Attch V - AF 522.pdf

PDF 2 MB Posted Aug 7, 2020

Attached to: Radio Frequency Identification System Commercial Solutions Opening Federal contract opportunity
Solicitation number: FA2487-20-S-C028
Issued by: Department of the Air Force Materiel Command Test Center

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Topic EAFB-003 - LRS Warehouse RFID (V1).pdf	PDF	Aug 23, 2020
Eglin CSO (FA2487-20-S-C028) (V4).pdf	PDF	Aug 23, 2020
Topic EAFB-002 - LRS RFID (V2).pdf	PDF	Aug 23, 2020
Eglin CSO (FA2487-20-S-C028) (V3).pdf	PDF	Aug 20, 2020
Eglin CSO (FA2487-20-S-C028) (V2).pdf	PDF	Aug 12, 2020
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USAF GROUND WEAPONS TRAINING DATA

PRIVACY ACT STATEMENT

LAST NAME

FIRST NAME

MIDDLE INITIAL

RANK

DoD ID

ORGANIZATION

OFFICE SYMBOL

BASE

DSN NUMBER

ARMING GROUP

PRIMARY DUTY WEAPON

DSN NUMBER

COMBAT ARMS E-MAIL ADDRESS (Optional)

STATUS

DATE

TRAINED

WEAPON

COURSE

ROUNDS

FIRED

DATE

EXPIRES

PRINTED NAME AND RANK OF INSTRUCTOR

SCORE

INSTRUCTOR'S SIGNATURE

STATUS

DATE

TRAINED

WEAPON

COURSE

ROUNDS

FIRED

DATE

EXPIRES

PRINTED NAME AND RANK OF INSTRUCTOR

SCORE

INSTRUCTOR'S SIGNATURE

STATUS

DATE

TRAINED

WEAPON

COURSE

ROUNDS

FIRED

DATE

EXPIRES

PRINTED NAME AND RANK OF INSTRUCTOR

SCORE

INSTRUCTOR'S SIGNATURE

STATUS

DATE

TRAINED

WEAPON

COURSE

ROUNDS

FIRED

DATE

EXPIRES

PRINTED NAME AND RANK OF INSTRUCTOR

SCORE

INSTRUCTOR'S SIGNATURE

STATUS

DATE

TRAINED

WEAPON

COURSE

ROUNDS

FIRED

DATE

EXPIRES

PRINTED NAME AND RANK OF INSTRUCTOR

SCORE

INSTRUCTOR'S SIGNATURE

AF Form 522, 20190724, AFI 36-2654

PREVIOUS EDITIONS ARE OBSOLETE.

SCORE

DATE

EXPIRES

STATUS

ROUNDS

FIRED

WEAPON

COURSE

DATE

TRAINED

INSTRUCTOR'S SIGNATURE

PRINTED NAME AND RANK OF INSTRUCTOR

COMBAT ARMS SECTION

AUTHORITY: 10 U.S.C. 9013, Secretary of the Air Force, 10 U.S.C. 9831, Custody of Departmental Records and Property, DoDI 5200.02, DoD Personnel Security Program and AFI 36-2654, Combat Arms Program

PRINCIPAL PURPOSE(S): Used to record results of small arms qualification training. Serves as the official source document for proof of firearms qualification when the Automated Readiness Information System (ARIS) is not available.

ROUTINE USE(S): Used to verify small arms qualification training and expiration for US Air Force personnel.

DISCLOSURE: Voluntary, however DoD ID may be used by arming authority officials to positively identify the individual for suitability to bear firearms.

Failure to provide information may result in the inability for arming authority to identify individual for suitability to bear firearms.

SYSTEM OF RECORDS NOTICE: F032 AF CE G, Automated Civil Engineer System Records (June 23, 2011, 76, FR, 36903) available at https:// dpcld.defense.gov/privacy/SORNS.aspx.

