Form ACR 105, Application for Certified Copy of a Military Discharge (DD 214), is the request form of the Riverside County Assessor-County Clerk-Recorder for a certified copy of a DD 214 that was recorded in Riverside County. Only the people Government Code Section 6107 authorizes can use it, and the form carries a sworn statement that must be signed. On FillingPDF you can fill out the form online and download or print the completed PDF; the county publishes the original PDF at rivcoacr.org, and the application goes to the county through its own channels.
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What is ACR 105?
Application for Certified Copy of a Military Discharge (DD 214), form ACR 105, is the Riverside County Assessor-County Clerk-Recorder form that authorized persons use to request a certified copy of a DD 214 military discharge record recorded in Riverside County.
Completing it produces a request for a certified copy of the record. The form asks for what you know about the document: the name used during service, branch of service, date released, year of recording, the document number if known, and the number of copies. It also asks you to check the box that shows why you are allowed to receive the copy, and it includes a sworn statement made under penalty of perjury.
The form's instructions explain the legal frame. Section 6107 of the California Government Code limits who may obtain a certified copy of a DD 214. Section 103526 of the California Health and Safety Code requires anyone requesting one to complete and sign the sworn statement. Government Code section 27303.5 lets an authorized person who needs the full Social Security number to receive benefits ask for an unredacted copy.
The county only holds DD 214s that were recorded in Riverside County. For any other DD 214, the instructions send you to the county where it was recorded or to the National Personnel Records Center, Military Personnel Records, 9700 Page Avenue, St. Louis, MO 63132-5100, phone (866) 272-6272.
Who needs to file ACR 105?
Section 2 of the form lists who may request a certified copy. You must fit one of these groups and check the matching box:
- The person who is the subject of the military discharge document.
- A child, parent, grandparent, grandchild, sibling, spouse or domestic partner of the person listed on the discharge record.
- A legal representative of the person who is the subject of the document.
- A member or representative of a state, county or city office that provides veteran's benefits.
- A United States official.
If you are not in one of these groups, the form's instructions say that Government Code section 6107 does not allow you to obtain a certified copy.
The form is only useful for a DD 214 that was recorded in Riverside County; the county has no other records. Anyone who needs the full Social Security number to receive benefits and is an authorized person may check the unredacted box. A representative of a state or local government agency who applies while conducting official business does not have to provide the notarized statement required for mail requests.
When to file ACR 105
Submit Form ACR 105 when you need a certified copy of a DD 214 that was recorded in Riverside County. The form prints no deadline, expiration or renewal period, so it is used whenever the need arises.
Before you apply, gather what you know about the record: the name used during service, branch of service, date released, year of recording and document number. The instructions say to give all the information available to identify the record. If you are ordering several certificates at the same time, every request needs the completed sworn statement, but only one request needs the notary statement. If the DD 214 was recorded in another county, contact that county or the National Personnel Records Center instead.
Documents you need
- A governmental issued picture I.D., required if you order in person.
- A completed Certificate of Acknowledgment signed before a notary public, required if you apply by mail; when you send several requests together, only one needs it, and government agency representatives on official business are exempt.
How to fill out ACR 105
Enter the name used during service
In section 1, DD214 Information, write the First, Middle and Last name used during service. Give all the information you have to identify the record.
Add branch of service and release date
Enter the Branch of Service and the Date Released shown for the discharge.
Enter recording details
Write the Year of Recording and the Document Number if you know it. Remember the county holds only DD 214s recorded in Riverside County.
State the number of copies
Enter the Number of Copies you want in the field provided.
Check your authorization box
In section 2, under I am, check the one box that matches you: the subject of the record, a listed family member, a legal representative, a veteran's benefits office member or representative, or a United States official.
Enter the requester's details
In section 3, Requested by, print or type your name, street address, city, state, ZIP code and phone number. Leave the office-use block blank.
