Attachment 0015 TE 6.7_ASC CCIR format.docx

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Worldwide Laboratory Operations - W31P4Q-21-R-0059
Solicitation number
W31P4Q
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Attachment 0002 GFP.pdf PDF
Attachment 0012 TE 6.5_Laboratory Personnel Staffing Requirements.pdf PDF
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DEPARTMENT OF THE ARMY

R

Army Sustainment Command (ASC) Rock Island, Illinois 61299-6500

EPLY TO ATTENTION OF

Type (Initial/Follow Up/Final): Initial Date Time Group

1: ASC CCIR Number w/ Description: CCIR #1: Death, Capture, Missing in Action or Serious Injury Resulting Loss or Potential Loss of Life, Limb or Eyesight of any ASC Personnel (Soldier DAC, or Contractor)

2: Type of Incident:

3: Date/Time Group (DTG) of Incident:

4: Location:

5: Personnel Involved:

(a) Subject Name:
(b) Rank or Grade:

(c) Title/Position:

(d) Security Clearance:
(e) Unit/Organization and Location:

(f) Duty Status:

6: Summary of Incident/Event:

7. Remarks: NA

8: Publicity: NA

9: Official Reporting:

10: POC:

Released By: DSN:

ASC Format (ANNEX R to ASV OPORD 002-17) image1.jpeg image2.jpeg

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