I was able to get my hands on the orignally Suicide Charley Certificates that was handed out to the Marines prior to them leaving the the unit. I believe Sgt Soltis now SSgt Soltis is credited for the creations. Either way I have attached the Adobe Acrobat document  to the image below. I am still working on trying to get the form fillable so you be able to type your name and just hit print but still no luck.

Note: If your able to make it fillable please email it back to me so I can post your version on the website.

DON MOORE'S
WAR TALES

Charley Company 1st Battalion, Leatherneck, Marine Helicopter Squadron 161, Suicide Charley

John Thomas Murphy was a Marine pilot who flew helicopters and observation planes in Vietnam during his two combat tours. He received a Distinguished Flying Cross on each deployment while piloting an H-34 helicopter and   a OV-10 Bronco twin-engine spotter plane into withering North Vietnam Army fire.