SECTION IV--INSTALLATION/LOSS DATA

TB 1-2840-248-20-2

n) Preparation Instructions For Completion of Copy 3 of DA Form 2410 For loss to the Army

inventory (Figure 12). Normally copy 2 and 3 will be with the uninstalled item, complete copy 3 and

discard copy 2.

SECTION IV--INSTALLATION/LOSS DATA

Blocks 41 through 51 Leave these blocks blank.

Block 52. Date installed. Enter the julian date that the item in block 1 was lost to the Army inventory.

Block 53. UIC (this action). Identify the organization or activity reporting the loss, if it is a contractor enter

the proper CAGE code prefixed with a "K".

Block 54. Manhrs (to install). Leave this block blank.

Block 55. Signature and telephone number. Enter the signature and telephone number of the person

verifying that the part is a loss to the Army inventory.

Block 56. New - NSN/PN/SN. Leave blank.

Block 36. Inspection & action codes. Enter the appropriate letter in the small block, for example, "A" for

serviceable, "B" for unserviceable, and so on.

Block 57. Reason for loss. Enter the reason for loss code that best describes the reason for the loss. (Refer

to Table 1-15 of DA Pamphlet 738-751)

Block 58. UIC (Received from). Leave this block blank.

Block 59. Shipped to. Enter the name of the DRMO, service, agency, department, or Military Assistance

Program (MAP) country to whom shipped.

Block 60 Location. Enter the address of the activity identified in block 59.

Block 61. UIC. Enter the unit identification code for the activity listed in block 59, if it is a contractor enter the

proper CAGE code prefixed with a "K."

Block 62. Date shipped. Enter the julian date that the item was shipped. Remarks block. If the item in

block 1 is being shipped to DRMO, enter the mutilation statement required by TM 1-1500-328-23. The

statement must be entered verbatim from TM 1-1500-328-23. Sign and date the mutilation statement.

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