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Use to provide a timely and accurate estimate of damage resulting from the application of military force, either lethal or non-lethal, against a predetermined objective. Reference: FM 9-43-1.

LINE 1 — DATE AND TIME______________________________(DTG)

LINE 2 — UNIT________________________________________(Unit Making Report)

LINE 3 — NAME_______________________________________(Target or Installation Name)

LINE 4 — COUNTRY CODE______________________________(Two-Letter Country Code)

LINE 5 — BEN_________________________________________(Basic Encyclopedia Number, NA or UNKNOWN)

LINE 6 — LOCATION___________________________________(UTM or Six-Digit Grid Coordinate With MGRS Grid Zone Designator)

LINE 7 — TM REF______________________________________(Target Material Reference)

LINE 8 — PAGE NO.____________________________________(Page or Sheet Number)

LINE 9 — COLLECTION DATE/TIME______________________(IMINT Collection DTG)

LINE 10 — TYPE_______________________________________(Type of IMINT)

LINE 11 — QUALITY___________________________________(Image Quality — GOOD/FAIR/POOR)

LINE 12 — ANGLE_____________________________________(Viewing Angle — VERTICAL or OBLIQUE)

LINE 13 — TOT________________________________________(Time Over Target for Attack DTG)

LINE 14 — DELIVERY SYSTEM__________________________(Number and Type of Delivery System)

LINE 15 — WEAPONS__________________________________(Number and Type of Weapons and Fusing)

LINE 16 — AIM POINT NAME___________________________(Name or Description of Target Element)

LINE 17 — LOCATION__________________________________(UTM or Six-Digit Grid Coordinate With MGRS Grid Zone Designator)

**Repeat lines 13 through 17 for multiple missions or sets of mission data. Assign sequential lines to succeeding iterations; for example, first iteration 13 through 17; second iteration 13a through 17a; third iteration 13b through 17b; and so on.

LINE 18 — BDA ANALYSIS______________________________(Narrative of Target Damage and Munitions Effects toInclude: Element Name, Grid Reference, Physical Damage, Confidence Level, and Whether Reattack is Required)

LINE 19 — NARRATIVE_________________________________(Free Text for Additional Information Required for Clarification of Report

LINE 20 — AUTHENTICATION___________________________(Report Authentication)

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