Instructions for Submitting Archive Records Request
If you are filling out this form to request Michigan Army National Guard Archive Records,
there are three methods for submitting your request:
1) Ground mail:
Archive Records
Michigan National Guard Joint Force Headquarters
3411 N. Martin Luther King Blvd Lansing, MI 48906-2934
2) Fax:
517-481-7361
ATTN: Archive Records
3) Email:
If you would like to email this form, please reach out to Michigan Army National Guard
Archive Records via phone at 517-481-8331 or email at ng.mi.miarng.mbx.archive-
records@army.mil in order to get instructions on how to correctly submit to encrypt
your Personally Identifiable Information (PII). DO NOT submit email without contacting
Archive Records first. Your SSN or PII may be automatically deleted from this form and
we will be unable to fulfill your request.
If you are filling out this form to request Michigan Air National Guard Archive Records,
please follow the instructions for step three above. However, please call 517-481-8276 or
email hqmiang.jfhq.workflow@us.af.mil. If you are unable to send the form via email,
Michigan Air National Guard Archive Records will provide you with alternate steps.
If you are requesting Medical Records from your Michigan Army National Guard time,
please fill out a DD 2870 and send in with a photo copy of your valid ID to SFC Herman,
Chelsea at [email protected] or mail to:
Michigan Medical Detachment
ATTN: Medical Records Request
4400 E. 8 Mile Rd.
Detroit, MI 48234
The signature on this form must be your physical payroll signature. The only way you may
digitally sign is if you have a Common Access Card (CAC). Any other digital signature
created that is not your physical signature will not be accepted.
Please fill out this form as complete as possible so we may be able to assist you.
INFORMATION REQUIRED TO LOCATE RECORDS
Request For
Michigan National Guard
Records
ng.mi.miarng.mbx.archive-records@army
.mil
Archive Records
MICHIGAN NATIONAL GUARD JOINT
FORCE HEADQUARTERS
3411 N. MARTIN LUTHER KING BLVD
LANSING, MI 48906-2934
Phone: (517) 481-8331 Fax: (517) 481-7361
RESTRICTIONS ON RELEASE OF INFORMATION: Information from records of retired/discharged military personnel
are released subject to restrictions imposed by military departments consistent with provisions in the Freedom of Information Act
of 1967 (Revised 1974) and the Privacy Act of 1974.
PLEASE PROVIDE ALL INFORMATION. INCOMPLETE FORMS WILL BE RETURNED.
SECTION 1 – SOLDIER INFORMATION (Required to Locate Records)
PLEASE PRINT:
NAME (Last, First, MI):
SSN/SERVICE NUMBER(S): DATE OF BIRTH:
MICHIGAN NATIONAL GUARD MEMBERSHIP:
ARMY AIR OFFICER
ENLISTED
APPROXIMATE DATES OF SERVICE
FROM: TO:
_
IS THE INDIVIDUAL DECEASED:
YES NO
IS THE INDIVIDUAL RETIRED:
YES
NO
SECTION II – REQUESTED INFORMATION
NGB 22 and/or DD 214, also includes all pertinent service records including NGB 23B
discharge orders and any other required forms for proof of service.
Other (Please specify what documents):
Purpose (Why do you need these documents?):
SECTION III – REQUESTOR INFORMATION
Individual Family Member Official Business Recruiter
Phone Number: Name:
FAX: Street Address
E-Mail: City, State, Zip
I understand by checking this box and typing my initials here that my digital signature
in the signature field below is legally binding and certifies that I am indeed the person requesting the
records or an authorized representative thereof and I declare under penalty of perjury that the foregoing
in true and correct.
Signature
Date
Note: Family members do not have access to spouse, sibling, or parental records without permission from said family member and subsequent filling out of
the above form and proof of identity. Additionally in the case of a death of a service member or incapacitation proof of death or power of attorney will be
required to obtain the records of said individual. RECORDS ARE PROTECTED UNDER THE FEDERAL PRIVACY ACT. JULY 2020
INSTRUCTION AND INFORMATION SHEET
1.
Personnel records and Service Treatment Records (STR). Personnel records of military members who were
discharged, retired, or died in service less than 62 years ago and STR’s are in the legal custody of the military
service department and are administered in accordance with rules issued by the Department of Defense, the
Department of Homeland Security (DHS, Coast Guard), and the State of Michigan.
a.
Release of information: Release of information is subject to restrictions imposed by the military
services consistent with Department of Defense regulations and the provisions of the Freedom of Information
Act (FOIA) and the Privacy Act of 1974. The service member (either past or present) or the member's legal
guardian has access to almost any information contained in that member's own record. An authorization
signature, of the service member or the member's legal guardian, is needed in Section III of the Michigan
National Guard Request Form. Others requesting information from military personnel records and/or STR’s
must have the release authorization in Section III signed by the member or legal guardian. If the
appropriate signature cannot be obtained, only limited types of information can be provided. If the former
member is deceased, surviving next of kin may, under certain circumstances, be entitled to greater access to a
deceased veteran's records than a member of the general public. The next of kin may be any of the
following: un-remarried surviving spouse, father, mother, son, daughter, sister, or brother. Requesters must
provide proof of death, such as a copy of a death certificate, letter from funeral home or obituary.
2.
Where reply may be sent. The reply may be sent to the service member or any other address designated by the
service member in Section III or other authorized requester.
3.
It is best to be very clear when filling out your purpose. In some cases you may be requesting the wrong
documents, and we want to be sure we provide you with the correct documentation.
4.
Definitions and abbreviations. DISCHARGED/ETS -- the individual has no current military status; SERVICE
TREATMENT RECORD (STR) -- The chronology of medical, mental health and dental care received by service
members during the course of their military career; OMPF – Official Military Personnel File.
5.
If you are currently serving please see your Readiness NCO for help downloading your service records
from IPERMS. If you served up to or beyond 2005 or enlisted in 2005 or later then your records may
be stored digitally. If you are retired or have been discharged from the Michigan Army National Guard
please visit the following link to the Army eBenefits site and set up an account which will allow you to
download your Official Military Personnel File https://eauth.va.gov/ebenefits-portal/ requests sent to this
office that can be obtained through IPERMS directly or an account on the eBenefits site will be returned
without action.
PRIVACY ACT OF 1974
COMPLIANCE INFORMATION
The following information is provided in accordance with 5 U.S.C. 552a (e)(3) and applies to this form. Authority for
collection of the information is 44 U.S.C. 2907, 3101, and 3103, and Public Law 104-134 (April 26, 1996), as amended
in title 31, section 7701. Disclosure of the information is voluntary. If the requested information is not provided, it may
delay servicing your inquiry because the facility servicing the service member's record may not have all of the
information needed to locate it. The purpose of the information on this form is to assist the facility servicing the records
(see the address list) in locating the correct military service record(s) or information to answer your inquiry. This form is
then retained as a record of disclosure. The form may also be disclosed to Department of Defense components, the
Department of Veterans Affairs, the Department of Homeland Security (DHS, U.S. Coast Guard), or the National
Archives and Records Administration when the original custodian of the military health and personnel records transfers
all or part of those records to that agency. If the service member was a member of the National Guard, the form may also
be disclosed to the Adjutant General of the appropriate state, District of Columbia, or Puerto Rico, where
he or she served.