CALIBRATION AND REPAIR REQUIREMENTS WORKSHEET

For use of this form, see TB 750-25, the proponent agency is USAMC

1. FROM (Customer Address)  
2. DATE (YYYYMMDD)  
3. REQUESTED ACTION  



4a. REQUESTOR'S NAME  
4b. PERSONNEL TYPE  
4c. REQUESTOR'S ORGANIZATION / UIC  
4d. REQUESTOR'S EMAIL ADDRESS    
4e. REQUESTOR'S PHONE NUMBER    
5a. ALTERNATIVE POC NAME  
5b. PERSONNEL TYPE  
5c. ALTERNATE'S ORGANIZATION / UIC  
5d. ALTERNATE'S EMAIL ADDRESS    
5e. ALTERNATE'S PHONE NUMBER    

ITEM INFORMATION

6. NATIONAL STOCK NUMBER  
7. MANUFACTURER  
8. MODEL NUMBER  
9. ITEM DESCRIPTION  
10. DID A PEO / PD AUTHORIZE THIS PURCHASE?  

a. If yes, what organization purchased and fielded this item?


b. If no, what organization authorized purchase?
11. WAS THE PREFERRED ITEMS LIST (PIL) CHECKED BEFORE PURCHASING THIS ITEM?  

12. WHAT WEAPON SYSTEM / PLATFORM WILL THE ITEM BE USED FOR?
13. LOCATION(S) THIS ITEM WILL BE FIELDED TO?
14. QUANTITY OF ITEMS ORDERED / FIELDED?
15. DO YOU HAVE CALIBRATION PROCEDURES AND OEM MANUALS?  
16. IS THIS ITEM IN THE TB 43-180?  

17. REMARKS

Enter the characters in the textbox exactly as they appear below:

You will be directed to a success page upon a successful submission. If you do not arrive at that page after clicking the submit button then your request has not been submitted.