TB 1-2840-248-20-2
(h) Preparation Instructions For Completion of Copy 3 of a DA Form 2410 For Changes From
Serviceable To Unserviceable Uninstalled Items (Figure 6).
NOTE: Copy 3 section I - Identification, block 10. Line out the old failure code and enter the failure code or
removal/achievement code that best describes why the item is being returned as an unserviceable item.
SECTION IV--INSTALLATION/LOSS
Block 41. Installed on (nomen nha). Enter the word damaged or uninstalled.
Blocks 42 through 51. Leave these blocks blank.
Block 52. Date installed. Enter the julian date that the item became unserviceable.
Block 53. UIC (this action). Enter the unit identification code for the activity that has the item listed in block
1. If a contractor enter the CAGE code prefixed with a "K."
Block 54. Manhrs (to install). Leave this block blank.
Block 55. Signature and telephone number. The person who verifies entries in section IV will sign in this
block and enter their telephone number (DSN/AUTOVON or commercial)
Block 56. New - NSN/PN/SN. Leave this block blank.
Block 36. Inspection and action codes. If the change in serviceability status resulted from the publication of
an urgent MWO, enter "C" in the small box in front of the (C) MWO due block. If the serviceability status
changed because of damage, place a "B" in the small box in front of the (B) unserv block also cross out entries
in other blocks. If the "B" and "C" codes both apply, or an urgent MWO includes an NSN change, enter only
NOTE: When copy 3 of the original DA Form 2410 is completed, initiate a new DA Form 2410. Do not change
the control number of the new form.
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