__________

(Date)

From: _________________________________________________________

(Grade) (Full Name) (SSN)

To: Commandant of the Marine Corps (MMSR-5)

Via: Commander, Marine Forces Reserve

(G-1 IPAC), 2000 Opelousas Avenue, New Orleans, LA 70146

Subj: RESIGNATION FROM THE U.S. MARINE CORPS RESERVE

Ref: (a) MARCORSEPMAN, Par. 3002

1. Per the provisions of the reference, I request to resign my commission in the U.S. Marine Corps Reserve effective the first day of the month of ______________________. The effective date is at least 150 days from the date submitted to allow sufficient time for processing. My reasons for tendering this resignation are (Optional):

__________________________

(Signature)

Current Address:

__________________________

__________________________

__________________________

__________________________

Phone:

(Home) ___________________

(Work) ___________________

E-mail ___________________