720th military police battalion gauntlet 401st military police company supply actions and forms 1lt...

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720th Military Police 720th Military Police Battalion Battalion Gauntlet Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks 1LT Alexis Marks

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Page 1: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

401ST MILITARY POLICE COMPANY

Supply Actions and Forms1LT Alexis Marks1LT Alexis Marks

Page 2: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

• Hand Receipt

• Subhand Receipt

• Hand Receipt Annex

• Component Hand Receipt

• Inventory List

USES OFDA FORM 2062

Page 3: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

Flow of Property

Com

pon

ent H

and

Receip

t

Com

ponent Hand

Receipt

Com

ponent Hand R

eceiptCompon

ent H

and R

eceip

t

C-21 C-22 C-23 C-24 PLT SGT

COMMANDERProperty Book Items

2nd Platoon LeaderSubhand Receipt Holder # 2

Com

pone

nt H

and

Rec

eipt

MTOE/TDA

PBO

Page 4: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

DA FORM 2062

• Required whenever property book or durable items are issued.

• Identifies the property that is being issued.

• Signature establishes direct responsibility.

• No restriction on number of items property can be subhand receipted.

• Should not exceed from commander to supervisor, to user.

Subhand Receipt

Page 5: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

Subhand ReceiptDA FORM 2062

B67766 TM 9-1240-381-10 NOV 1977 1240-00-930-3833 Binoculars, M19A1 w/e SN: 2332, 2333, 2334, 2335 J ea 4 4

FROM: TO: HAND RECEIPT NUMBER

FORANNEX/CR ONLY

END ITEM STOCK NUMBER END ITEM DESCRIPTION PUBLICATION NUMBER PUBLICATION DATE QUANTITY

STOCK NUMBER ITEM DESCRIPTION

* WHEN USED AS A: HAND RECEIPT, enter Hand Receipt Annex Number HAND RECEIPT FOR QUARTERS FURNITURE, enter Condition Codes HAND RECEIPT ANNEX / COMPONENTS RECEIPT, enter Accounting Requirements Code (ARC) PAGE 1 OF 2 PAGE.

SEC UI

QTYAUTH f. c. d. e.

g. QUANTITY

a. b. A B C D E F

A32355 TM 3-6665-225-12 AUG 1975 w/c 1-2

6665-01-105-5623 Alarm, Chemical Agent, Automatic, Manpack, M8A1 7 ea 2 2

HAND RECEIPT / ANNEX NUMBERFor use of this form, see DA P AM 710-2-1.The proponent agency is ODCSLOG.

CIIC--Now known as the Controlled Inventory Item Code

User entriesA thru F

LINLine Item Number

NSN

On Hand Amount

Page Number

Page 6: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

Subhand ReceiptDA FORM 2062

* WHEN USED AS A: HAND RECEIPT, enter Hand Receipt Annex Number HAND RECEIPT FOR QUARTERS FURNITURE, enter Condition Codes

HAND RECEIPT ANNEX / COMPONENTS RECEIPT, enter Accounting Requirements Code (ARC) PAGE 1 OF 2 PAGE.

B67766 TM 9-1240-381-10 NOV 1977 1240-00-930-3833 Binoculars, M19A1 w/e SN: 2332, 2333, 2334, 2335 J EA 4 4

HAND RECEIPT / ANNEX NUMBERFor use of this form, see DA P AM 710-2-1.The proponent agency is ODCSLOG.

FROM: TO: HAND RECEIPT NUMBER

FORANNEX/CR ONLY

END ITEM STOCK NUMBER END ITEM DESCRIPTION PUBLICATION NUMBER PUBLICATION DATE QUANTITY

STOCK NUMBER ITEM DESCRIPTION SEC UI

QTYAUTH f. c. d. e.

g. QUANTITY

a. b. A B C D E F

A32355 TM 3-6665-225-12 AUG 1975 w/c 1-2

6665-01-105-5623 Alarm, Chemical Agent, Automatic, Manpack, M8A1 7 EA 2 2

*

SN: Serial Numbers and Registration Numbers

Page 7: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

Subhand ReceiptShortage Annex Number

** STOCK NUMBER ITEM DESCRIPTION SEC UI

QTYAUTH f. c. d. e.

g. QUANTITY

a. b. A B C D E F

R59160

3895-00-498-8343 Reeling Machine, Cable, Hand U EA 2 2 S01373 5810-00-434-3644 Speech, Security Equipment, TSEC/KY-57 9 EA 6 6

SN: 13579, 24680, 14702, 37159, 50501, 51627

PAGE 2 OF 2 PAGE.

