Memorandum of Fact

United Daughters of the Confederacy

MEMORANDUM OF FACT FOR MILITARY SERVICE AWARDS

CROSS OF MILITARY SERVICE / NATIONAL DEFENSE MEDAL
ARMED FORCES EXPEDITIONARY SERVICE MEDAL / CERTIFICATE OF APPRECIATION

Name of Recipient

/ Sex / M / F

Name of war, conflict, or military operation

Rank during war, conflict, or military operation

Planned Date of Bestowal

Address of Recipient

If posthumous, date of death and city/state of residence at time of death

If posthumous, name, address, and relationship of person who will receive award on recipient’s behalf

RECIPIENT’S U.S. MILITARY RECORD

Enclose one photocopy of honorable discharge and/or service record (DD214 or equivalent) showing service for timeframe for which award is being presented. If on active duty, enclose statement signed by recipient indicating current assignment and rank.

Complete this section only for Cross of Military Service (only check one)

Served in: World War I World War II Korean War Vietnam Conflict Global War on Terror

Length of overseas service in war/conflict

Complete this section only for National Defense Medal

Served in

Name of war/conflict. Refer to Recorders Manual or Instruction Brochure for list of wars/conflicts/operations

Complete this section only for Armed Forces Expeditionary Service Medal

Served in

Name of military operation. Refer to Recorders Manual or Form 36 for list of eligible operations

Complete remainder of application for all awards

Entered service on / as a
day, month, year / rank at entry

During war/conflict served in

Branch of service / Full Name of Unit (NO ABBREVIATIONS)
if U.S. Navy or Coast Guard, name of ship(s)/boat(s)

Rank

Served until honorably discharged on / as a
day, month, year / rank at discharge

If on active duty, current assignment and rank

Citations and/or Decorations

FOR USE ONLY BY RECORDER GENERAL OF MILITARY SERVICE AWARDS

CMS / / NDM / / AFESM / / CofA / / Award Number / ______/ Lapel Pin? / Yes / No

Planned date of Bestowal ______Name of war, conflict, operation______

Overseas? Yes No Posthumous? Yes No

PAGE 2

CONFEDERATE ANCESTOR MILITARY RECORD AND PROOF
CONFEDERATE MILITARY RECORD OF ANCESTOR
Name of lineal bloodline Confederate Ancestor
Relationship to Recipient (e.g., grandfather, great-grandfather)
Entered service on / at / as a
day, month, year / place of enlistment / rank at enlistment
Served in / Artillery / Cavalry / Infantry / Navy / Other / from the State of /
include company, battery, regiment, battalion, brigade, Field & Staff, ship, etc., as applicable
Served until / at / as a
day, month, year / city/state, if known / final rank
Additional pertinent information
PROOF OF CONFEDERATE MILITARY RECORD OF ANCESTOR
Enclose one photocopy of one of the following three sources of acceptable proof. Check the box indicating the appropriate source and complete that section. The recipient’s Confederate ancestor upon whom proof is submitted must be the same lineal bloodline ancestor as listed in the section above.
1. National Archives Compiled Service Records or other authoritative published records
If National Archives records, enclose one photocopy of the entire record.
National Archives roll number
If other published records, enclose one photocopy of title page and other pertinent pages.
Name of Publication
Author of Publication
Date of Publication / Volume / Page(s)
Where found
name and location of library or name and address of private owner
Additional information
2.Confederate Pension Records
Enclose one photocopy of the veteran or widow’s entire pension application showing approval by the state.
Name on pension application
Pension approved by the State of / on
day, month, year
Additional information
3.United Daughters of the Confederacy®or Children of the Confederacy®records
Enclose one photocopy of all 4 pages of the UDC/CofC Original/Supplemental approved membership application.
Name of UDC or CofC member
Name/number of Chapter
Location of Chapter (City/State)
Date membership approved by General
Relationship of recipient to the UDC or CofC member (explain as necessary; Confederate ancestor of recipient must be the same Confederate Ancestor shown on UDC or CofC records)

PAGE 3

LINEAGE CHART

Complete lineage chart up to and including Confederate ancestor only. Confederate ancestor must be lineal (i.e., grandfather, great-grandfather, etc.) of recipient and relationship must be by bloodline (i.e., relationship by adoption not permitted).

Name of Recipient

I am the son daughter of

Father
Mother (maiden name)

The said