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Use to provide data required to request establishment of a temporary cemetery and special burial procedures/ceremonies. Reference: FM 10-296.

LINE 1 -- DATE AND TIME______________________________(DTG)

LINE 2 -- UNIT________________________________________(Unit Making Report)

LINE 3 -- REQUESTING AGENCY________________________(Identification of the Component/ Unit Making the Request)

LINE 4 -- COORDINATES_______________________________(UTM or Six-Digit Grid Coordinate With MGRS Grid Zone Designator of the Requesting Unit)

LINE 5 -- SITE JUSTIFICATION__________________________(Reason a Temporary Burial Site is Necessary)

LINE 6 -- FEATURE ____________________________________(Prominent Terrain Feature of the Proposed Site)

LINE 7 -- COORDINATES_______________________________(UTM or Six-Digit Grid Coordinate With MGRS Grid Zone Designator of the Area Containing the Features Listed in the Preceding Line)

LINE 8 -- NAME_______________________________________(Cemetery Name or Title)

LINE 9 -- GRADIENT___________________________________(Relative Terrain Gradient (GENTLY ROLLING, MODERATE, STEEP, or VERY STEEP)

LINE 10 -- DRAINAGE__________________________________(Type of Drainage (NATURAL, MAN-MADE, or NONE)

LINE 11 -- SOIL _______________________________________(Type of Soil)

LINE 12 -- LAND USE __________________________________(Current Use of the Land)

LINE 13 -- ROAD NUMBER______________________________(Access Road Number)

LINE 14 -- ROAD NAME ________________________________(Name of Access Road to Cemetery Site)

LINE 15 -- ROAD SURFACE _____________________________(Type of Surface on Access Road)

LINE 16 -- VEGETATION________________________________(Type of Vegetation)

LINE 17 -- LOCAL LABOR_______________________________(Number of Local Laborers Available)

LINE 18 -- EQUIPMENT_________________________________(Type, Name, or Nomenclature of Available Cemetery Equipment)

LINE 19 -- BURIAL TYPE________________________________(Type of Special Burial Procedure/Ceremony Requested)

LINE 20 -- PERSONNEL QUANTITY AND CLASS___________(Quantity and Classification of Remains (Military and Whether US, Allied, or Enemy))

**Transmit lines 19 and 20 for a special burial request.

**Repeat lines 19 through 20 to request multiple types of special burial procedures/ceremonies. Assign sequential line numbers to succeeding iterations; for example, first iteration 19 through 20; second iteration 19a through 20a; third iteration 19b through 20b; and so on.

LINE 21 -- BURIAL JUSTIFICATION______________________(Reason for Requesting Mass Burial)

LINE 22 -- NARRATIVE_________________________________(Free Text for Additional Information Required for Clarification of Report)

LINE 23 -- AUTHENTICATION___________________________(Report Authentication)