Questions About This Form? Use Email

Phone: 1-562-422-4100

Civil War Campaign/Organization Service
Replacement Recognition Application Form

INSTRUCTIONS:

1. Complete this form in full. ( Click here to email amerwar@amervets.com if you have any technical problems sending this Application Form after you have completed it )

2. Print and mail or email this completed form, along with a photocopy of the required document(s) described on the Operation's Information Page, or other pre-arranged 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.

Charge card or Debit card applicants: To expedite shipment of your Replacement Recognition you may email this form today. Your Replacement Recognition will be prepared and awaiting the arrival of your DD-214 or other, pre-arranged military document(s).

NAME OF UNIT OR ACTIVITY

ENTER THE NAME OF THE ACTION/EVENT THAT IS NOT LISTED ABOVE:

Recipient's LAST Name:
FIRST Name:
MIDDLE name:
Title (Must appear on military documentation):Jr Sr II III IV

Is this veteran currently living, deceased or KIA:
  LIVING
  DECEASED
  KILLED IN ACTION

Service Branch:

Rank Title (Please Do Not Abbreviate):

I have not moved. My current address info is on file from a previous application

Street Address:

City:
State:
ZipCode:
Phone:

Your full and complete contact email address:

SERVICE NUMBER:

  • Enter the veteran's FIRST FOUR DIGITS ONLY (Do Not enter any alphabet letters. Numbers only.) 
  • Enter the SECOND FOUR (or remaining) DIGITS ONLY  

    • Full Name of Veteran's Unit



    If you are sending a Check or Money Order please indicate:

    • I will mail a Check along with my application and documentation
    • I will mail a money order along with my application and documentation

    Charge or Debit Card applicants, please complete the following:

    Please choose between ASAP or Monthly shipping...

    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

    TOTAL ADMIN PROCESSING/DELIVERY:
    (USPS Priority Mail shipping fee is included in the totals)

    I want to purchase the Full Color...

  • PDF emailed (full color, printable) ($7.50) (No shipping fee)
  • Document shipped ($24.50)...
       Document only with wallet card ($30.50)
  • Document shipped in Bond Enclosure ($29.50)...
       Document in Bond Enclosure with wallet card ($35.50)

    • 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) Available only when a published certificate is requested. Not available with emailed certificates.

  • 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 twenty [.20] cents extra)?

  • No, I don't want to track my package
  • Yes, add 20 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. Print, Sign and Mail this completed form to the address below along with the required military-issued Report of Separation or other (pre-approved) document(s). You may (OPTIONAL) email this form for faster processing. However, you must still mail or email a copy of your military document(s).

    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)

  • I have read and understand the Certificate Return/Exchange Policy printed above.

    • Print a copy for yourself before clicking the bar below..