Dd Form 3 – Fill Out and Use This PDF

1. I HEREBY MAKE APPLICATION FOR THE STYLE GOLD STAR LAPEL BUTTON INDICATED BELOW (X one)

PIN JOINT AND SAFETY CATCH

CLUTCH TYPE

b. NAVY (If application is made w ithin one year from date of death)

(1) MAIL TO:

Chief of Naval Personnel (Pers-E)

Washingt on, DC 20370 -2000

(If application is made after one year from date of death)

(2)MAIL TO:

Nat ional Personnel Records Cent er, NARA (Milit ary Personnel Records)

9700 Page Boulevard

St . Louis, MO 63132 -5199

c. MARINE CORPS (If application is made w ithin one year from date of death)

(1) MAIL TO:

Commandant of t he Marine Corps (Code MMDM)

Washingt on, DC 20380 -0001

(If application is made after one year from date of death)

(2)MAIL TO:

Nat ional Personnel Records Cent er, NARA (Milit ary Personnel Records)

9700 Page Boulevard

St . Louis, MO 63132 -5199

d.AIR FORCE MAIL TO:

Nat ional Personnel Records Cent er, NARA (Milit ary Personnel Records)

9700 Page Boulevard

St . Louis, MO 63132 -5199

e.COAST GUARD MAIL TO:

Commandant (G-PS)

Unit ed St at es Coast Guard 2100 2nd St reet , SW Washingt on, DC 20593 -0001

3. APPLICANT' S RELATIONSHIP TO DECEASED SERVICEMEMBER (X one)

SON

DAUGHTER

STEPSON

STEPDAUGHTER

SON BY ADOPTION

DAUGHTER BY ADOPTION

BROTHER

SISTER

HALF BROTHER

HALF SISTER

a. NAME (Last, First, Middle Initial)

b. PAY GRADE OR RANK

c.SOCIAL SECURITY NUMBER OR SERVICE SERIAL NUMBER

d. DATE OF DEATH (YYYYMMDD)

e. BRANCH OF SERVICE

f. GEOGRAPHICAL AREA OF SERVICE

a. NAME (Last, First, Middle Initial)

b. NUMBER, STREET, AND APARTMENT NUMBER (If applicable)

Public Law 534 - 89t h Congress, direct s t he design and dist ribut ion of a lapel but t on, t o t he know n as t he " Gold St ar Lapel But t on," t o ident if y w idow s, parent s and next of kin of members of t he Armed Forces of t he Unit ed St at es w ho lost t heir lives:

(1)During World War I, April 6, 1917 t o March 3, 1921;

(2)During World War II, Sept ember 8, 1939 t o July 25,

1947;

(3)During any subsequent period of armed host ilit ies in w hich t he Unit ed St at es w as engaged bef ore July 1, 1958 (Unit ed Nat ions act ion in Korea, June 27, 1950 t o July 27, 1954);

(4)Af t er June 30, 1958

(a) w hile engaged in an act ion against an enemy of t he Unit ed St at es;

(b)w hile engaged in milit ary operat ions involving conf lict w it h an opposing f oreign f orce;

(c)w hile serving w it h f riendly f oreign f orces engaged in an armed conf lict in w hich t he Unit ed St at es is not a belligerent part y against an opposing armed f orce.*

The law provides t hat one Gold St ar Lapel But t on w ill be f urnished, w it hout cost , t o t he w idow and t o each of t he parent s and t he next of kin. The t erm " w idow " includes w idow er; t he t erm " parent s" includes mot her,

f at her, st epmot her, st epf at her, mot her t hrough adopt ion, f at her t hrough adopt ion, and f ost er parent s w ho st ood in loco parent is; t he t erm " next of kin" includes only children, brot hers, sist ers, half brot hers, and half sist ers; and t he

t erm " children" includes st epchildren and children t hrough adopt ion.

The law f urt her provides t hat not more t han one Gold St ar Lapel But t on may be f urnished t o any one individual except t hat , w hen a Gold St ar Lapel But t on f urnished under t his sect ion has been lost , dest royed, or rendered unf it f or use w it hout f ault or neglect on t he part of t he person t o w hom it w as f urnished, t he but t on may be replaced upon applicat ion and payment of an amount suf f icient t o cover t he cost of manuf act ure and

dist ribut ion.