TB 5-6115-585-23-1
Print the
(6)
NOUN
NOMENCLATURE.
(12)
DEFICIENCY
OR
SYMPTOM.
Briefly
describe the problem.
noun abbreviation of the item to be exchanged.
(7) PD. Enter the priority designator (PD)
(13) DATED ACCEPTED. When the form is
that applies to the action. The unit or organ-
used as a receipt, the support unit will enter
the Julian date.
ization listed in Block 3 normally assigns the
PD. When the form supports a customer main-
tenance request, use the PD of the mainte-
(14) SIGNATURE. The person who receives
nance request.
the item signs.
(8) PD AUTHENTICATION.
Print the word "Yes" for an
(15) NMCS.
NMC condition.
The commander or the designated
a.
representative signs when a PD of 01 through
(16) JON. The facility that will repair the
10 is in Block 7.
item enters the job order number.
For war-
rarity claims actions, use the control number
instead of the JON.
b. Enter the job order number when a PD
of 01 through 10 is taken from a maintenance
request.
The person receiving the
(17) INITIALS.
item for repair initials in this block.
(9) END ITEM NOMENCLATURE. Enter the
noun abbreviation of the end item for the part
The person doing
(18) DATE REPAIRED.
or component in Block 6.
the work enters the date the work was fin-
ished.
(10) MODEL.
Enter the model number of
the end item.
(19) INITIALS. The person doing the work
initials in this block.
Enter the serial number
(11) SERIAL NO.
of the end item.
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