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Touchstone Research Group LLC ("TRG")   |   Voice/Fax 800-283-3214   |   Form Expires 12/30/2023

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We Need the Order ID

To quickly get started, please enter the Last Name & Email Address that was used in registering with Touchstone, so that we can pull the proper Order ID.

*Please note that the Discharge Dates you enter do not need to be accurate. However they must be entered into the form as 2-digit month, 2-digit day and 4-digit year.

* If you are representing your client, please enter your last name (if applicable), the Veteran's Last Name and Email which is used in the Touchstone account registration. The name on the form can be changed at any time beyond this point.

Representative's Last Name: (used during registration)
Veteran's Last Name:
Veteran's Email:

Important Information!

You have selected "Funeral"

Under new Department of Defense regulations we will also require a proof of death. This can be in the form of a working copy of the Death Certificate, Obituary or Letter from Funeral Home indicating he/she has passed away.

If you choose to do a funeral letter (easiest) Here is what is required on the letter from the funeral home:

You can upload one or more of these documents as listed above in green.
Click Here for instructions.
Click Here to see a list of acceptable file formats.
Files Ready For Upload:

    How To Upload Files

    1. Click on "Browse Computer for File..." button
    2. Select a file from the window that opens. See list of Acceptable File Types & Formats for more info.
    3. You can repeat step 1 above for multiple files.
    4. Once you have a selection of files, click the "Upload Selected Files" button to upload them.

    Acceptable File Types and Formats

    • Images:
      • JPG, JPEG
      • PNG
      • BMP
      • GIF
    • Documents:
      • Adobe PDFs
      • Microsoft Word Docs
      • Plain Text files
      • Rich Text files

    REQUEST PERTAINING TO MILITARY RECORDS

    To ensure the best possible service, please thoroughly review the
    accompanying instructions before filling out this form. Please print
    clearly or type. If you need more space, use plain paper

    SECTION I - INFORMATION NEEDED TO LOCATE RECORDS (Furnish as much as possible.)

    1. NAME USED DURING SERVICE (last, first, and middle)

    2. SOCIAL SECURITY NO.

    3. DATE OF BIRTH

    4. PLACE OF BIRTH

    5. SERVICE , PAST AND PRESENT

    (For an effective records search, it is important that all service be shown below.)
    DATES OF SERVICE CHECK ONE SERVICE NUM. FOR THIS PERIOD
    BRANCH OF SERVICE DATE ENTERED DATE RELEASED OFFICER ENLISTED (If unknown, write "unknown")
    a. ACTIVE
    SERVICE
    b. RESERVE
    SERVICE
    c. NATIONAL
    GUARD
    6. IS THIS PERSON DECEASED? If "YES" enter the date of death.
    7. IS (WAS) THIS PERSON RETIRED FROM MILITARY SERVICE?

    SECTION II - INFORMATION AND/OR DOCUMENTS REQUESTED

    1. CHECK THE ITEM(S) YOU WOULD LIKE TO REQUEST A COPY OF:
    DD Form 214 or equivalent. This contains info normally needed to verify military service. A copy may be sent to the veteran, the deceased veteran's next of kin, or other persons or organizations if authorized in Section III, below. NOTE: If more than one DD214 Check the appropriate box below to specify a deleted or undeleted copy.
    When was the DD Form(s)214 issued? YEAR(s):
    UNDELETED: Ordinarily required to determine eligibility for benefits. Sensitive items, such as, the character of separation, autherity for separation, reason for separation, reenlistment eligibility code, separation (SPP/SPN) code, and dates of time lost are usually shown.
    DELETED: The following items are deleted.authority for separation, reason for separation, reenlistment eligibility code,separation(SPD/SPN) code, and for separations after June 30, 1979, character of separation and dates of time lost.
    All Documents in Official Military Personnel File (OMPF)
    Medical records (Includes Service Treatment Records (outpatient), inpatient and dental records.) If hospitalized, provide facility name and
    date for each admission:
    Other (Specify):
    2. PURPOSE ( An explanation of the purpose of the request is strictly voluntary, however, Such information may help to provide the best possible response and may result in a faster replay. Information provided will in no way be used to make a decision to deny the request.) Check appropriate box:

    SECTION III - REQUESTER'S ADDRESS AND SIGNATURE

    1. REQUESTER IS:
      Military service member or veteran identified in Section I, above
      Legal guardian (must submit copy of court appointment)
      Next of kin of deceased veteran (relation)
      Other (specify)
    2. To the NPRC and any other government agency in possession of any of my military and/or medical records: I hereby grant Touchstone Research Group LLC and their researchers a Limited Power of Attorney for the sole purpose of obtaining my records, and to do and perform all and every act and thing whatsoever necessary to be done in and about the specific and limited premises(set out herein) as fully, to all, intents and purposes, as might or could be done if personally present, with fullpower of substitution and revocation, hereby ratifying and confirming all that said attorney shall lawfully do or cause to be done by virtue hereof.

    I declare (or certify, verify, or state) under penalty of perjury under the laws of the United States of America that the information in this Section III is true and correct.

    Date of this request Daytime phone   () Email address
    For questions or guidance concerning this request, contact:

    the Touchtone researcher who submitted this request;

    OR: Touchstone Research Group LLC
    Processing
    4847 Navy Road
    Unit# 1167
    Millington TN 38083
    800-AT-DD214 (800-283-3214)


    FAX to: 646-530-8701
    Order No.

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    Signature     (Please do not print.)