LINE 1 -- DATE AND TIME______________________________(DTG)
LINE 2 -- UNIT________________________________________(Unit Making Report)
LINE 3 -- REQUEST TYPE_______________________________(Update, Forecast, or Request)
LINE 4 -- MATERIALS__________________________________(Type) a) Pickets
__________________________________________________________ b) Wire
__________________________________________________________ c) Sand Bags
__________________________________________________________ d) Wood Type/Size
LINE 5 -- QTY OH______________________________________(Specify)
**Repeat as Required
LINE 6 -- QTY REQ_____________________________________(Required Quantity)
**Repeat as Required
LINE 7 -- UOM________________________________________(Unit of Measurement Times Number Requested)
LINE 8 -- MOR________________________________________(Method of Resupply Requested (Aerial, LOGPAC))
LINE 9 -- LOCATION___________________________________(UTM or Six-Digit Grid Coordinate With MGRS Grid Zone Designator) to Class IV Supply Point or LRP)
LINE 10 -- NLT TIME___________________________________(Time Limit For Class IV to Arrive at Supply Point)
LINE 11 -- NARRATIVE_________________________________(Free Text for Additional Information Required for Clarification of Report
LINE 12 -- AUTHENTICATION___________________________(Report Authentication)