Indicates that this major end item has component shortages.

T13168 TM 9-2350-264-10-HR DEC 1991

2350-01-087-1095 Tank, combat, F/T 120mm M1A1 SN: 1011, 1321 1 7 EA 4 4 1374, 1677

* WHEN USED AS A: HAND RECEIPT, enter Hand Receipt Annex Number

*Column c

Page 8: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

Subhand ReceiptSigning for Property

STOCK NUMBER ITEM DESCRIPTION SEC UI

QTYAUTH f. c. d. e.

g. QUANTITY*a. b. A B C D E F

PAGE 2 OF 2 PAGE.

You

r S

ugn

atu

re,2

Lt,1

6 M

ar19

XX

Signature

Page 9: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

ULLS-S4AUTOMATED SUBHAND RECEIPT

SUB-HAND RECEIPT ORGANIZATIONAL PROPERTY

PAGE 1 OF 2 09 / 14 / 9506 : 34 : 15

UIC / DESC : WHYNOT D CO. 1-61 AR

HAND RECEIPT FROM : HRH / CDR, D CO. 1-61 AR TO : D / 1-61 AR HAND RECEIPT NUMBER:

1ST PLATOON LEADER D1 GEN NOMENCLATURE AUTH O / H LIN SUBLIN STOCK NUMBER NSN NOMENCLATURE PUBLICATION AI CIIC UI QTY QTY REMARKS

A32355 ALARM CHEMICAL AGENT AUTOMATIC: PORTABLE MANPACK 2 6665-01-105-5623 ALARM CHEM AGT M8A1 TM 3-6652-225-12W / C3 7 EA 2 SER /REG NO NN4011-NN 4333/ NN4015-NN 4337/

C89070 CAMOUFLAGE SCREEN SUPPORT SYSTEM : WOODLAND / DESERT 2 8 1080-00-623-7295 CAM SCN WDLD / DST / PL NO DA PUB 7 EA 8

Annex Indicator AUTH &O/HQTY

Line Item Number

Page 10: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

DA FORM 2062Shortage Annex

• Nonexpendable (N) and Durable (D) component shortages.

• All component shortages less expendable consumables (includes other “X” items).

• Record shortages on hand receipt annex.

• Keep it current.

• Destroy when all shortages are filled.

Shortage Annex

Page 11: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

Shortage AnnexHAND RECEIPT / ANNEX NUMBER

For use of this form, see DA P AM 710-2-1.The proponent agency is ODCSLOG.

FROM: TO: HAND RECEIPT NUMBER

FORANNEX/CR ONLY

END ITEM STOCK NUMBER END ITEM DESCRIPTION PUBLICATION NUMBER PUBLICATION DATE QUANTITY

STOCK NUMBER ITEM DESCRIPTION

* WHEN USED AS A: HAND RECEIPT, enter Hand Receipt Annex Number

HAND RECEIPT FOR QUARTERS FURNITURE, enter Condition Codes 1 1 HAND RECEIPT ANNEX / COMPONENTS RECEIPT, enter Accounting Requirements Code (ARC) PAGE OF PAGES.

SEC UI

QTYAUTH f. c. d. e.

g. QUANTITY*a. b. A B C D E F

2350-01-087-1095 TANK, COMBAT F/T 120mm M1A1 TM 9-2350-264-10-2 w/c 1&2 Sept 1990 4

5110-00-293-2336 Ax, single bit, 4-lb D EA 2

16Mar98

ABR

COMMANDER Platoon Leader

C Co 2/15 Armor Bn 2nd Platoon, C Co 2/15 Armor Bn 2

MISSING COMPONENTS OF THEMAJOR END ITEM

Tank, M1A1

1015-01-258-0997 Testor, firing circuit X EA 2

3950-00-092-9064 Hoist, Chain, 1/2 ton N EA 1

CDR’s INITIALS

ARC CODE

NumberMissing

Page 12: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

ULLS-S4 AUTOMATEDShortage Annex

END ITEM STOCK NUMBER END ITEM DESCRIPTION PUBLICATION NUMBER PUB DATE QUANTITY 2350-01-087-1095 TANK, CBT F/ T 120MM, M1A1 TM 9-2350-264-10-2 01 SEP 98 4

