ZIP CODE
11. SPOUSE'S NAME (First, Middle Initial, Last)
12. SPOUSE'S LIVING FATHER a. FIRST NAME, MIDDLE INITIAL, LAST NAME
b. ADDRESS (Number and Street) c. CITY d. STATE e. ZIP CODE
13. SPOUSE'S LIVING MOTHER a. FIRST NAME, MIDDLE INITIAL, LAST NAME
b. ADDRESS (Number and Street) c. CITY d. STATE e. ZIP CODE
a. COMPLETE NAME b. DEGREE c. YEAR GRADUATED d. CITY e. STATE f. ZIP CODE
GUARD
