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UESTED BY 13b. DATE (YYYYMMDD) 13c. SIGNATURE 14a. APPROVED BY 14b. DATE (YYYYMMDD) 14c. SIGNATURE 19. UI 20. QTY REQUESTED/ TURNED IN 21. TEC 22. ACTION CODE 23. QTY ISSUED/ RECEIVED 24. LOT/SERIAL NO. 25. CC 29. 30c. DATE 31a. RECEIVED BY (YYYYMMDD) 30b. SIGNATURE 6. FOR LOCAL USE OF 9. DATE MATERIEL REQUIRED (YYYYMMDD) REMARKS 30a. ISSUED BY 5. PAGE 2. TURN-IN For use of this form, see AR 710-2; the proponent agency is DCS, G-4. 7. SEND TO 3. DOCUMENT NO. 1. ISSUE 1.

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