SUB-HAND RECEIPT SHORTAGE ANNEX ORGANIZATIONAL PROPERTY

PAGE 1 OF 1 09 / 14 / 9507 : 15 : 16

UIC / DESC : WHYNOT / D CO. 1-61 AR ANNEX NUMBER FROM : D CO. 1-61 AR TO : D / 1-61 AR HAND RECEIPT NO:

3 3D PLATOON LEADER D3

C A I

C R I QTY QTY STOCK NUMBER ITEM DESCRIPTION T C C UI AUTH SH ORT REMARKS

3950-00-092-9064 HOIST, CHAIN, 1 / 2 - TON : MP10 B N J EA 4 1 ____ ___________ 4930-01-133-7143 GUN, HAND, LUBRICATING : 12312110 B X U EA 4 1 _______________

INITIALS__________________GRADE____________DATE__________

Cdr.'s INTIALS

AI

Implies from the Commander.

AMOUNT SHORT FROM 4 TANKS

ARC

Page 13: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

DA FORM 2062

Component Hand Receipt

• Lists components of end item or SKO issued to an individual.

• Use preprinted DA Form 2062 when available.

• Mandatory when property is issued to user.

• User has direct responsibility.

Page 14: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

DA FORM 2062

Component Hand Receipt

5820-00-892-0623 Receiver-Transmitter: RT-246/VRC (800581) N 7 EA 1 1

HAND RECEIPT / ANNEX NUMBERFor use of this form, see DA P AM 710-2-1.The proponent agency is ODCSLOG.

FROM: TO: HAND RECEIPT NUMBER

FORANNEX/CR ONLY

END ITEM STOCK NUMBER END ITEM DESCRIPTION PUBLICATION NUMBER PUBLICATION DATE QUANTITY

STOCK NUMBER ITEM DESCRIPTION

* WHEN USED AS A: HAND RECEIPT, enter Hand Receipt Annex Number HAND RECEIPT FOR QUARTERS FURNITURE, enter Condition Codes

HAND RECEIPT ANNEX / COMPONENTS RECEIPT, enter Accounting Requirements Code (ARC) PAGE 1 OF 2 PAGE.

SEC UI

QTYAUTH f. c. d. e.

g. QUANTITY*a. b. A B C D E F

5820-00-223-7412 Radio Set AN/VRC-12 TM 11-5820-401-10-2-HR JAN 1979 1

PLATOON LEADER

2nd Platoon, C Co 2/15 Armor SGT BILL A. TOY C-21

5820-00-892-0624 Receiver-Radio: R-442/VRC (80058) N 7 EA 1 1

5985-01-017-0785 Antenna Assembly (issued in lieu of AS-1729/VRC): X 7 EA 1 1

AS-2731/GRC *80058)

CONSISTING OF :

5985-01-017-0784 Antenna Element : AS-2732/GRC (80058) X 7 EA 1 1

5985-01-025-8892 Base, Matching Unit: MX-9146/GRC (80058) X 7 EA 1 1

5995-01-038-2203 Cable Assembly : CX-13055/GRC (80058) X 7 EA 1 1

LIN not Identified

ARC CODE

NSN

COL g. AAMOUNT ON HAND

Page 15: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

DA FORM 2062

Component Hand Receipt

STOCK NUMBER ITEM DESCRIPTION SEC UI

QTYAUTH f. c. d. e.

g. QUANTITY*a. b. A B C D E F

PAGE 2 OF 2 PAGE.B

ill A

. Toy

, SG

T,

,16

Mar

19X

X

Signature

Page 16: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

C A I

C R I QTY QUANTITY ON HAND STOCK NUMBER ITEM DESCRIPTION T C C UI AUTH A B C D E F

1080-00-107-8589 SCREEN , HEXAGON, WDLD, RADAR SCAR, TYII C N U EA 1 ______ ______ _ _____ ______ ______ ______ 1080-00-107-8589 SCREEN , HEXAGON, WDLD, RADAR SCAR, TYII C N U EA 1 ______ ______ _ _____ ______ ______ ______

1080-00-107-9206 SCREEN , D IAMOND, WDLD, RADAR SCAR, TYII C N U EA 1 ______ ______ _ _____ ______ ______ ______

SIGNATURE__________________________ GRADE__________ DATE________ (COLUMN A)

SIGNATURE__________________________ GRADE__________ DATE________ (COLUMN B)

SIGNATURE__________________________ GRADE__________ DATE________ (COLUMN C)

COMPONENT SUB-HAND RECEIPT PAGE: 1 OF 209 / 14 / 9506 : 33 : 28

END ITEM STOCK NUMBER END ITEM DESCRIPTION PUBLICATION NUMBER PUB DATE QUANTITY 1080-00-103-1246 SCREEN SYSTEM, CAMOUFLAGE, LTWT, WDLD, RADAR SCAT, TY II TM 5-1080-280-13 & P 01 JAN 87 ___1____

HAND RECEIPT FROM : TO : HAND RECEIPT NO :

ARCCOL g. AAMOUNT ON HAND

ULLS-S4 Component Hand Receipt

Page 17: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

DA FORM 3161

Change Document

• Use DA Form 3161.