Decide on the unredacted copy
Check the section 4 box only if you are an authorized person who needs the full Social Security number to receive benefits. Without it, the first five digits are not shown.
Complete the sworn statement
In section 5, print your full name, then enter the date and the city and state where you sign.
Sign the application
Sign as applicant. If you order in person, sign in front of the Clerk.
Get the notary statement for mail
If you apply by mail, complete the Certificate of Acknowledgment before a notary public, unless you are a government agency representative on official business.
Review and download the PDF
Check every entry and the box you marked, then download or print the completed PDF from FillingPDF and send or bring it as described under How to submit.
How to submit ACR 105
You can submit Form ACR 105 by mail or in person.
- By mail: Send the application to Riverside County Recorder, P.O. Box 751, Riverside, CA 92502-0751. Complete the sworn statement and the Certificate of Acknowledgment in front of a notary public. When you send multiple requests together, only one needs the notary statement. A representative of a state or local government agency conducting official business does not need the notarized statement.
- In person: A governmental issued picture I.D. is required. Sign the sworn statement in front of the Clerk.
The form lists the Assessor at (951) 955-6200 and the County Clerk-Recorder at (951) 486-7000, and the county website is www.rivcoacr.org. The form does not state a fee or a processing time; ask the county through those numbers. FillingPDF lets you fill out and download the PDF; submission follows the county channels above.
Common mistakes to avoid
- Requesting a DD 214 that was not recorded in Riverside County; the county only holds records recorded there.
- Mailing the application without the notary's Certificate of Acknowledgment, unless you are a government agency representative on official business.
- Checking none of the boxes in section 2, or one that does not describe your relationship to the person on the discharge record.
- Leaving the unredacted box unchecked when you need the full Social Security number; the copy then omits the first five digits.
- Signing the sworn statement before arriving when ordering in person; you must sign in front of the Clerk.
- Forgetting the governmental issued picture I.D. for an in-person request.
- Leaving out the date and city and state of signing in the sworn statement.
- Mailing the application to a street address instead of Riverside County Recorder, P.O. Box 751, Riverside, CA 92502-0751.
Frequently asked questions
What is Form ACR 105 used for?
Form ACR 105 is the Riverside County Assessor-County Clerk-Recorder application for a certified copy of a military discharge (DD 214). It covers only DD 214s recorded in Riverside County and includes a sworn statement made under penalty of perjury.
Who can request a certified copy of a DD 214 in Riverside County?
The person named on the record, a child, parent, grandparent, grandchild, sibling, spouse or domestic partner, a legal representative, a member or representative of a state, county or city veteran's benefits office, or a United States official. Government Code section 6107 sets these limits.
Does Riverside County have my DD 214 if it was recorded elsewhere?
No. The county only has DD 214s recorded in Riverside County. For others, contact the county where it was recorded, or the National Personnel Records Center, 9700 Page Avenue, St. Louis, MO 63132-5100, phone (866) 272-6272.
Do I need a notary to request a DD 214 by mail?
Yes, for a mail request you complete the sworn statement and the Certificate of Acknowledgment before a notary public. With multiple requests sent together, only one needs the notary statement, and government agency representatives on official business do not need it.
What ID do I need to request a DD 214 in person?
A governmental issued picture I.D. is required for in-person orders. You must also sign the sworn statement in front of the Clerk, so do not sign the application beforehand.
How do I get the full Social Security number on my DD 214 copy?
Check the unredacted box in section 4. You must be an authorized person who needs the full number to receive benefits. If you leave it unchecked, the certified copy will not show the first five digits of the Social Security number.
Where do I mail Form ACR 105?
Send it to Riverside County Recorder, P.O. Box 751, Riverside, CA 92502-0751, with the completed sworn statement and the notary's Certificate of Acknowledgment unless you are exempt as a government agency representative.
Can I fill out Form ACR 105 online?
You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not file the application with the county; you send or bring it through the Riverside County channels.
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