B08_SOL_W912PF22Q0008_Attachment 3_GFP.pdf

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Hand Receipt Date:

Time:

Page of Responsible UIC:

Loan UIC:

Loan SLoc:

Issuing Date:

Return Date:

EPA Number:

MPO

MPO Description

NSN

NSN Description

UI

OH Qty Serial Number Serial Number Serial Number Table of Serial Number with Three in a Row Received From (Print Name) Rank Date Signature Issued To (Print Name) Rank Date Signature Returned By:

Received By:

10.4.0.20121103.1.882846