• Issue and Turn-in Transactions between

Commander and SHR.

• Post Change Documents : Oldest Change document is Six Months Old. Before Change of HR / SHR. Before Change of PHRH Inventory.

• Destroy After Posting.

DA PAM 710-2-1, CH 5

Page 18: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

DA Form 3161 -- Issue

REQUEST FOR ISSUE OR TURN -IN

1. SEND TO : 5. DATE MATERIAL REQUIRED 6. DODAAC 7. PRIORITY 8. ACCOUNTING/FUNDING DATA

2. REQUEST FROM : 9. END ITEM IDENT 9a. NAME/MANUFACTURE 9b. MODEL 9c. SERIAL NO.

* CODE ISSUE TURN-INI - Initial FWT - Fair Wear and Tear EX - ExcessR - Replacement RS - Report of Survey SC - Stmt of

Charges

12. ITEM UNIT SUPPLY j. POSTED NO. STOCK NO. ITEM DESCRIPTION OF QUANTITY CODE * ACTION UNIT PRICE TOTAL COST

ISSUE DATE BY a b c d e f g h i

13. ISSUED / TURN- DATE BY 14. ISSUE QTY DATE BY 15 .REC QTY DATE BY IN “QUANTITY” IN “SUPPLY IN “ SUPPLY COLUMN IS ACTION” ACTION” REQUESTED COLUMN COLUMN

1 2590-00-148-7961 Cable Kit, Special Purpose EA 1 I 1

2 5120-00-264-3796 Wrench, Adj, 12-in long EA 1 I 1

////////////////////////////////////////////// NOTHING FOLLOWS /////////////////////////////////////////////////////////////////////////////////////////////

3 5120-00-293-336 Shovel, hand round point EA 1 I 0

4 1290-00-891-9999 Quadrant, Gunner’s, M1A1 EA 1 I 1

(DA PAM 710-2-1 ))

ISSUE SHEET NO. 3. REQUEST NO. 4. VOUCHER NO NO. SHEET TURN-IN

10.. PUBLICATION 11. JOB ORDER NO.

SHEET TOTAL GRAND TOTAL

X 1 1 Change Doc

15 May 19XX

15 May 19XX

W/case, SN: 966 CIIC 7

Actual QTY Received

Page 19: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

DA Form 3161 -- Turn In

(DA PAM 710-2-1 ))

REQUEST FOR ISSUE OR TURN -IN

ISSUE SHEET NO. 3. REQUEST NO. 4. VOUCHER NO NO. SHEET TURN-IN

1. SEND TO : 5. DATE MATERIAL REQUIRED 6. DODAAC 7. PRIORITY 8. ACCOUNTING/FUNDING DATA

2. REQUEST FROM : 9. END ITEM IDENT 9a. NAME/MANUFACTURE 9b. MODEL 9c. SERIAL NO.

* CODE ISSUE TURN-IN

I - Initial FWT - Fair Wear and Tear EX - ExcessR - Replacement RS - Report of Survey SC - Stmt of Charges

10. PUBLICATION 11. JOB ORDER NO.

12. ITEM UNIT SUPPLY j. POSTED NO. STOCK NO. ITEM DESCRIPTION OF QUANTITY CODE * ACTION UNIT PRICE TOTAL COST

ISSUE DATE BY a b c d e f g h i

13. ISSUED / TURN- DATE BY 14. ISSUE QTY DATE BY 15. REC QTY DATE BY IN “QUANTITY” IN “SUPPLY IN “ SUPPLY COLUMN IS ACTION” ACTION” REQUESTED COLUMN COLUMN

SHEET TOTAL GRAND TOTAL

X 1 1 Change Doc

1 1240-00-930-3833 Binoculars, M19A1 EA 1 FWT 1

2 5805-00-507-7722 Reel Equipment, CE-11 EA 1 FWT 1

1 Jun 19XX

1 Jun 19XX

////////////////////////////////////////////// NOTHING FOLLOWS ///////////////////////////////////////////////////////////////////////////////////////////////////////////////////

