Lesson 3/Learning Event 4
Block 4. Leave this block blank.
Block 5. Enter the item model number.
Block 6. Enter the NSN of equipment listed in block 3. When completing this form for multiple
items having a multiple NSN, leave blank.
Block 7. Enter the name of the supporting activity.
Block 7a. Enter the symbol of the maintenance category performing the maintenance. Enter the
letter" O" for organizational maintenance and "F" for direct support maintenance. You will most
often deal with direct support maintenance. In the event that you need to request repairs from a
higher level of maintenance, enter the letter "H" for general support maintenance, and "L" for
special repair activity.
Block 8. Obtain the appropriate utilization code from unit supply personnel, and enter it in this
block.
Blocks 9, 9a, and 9b. Obtain the information to fill in these blocks from unit supply personnel.
Block 10. Enter the hour reading (rounded to the nearest hour) from the hour meter mounted on
the equipment. If not applicable, leave blank.
Block 11. Enter the mileage reading (rounded to the nearest mile) of the equipment. If not
applicable, leave blank.
Block 12. Leave blank for NBC equipment.
Block 13. Leave blank for NBC equipment.
Block 14. Enter a check mark or an "x" in the space provided to indicate when the failure was
detected. Leave blank if no failure is involved.
Block 15. Place a check mark or an "x" in the space provided that most accurately describes the
conditions at the time of the first indication of trouble. For "other", place a check mark or "x" in
the space provided, and enter a code number selected from the following codes: Intermittent,
360; unstable, 680; mid-service life, 777. For still other conditions, use 099 in the "other" block
with a description in the remarks section.
Block 16. Utilizing the information contained in column C, DA Form 2404, describe briefly and
clearly the fault or symptoms requiring correction (for example, "Engine does not develop full
power," or" Cannot zero meter"'). Do not request general or specific repair or replacements,
such as "Replace Geiger-Mueller tube," or "Repair as needed."
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