TB 1-2840-248-20-2
Block 32. Date checked. Enter the julian date that the item listed in block 1 was declared serviceable by the
manufacturer/contractor or the item was accepted into the Army inventory by the receiving unit.
Block 33. Signature and telephone number. Enter the signature and telephone number of the
manufacturer's/contractor's representative declaring the item serviceable. Acceptance into the Army inventory
is via DD Form 250 (Material Inspection and Receiving Report). Army units receiving items without DA Form
2410 will fill out the forms and sign in this block as gained in the Army inventory. Also related information on
the item and origin of shipment will be provided to ATCOM, ATTN: AMSAT-I-MDO.
Block 34. UIC (this action). Enter the Unit Identification Code for the organization taking this action. If a
contractor, enter the CAGE code prefixed with a "K."
Block 35. Manhours to repair/overhaul. Leave this block blank.
Block 36. Inspection and action code. Enter an "A" in the small block next to serviceable or appropriate
letter in other blocks as it applies. Do not use check marks.
Block 37. Reason for gain. Enter "A" for new manufactured items, or other codes from Table 1-16 which
best describes the reason for gain.
Block 38. Maintenance level. Leave this block blank.
Block 39. UIC (shipped to). Leave this block blank.
Block 40. Actual failure code. Leave this block blank.
Remarks block. Enter the contract number that the item in block 1 was procured through. Provide any
information not considered routine.
SECTION IV--INSTALLATION/LOSS Copy 3.
36. Inspection & action code. Enter an "A" in the block next to serv.
NOTE: Mail Copy 2 to USAATCOM. Copy 3 remains with the item entered in block 1 until installation.
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