3 5110-00-595-8229 Cutter, Wire Rope EA 1 FWT 1

4 5120-01-052-5642 Puller and Pump, End EA 1 FWT 0 Connector

Page 20: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

DA Form 3161 -- Turn In

(DA PAM 710-2-1 ))

REQUEST FOR ISSUE OR TURN -IN

ISSUE SHEET NO. 3. REQUEST NO. 4. VOUCHER NO NO. SHEET TURN-IN

1. SEND TO : 5. DATE MATERIAL REQUIRED 6. DODAAC 7. PRIORITY 8. ACCOUNTING/FUNDING DATA

2. REQUEST FROM : 9. END ITEM IDENT 9a. NAME/MANUFACTURE 9b. MODEL 9c. SERIAL NO.

* CODE ISSUE TURN-IN

I - Initial FWT - Fair Wear and Tear EX - ExcessR - Replacement RS - Report of Survey SC - Stmt of

Charges

10. PUBLICATION 11. JOB ORDER NO.

12. ITEM UNIT SUPPLY j. POSTED NO. STOCK NO. ITEM DESCRIPTION OF QUANTITY CODE * ACTION UNIT PRICE TOTAL COST

ISSUE DATE BY a b c d e f g h i

13. ISSUED / TURN- DATE BY 14. ISSUE QTY DATE BY 15. REC QTY DATE BY IN “QUANTITY” IN “SUPPLY IN “ SUPPLY COLUMN IS ACTION” CTION” REQUESTED COLUMN COLUMN

SHEET TOTAL GRAND TOTAL

X 1 1 Change Doc

1 1240-00-930-3833 Binoculars, M19A1 EA 1 FWT 1

2 5805-00-507-7722 Reel Equipment, CE-11 EA 1 FWT 1

1 Jun 19XX

1 Jun 19XX

////////////////////////////////////////////// NOTHING FOLLOWS /////////////////////////////////////////////////////////////////////////////////////////////////////////////

3 5110-00-595-8229 Cutter, Wire Rope EA 1 FWT 1

4 5120-01-052-5642 Puller and Pump, End EA 1 FWT 0 Connector

Page 21: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

• Property is Issued or Loaned for < 30 days.

• Use DA Form 3161.

• Notify HR Holder to Return Property

5 DAYS PRIOR to Expiration.

• Destroy ALL Copies when Property is

Returned.

TEMPORARY HAND RECEIPTDA Form 3161

Page 22: 720th Military Police Battalion Gauntlet 401ST MILITARY POLICE COMPANY Supply Actions and Forms 1LT Alexis Marks

720th Military Police Battalion720th Military Police BattalionGauntletGauntlet

DA Form 3161Temporary Hand Receipt

(DA PAM 710-2-1 ))

REQUEST FOR ISSUE OR TURN -IN

ISSUE SHEET NO. 3. REQUEST NO. 4. VOUCHER NO NO. SHEET TURN-IN

1. SEND TO : 5. DATE MATERIAL REQUIRED 6. DODAAC 7. PRIORITY 8. ACCOUNTING/FUNDING DATA

2. REQUEST FROM : 9. END ITEM IDENT 9a. NAME/MANUFACTURE 9b. MODEL 9c. SERIAL NO.

* CODE ISSUE TURN-IN

I - Initial FWT - Fair Wear and Tear EX - ExcessR - Replacement RS - Report of Survey SC - Stmt of Charges

10.. PUBLICATION 11. JOB ORDER NO.

12. ITEM UNIT SUPPLY j. POSTED NO. STOCK NO. ITEM DESCRIPTION OF QUANTITY CODE * ACTION UNIT PRICE TOTAL COST

ISSUE DATE BY a b c d e f g h i

13. ISSUED / TURN- DATE BY 14. ISSUE QTY DATE BY 15. REC QTY DATE BY IN “QUANTITY” IN “SUPPLY IN “ SUPPLY COLUMN IS ACTION” ACTION” REQUESTED COLUMN COLUMN

SHEET TOTAL GRAND TOTAL

X 1 1 TEMPORARY HAND RECEIPT

1 5120-00-221-7983 Wrench Torque : 3/4-inch EA 1 I 1

28 Jul 19XX 28 Jul 19XX

////////////////////////////////////////////// NOTHING FOLLOWS /////////////////////////////////////////////////////////////////////////////////////////////////////////

Sq. Male Dr 600 ft-lb, SN: 91827

Put Unit location and PhoneSomewhere on this form !