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Date of Birth:                  

Service Number:              
Rank/Rating:                   

Date of enlistment:          
Place of enlistment:          

Date on USS Champlin:     
Date off USS Champlin:     

Date Discharged:             

Date of Death:                 



Wife:


Children:


Grandchildren:

Great Grandchildren:


High School:


College:


Interests and Hobbies:



Post World War II Life Experience:




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