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Use (1) to request explosive ordinance disposal (EOD) support, (2) to report the results of an EOD mission, or (3) to request EOD support to protect designated very important persons. Reference: FM 9-15.

LINE 1 — DATE AND TIME______________________________(DTG)

LINE 2 — UNIT________________________________________(Unit Making Report)

LINE 3 — ACTIVITY____________________________________(Type of EOD Activity the Report Concerns: Either EOD REQUEST, EOD RESPONSE, or VIP REQUEST)

LINE 4 — REQUESTOR _________________________________(Identifier of Unit/Agency Requesting EOD Support)

LINE 5 — EOD UNIT____________________________________(Identifier of Unit/Agency Performing the EOD Mission)

LINE 6 — CATEGORY___________________________________(EOD Incident Category Assigned by Requestor; Either INDIRECT, IMMEDIATE, MINOR, or NONE)

LINE 7 — DISCOVERED_________________________________(DTG Zone When the Unexploded Ordnance Was Discovered)

LINE 8 — DESCRIPTION________________________________(If Applicable, Any Additional Descriptive Information Related to the Threat Posed to Resources and Facilities by Unexploded Ordnance)

LINE 9 — ORDNANCE__________________________________(Number, Type, and Location of Unexploded Ordnance to be Neutralized; Repeat, as Required)

LINE 10 — CONDITION_________________________________(Either ARMED or UNARMED)

LINE 11 — SITUATION _________________________________(Either DROPPED, IN FIRE, UNDERWATER, ACCIDENT, or a Literal Description of the Circumstances Surrounding the Incident)

**Lines 6 through 11 are applicable if the report is a request for explosive ordnance neutralization.

LINE 12 — REPORTED__________________________________(DTG Zone When EOD Incident Was Reported)

LINE 13 — EOD TEAM TIME OF ARRIVAL_________________(DTG Zone When EOD Team Arrived)

LINE 14 — COMPLETED_________________________________(DTG Zone When EOD Action Completed)

LINE 15 — EOD ACTION TAKEN_________________________(Disposition, Condition, Situation, or Other Information Concerning EOD Action Taken)

**Lines 12 through 15 are applicable if the report contains the results of an EOD mission.

LINE 16 — PROTECT___________________________________(Title and Last Name of Individual to be Protected)

LINE 17 — NO. OF PERSONNEL_________________________(Number of EOD Personnel Required for Mission)

LINE 18 — DEPART_____________________________________(Departure Point Name or Coordinates)

LINE 19 — TRANSPORTATION __________________________(Transportation Mode(s) of VIP During Support Period)

LINE 20 — COUNTRIES/AREAS__________________________(Countries/Areas in Which Support is Required)

**Repeat lines 17 through 20 to indicate the number of personnel required, departure point, VIP transportation mode, and country/area requiring support. Assign repetitions in succeeding iterations sequential line numbers; for example, first iteration 17 through 20; second iteration 17a through 20a; third iteration 17b through 20b, and so on.

LINE 21 — BEGIN______________________________________(DTG to Begin Zone VIP Support)

LINE 22 — END________________________________________(DTG to End Zone VIP Support)

**Repeat lines 21 and 22 to indicate the time VIP support is to begin and end. Assign sequential line numbers to succeeding iterations; for example, first iteration 21 through 22; second iteration 21a through 22a; third iteration 21b through 22b, and so on.

LINE 23 — POC________________________________________(Title and Last Name of Individual Designated as the Requesting Unit’s POC for Coordinating EOD VIP Support)

LINE 24 — TELEPHONE_________________________________(Telephone Number of POC)

LINE 25 — FREQUENCY ________________________________(Primary Radio Frequency of Unit/Agency Requiring EOD Support)

LINE 26 — LOCATION__________________________________(UTM or Six-Digit Grid Coordinate With MGRS Grid Zone Designator) of POC)

**Lines 16 through 26 are applicable if report is a VIP EOD support request.

**Lines 23 through 26 are applicable if a POC has been designated by the unit requesting VIP EOD protection support.

LINE 27 — SPECIAL REQUIREMENTS_____________________(Statement of Any Special Requirements for EOD Support Mission)

LINE 28 — NARRATIVE_________________________________(Free Text for Additional Information Required for Clarification of Report)

LINE 29 — AUTHENTICATION___________________________(Report Authentication)

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