LINE 1 -- DATE AND TIME______________________________(DTG)
LINE 2 -- UNIT________________________________________(Unit Making Report)
LINE 3 -- FROM_______________________________________(DTG for the Beginning of Period Applying to Personnel Information)
LINE 4 -- TO__________________________________________(DTG for the End of Report Period)
LINE 5 -- UNIT ________________________________________(Designation of the Unit for Which the Personnel Status Information is Being Submitted)
LINE 6 -- AUTHORIZED_________________________________(Number of Personnel Authorized by Personnel Classification)
LINE 7 -- ASSIGNED ___________________________________(Number of Personnel Assigned by Personnel Classification)
LINE 8 -- ON HAND____________________________________(Number of Personnel Authorized by Personnel Classification)
LINE 9 -- GAINS_______________________________________(Number of Personnel Gains by Personnel Classification)
LINE 10 -- REPLACEMENTS_____________________________(Number of Personnel Gained That Are Replacements by Personnel Classification)
LINE 11 -- RETURNED TO DUTY_________________________(Number of Personnel Gained That Have Been Returned to Duty Through Medical Channels by Personnel Classification)
LINE 12 -- KILLED_____________________________________(Number of KIA by Personnel Classification)
LINE 13 -- WOUNDED__________________________________(Number of WIA by Personnel Classification)
LINE 14 -- NONBATTLE LOSS___________________________(Number of Disease Nonbattle Injury Loss by Personnel Classification)
LINE 15 -- MISSING____________________________________(Number of MIA by Personnel Classification)
LINE 16 -- DESERTERS_________________________________(Number of Deserters by Personnel Classification)
LINE 17 -- AWOL______________________________________(Number Absent Without Leave by Personnel
Classification)
LINE 18 -- CAPTURED__________________________________(Number of Enemy Personnel Captured Duringthe Reporting Period)
**Repeat lines 5 through 18 to indicate the personnel summary of additional units. Assign sequential line numbers to succeeding iterations; for example, first iteration 5 through 18; second iteration 5a through 18a; third iteration 5b through 18b, and so on.
LINE 19 -- NARRATIVE_________________________________(Free Text for Additional Information Required for Clarification of Report)
LINE 20 -- AUTHENTICATION___________________________(Report Authentication)