SECTION I--IDENTIFICATION - TB-1-2840-248-20-20024

TB 1-2840-248-20-2

(i) Preparation Instructions For Completion of Copy 1 of a DA Form 2410 For Changes From

Serviceable To Unserviceable Uninstalled Item (Identification and Removal Data) (Figure 7).

SECTION I--IDENTIFICATION

Blocks 1 through 13. Complete these blocks, using the data from Copy 3 of the original DA Form 2410.

SECTION II--REMOVAL DATA

Block 14 Removed from (nomen NHA). Enter the word uninstalled or damaged.

Blocks 15 through 24. Leave these blocks blank.

Block 25. Date removed. Enter the julian date when the item was discovered unserviceable. Take this julian

date from block 52 (Copy 3) of the original DA Form 2410.

Block 26. UIC (this action). Enter the unit identification code for the activity that determined the

component/module is unserviceable. Commercial activities will enter "K," plus assigned CAGE code.

Block 27. Manhours (to Remove). Leave this block blank.

Block 28. UIC (shipped to). Enter the unit identification code for the unit the part is shipped to. If unknown

leave blank.

Block 29. Signature and telephone number. The person verifying the proper completion of the DA Form

2410 and other related forms will sign their signature and enter their telephone number (DSN/AUTOVON

or commercial).

Block 30. Malfunction code. Leave this block blank.

Block 31. When discovered. Leave this block blank.

Remarks block. Enter any additional information that could be helpful in the repair of the item, or the cause of

the damage.

NOTE: Attach copy 1 to copy 3 of the old DA Form 2410 and mail to USAATCOM. Copies 2 and 3 will

accompany the unserviceable item.

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