8.2.1.3158.1.475346.466429 rolland.roth@us.af.mil 12 Aug 16 Combat Arms Policy USAF Ground Weapons Training Data

HQ USAF/A4SX

AF522

Student's last name.:

Student's first name.:

Student's middle initial or "NMI" (if no middle name).:

Student's unit of assignment.:

Student's office symbol.:

Student's work DSN number.:

Select student's arming group.:

Student's primary duty weapon.:

DSN number of Combat Arms section that accomplished current training.:

Email address (workgroup preferred) of Combat Arms section that accomplished current training.:

Select student's status from list (you may only select from the list).:

Select date student completed all training (DD MMM YY).:

Weapon model and qualification course (enter tables/phases if necessary). e.g., M4 AFQC T1 & T2, M4 AFQC T1 - T3.:

Total number of rounds expended by student to complete course of fire.:

Select student's status from list (you may only select from the list).:

Enter student's score on evaluation portion of course. If permitted by AFI 36-2654 for multiple phases/tables, enter N/A.:

Select date qualification expires IAW AFI 36-2654 (DD MMM YY). Normally, the last day of the month, 12 months from the date qualified.:

Printed name and rank of Combat Arms instructor (First MI Last, Rank).:

Select date student completed all training (DD MMM YY).:

Weapon model and qualification course (enter tables/phases if necessary). e.g., M4 AFQC T1 & T2, M4 AFQC T1 - T3.:

Total number of rounds expended by student to complete course of fire.:

Select student's status from list (you may only select from the list).:

Enter student's score on evaluation portion of course. If permitted by AFI 36-2654 for multiple phases/tables, enter N/A.:

Select date qualification expires IAW AFI 36-2654 (DD MMM YY). Normally, the last day of the month, 12 months from the date qualified.:

Printed name and rank of Combat Arms instructor (First MI Last, Rank).:

Select date student completed all training (DD MMM YY).:

Weapon model and qualification course (enter tables/phases if necessary). e.g., M4 AFQC T1 & T2, M4 AFQC T1 - T3.:

Total number of rounds expended by student to complete course of fire.:

Select student's status from list (you may only select from the list).:

Enter student's score on evaluation portion of course. If permitted by AFI 36-2654 for multiple phases/tables, enter N/A.:

Select date qualification expires IAW AFI 36-2654 (DD MMM YY). Normally, the last day of the month, 12 months from the date qualified.:

Printed name and rank of Combat Arms instructor (First MI Last, Rank).:

Select date student completed all training (DD MMM YY).:

Weapon model and qualification course (enter tables/phases if necessary). e.g., M4 AFQC T1 & T2, M4 AFQC T1 - T3.:

Total number of rounds expended by student to complete course of fire.:

Select student's status from list (you may only select from the list).:

Enter student's score on evaluation portion of course. If permitted by AFI 36-2654 for multiple phases/tables, enter N/A.:

Select date qualification expires IAW AFI 36-2654 (DD MMM YY). Normally, the last day of the month, 12 months from the date qualified.:

Printed name and rank of Combat Arms instructor (First MI Last, Rank).:

Select date student completed all training (DD MMM YY).:

Weapon model and qualification course (enter tables/phases if necessary). e.g., M4 AFQC T1 & T2, M4 AFQC T1 - T3.:

Total number of rounds expended by student to complete course of fire.:

Enter student's score on evaluation portion of course. If permitted by AFI 36-2654 for multiple phases/tables, enter N/A.:

Select date qualification expires IAW AFI 36-2654 (DD MMM YY). Normally, the last day of the month, 12 months from the date qualified.:

Printed name and rank of Combat Arms instructor (First MI Last, Rank).:

Student's assigned base/installation.:

Warning: Once signed, the fillable fields in this section and the static personal data section will be locked and no longer editable.:

Ensure equipment/accessories student used are annotated and any portions of the course not completed or waivers are documented IAW AFI 36-2654.:

Student's rank (e.g., A1C, SSgt, CMSgt, 1Lt, Maj, Lt Col).:

Unit and base of Combat Arms section that accomplished current training.:

Student's DoD Identification number of N/A.:

RemarksStyle1:

RemarksStyleNew:

File details come from the government source that posted it. Updated Aug 7, 2020.