INSTRUCTIONS
1. List complete command mailing address including homeport or base.
2. Name and signature of person at command who authorized form for release. Must be signed on each form, unless
a group of forms (10 or more) is submitted under a signed cover letter. List duty phone. Indicate if AUTOVON
or Commercial.
3. Reporting unit code (USMC), unit identification code (USN), or operating facility code (USCG).
4. Self explanatory.
5. Actual date of event or date of presentation in the case of awards.
6. Rank such as SGT or J03.
7. Pay grade such as E-6 or 0-2.
8. Date entered active duty, if you delayed enlisted, etc., also indicate date and explain.
9., 10. and 11. Self explanatory.
12. Social security number is mandatory. SSN is for FHTNC use only in casualty searches. SSN is not released to media.
13.,14 .,1 S., 16.,17., and 18. Self explanatory. (NOTE – ZIP Codes mandatory for release preparation.)
19. Self explanatory.
20. and 21. Include type of degree (BA, BS, AA, etc.) and year awarded. List only two highest degrees.
22. Indicate your duties by job title, (e.g. squad leader, cook, plane captain, etc.) not by NEC/MOS/QC.
23. Check apprpriate box or give complete details of event – use extra paper as required. Attach copies of citations/a
awards, etc. If qualified as pilot, etc., list type. aircraft, etc.
24. Self explanatory.
25. Payroll signature required to permit release of news story.
26. Self explanatory.
27. Complete company name, address, your position/job with the company and number years employed with company.
28. Name of company publication/newsletter that you want story released to. Include complete address and ZIP code.
29. Fleet Home Town News Center telephone number is: (804) 444-2221, AUTOVON: 564-2221.
30. Mail to: Fleet Home Town News Center, Building X-18, Naval Station, Norfolk, VA 23511-6698.
Figure 17-2B.—Completed NAVSO 5724/1 (back).
17-6
