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Use to provide timely reports of close, air-support missions and other information obtained during post-flight aircrew debriefing. Reference: FM 6-71.

LINE 1 — DATE AND TIME______________________________(DTG)

LINE 2 — UNIT________________________________________(Unit Making Report)

LINE 3 — NO. CAS MSN________________________________(Mission Number for First Mission of the Period and All Remaining Missions)

LINE 4 — NO. AND TYPE ACFT__________________________(Number and Type of Aircraft Used)

LINE 5 — SIGHTINGS __________________________________(Information on Enemy Aircraft and Ground Targets Sighted During Ingress and Egress; Include Location, Direction, Type, Numbers)

LINE 6 — TARGET AREA LOCATION_____________________(UTM or Six-Digit Grid Coordinate With MGRS Grid Zone Designator of Target)

LINE 7 — TARGET RESULTS_____________________________(Type and Quantity of Targets Sighted, Destroyed, or Damaged in the Target Area)

LINE 8 — TARGET DEFENSE_____________________________(Type, Quantity, and Location of Target Area Defense)

LINE 9 — TARGET WEATHER____________________________(Include Low Cloud Cover, Height of Low Cloud Base, Surface Visibility, and the General Weather Condition)

LINE 10 — TARGET AREA JAMMING _____________________(Include Type of Jamming Frequencies Jammed, Time Period of Jamming Electronic Protection Action Used, and Effectiveness of Electronic Protection Action Used)

**Repeat lines 3 through 10 to report more than one CAS mission in a report period. Repeat lines 6 through 10 to report more than one target area within a CAS mission. Assign sequential line numbers to succeeding iterations; for example, first iteration 3 through 10 or 6 through 10; second iteration 3a through 10a or 6a through 10a; and so on.

LINE 11 — ORDNANCE_________________________________(Type and Quantity Expended During Reporting Period)

LINE 12 — NARRATIVE_________________________________(Free Text for Additional Information Required for Clarification of Report

LINE 13 — AUTHENTICATION___________________________(Report Authentication)