Attachment_J-11_REPSHIP_Form.xls

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Multifunction Modular Mast
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Attachment J-11 REPSHIP Form

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Sheet1

Naval Sea Logistica Center, Newport, RI
Advance Report of Shipment (REPSHIP)
The following information is provided as required by DoD 4500.9-R, the Defense Transportation Regulation, Chapter 205, and constitutes official notification of a pending shipment that will require special handling upon receipt.
Central Receiving Point of Contact
NameCommercial Phone
Inbound REPSHIP Folder(401) 832-6150
EmailFax
NWPT.NUWC_NPT_IBND_REPSHIP@navy.mil(401) 832-6198
Consignor at Point of Origin
DODAACCommand Name and Address
Consignee and Ultimate Destination
DODAACCommand Name and Address
N66604Commanding Officer Naval Undersea Warfare Center Newport 47 Chandler Street, Newport, RI 02841-1708
POC NameCommercial Phone
Fax
Shipment Information
Requisition Document No. / Pruchase Order No. / Contract No.
TCN:
Specific Description of Material
PiecesWeightLengthWidthHeightSpecifics regarding heavy lift or oversize pieces
NOMENCLATURE:
Special Handling Requirements
Highest Classification of any piece in the shipmentDoes the shipment contain NRNW? NO
Environmental and Other Special Handling Requirements
Transportation Information
Anticipated shipping methodCarrier
Estimated Shipping Date*Bill of Lading No. / Transportation Control No. / Tracking No.
Route Order NumberRouting
MTX No.RIS No.Seal Numbers.
Consignor Acknowledgements
Please confirm receipt of this Advanced REPSHIP notificiation by signing in this block and faxing or emailing the form back to the POC indicated above. *Note, we will not release the shipment to the carrier until we have received this acknowledgement.
* Request your acknowledgement NLT

or shipment will be delayed until you respond

Name of Person Acknowledging Receipt of REPSHIPSignatureDate
When material is received, sign these blocks and fax or email form to the same POC
Name of Person Acknowledging Receipt of MaterialSignatureDate
FISCN Form 4500/1 version 25 FEB 10

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