Mayoral Retirement Letter Request

Veterans Service Division
117 West Duval Street, Suite 175
Jacksonville, FL 32202
Telphone: (904) 630-3680 Facsimile: (904) 630-3422
E-mail: vetsvcs@coj.net

Your E-mail Address:
Date of Retirement:
RATE/RANK (Spell out and include special designators in parenthesis):
NAME – First/Middle/Last:
Organization and Address (Spell out):
POC:
Phone:
Special career accomplishments that are worthy of note which should be considered for mention:
Spous's Name:
Number of children:
Names of Children:
List any Community involvement (i.e. volunteer efforts, service on boards of directors, etc.):
Is Retiree remaining in Jacksonville?:	YesNo
Date Letter is needed:
Would you like to:	Pick-up the letterHave it Mailed

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