PWS_Attachment 3 ARL Modified DA Form 2404 (ANNUAL PM).pdf

PDF 96 KB Posted Feb 23, 2026

Attached to: Mobile and Stationary Equipment Maintenance - Amendment 0001 (To provide the Government's responses to questions submitted in response to the RFQ)
Solicitation number: W911QX26QA021
Issued by: Department of the Army Materiel Command Army Contracting Command Aberdeen Proving Ground

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Written by GovTribe AI · Feb 23, 2026

This is DA Form 2404, an Equipment Inspection and Maintenance Worksheet used by the U.S. Army for documenting equipment inspections and maintenance activities. The form is governed by DA PAM 750-8 with the proponent agency being DCS, G-4.

The form provides a standardized template for recording inspection findings and maintenance actions on military equipment. It captures organizational information, equipment nomenclature and model, registration/serial numbers, National Stock Numbers (NSN), mileage, hours, rounds fired, and hot starts. The inspection type (such as Annual PM) and applicable Technical Manual (TM) references are documented with TM numbers and dates. The form uses five columns to structure findings: Column a for TM item numbers, Column b for condition status symbols, Column c for deficiencies and shortcomings, Column d for corrective actions, and Column e for inspector initials upon completion of corrections. Status symbols include "X" for inoperable deficiencies, circled "X" for operable-with-limitations deficiencies, horizontal dash for overdue maintenance, diagonal slash for material defects affecting efficiency, and initials for satisfactory conditions. The form requires signatures from personnel performing the inspection and the maintenance supervisor, with corresponding timestamps and manhours required. The template includes example inspection items such as greasing and lubricating vehicles, checking fluids, lights, battery, oil, filters, tire pressure, and anti-freeze testing, with blank rows available for additional items.

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ALL INSPECTIONS AND EQUIPMENT CONDITIONS RECORDED ON THIS FORM HAVE BEEN DETERMINED

IN ACCORDANCE WITH DIAGNOSTIC PROCEDURES AND STANDARDS IN THE TM CITED HEREON.

EQUIPMENT INSPECTION AND MAINTENANCE WORKSHEET

For use of this form, see DA PAM 750-8; the proponent agency is DCS, G-4.

HOT

STARTS

d.b. HOURS ROUNDS

FIRED

10.9a. SIGNATURE

3. REGISTRATION/SERIAL/NSN

1. ORGANIZATION 2. NOMENCLATURE AND MODEL

5. DATE 6. TYPE INSPECTION

APPLICABLE REFERENCE7.

TM NUMBER TM DATE TM NUMBER TM DATE

COLUMN a COLUMN b COLUMN c

Enter TM item number.

Enter the applicable condition status symbol.

Enter deficiencies and shortcomings.

COLUMN d shortcoming listed in Column c.

Show corrective action for deficiency or

STATUS SYMBOLS

COLUMN e action initial in this column.

Individual ascertaining completed corrective

Indicates a deficiency in the equipment that places"X" it in an inoperable status.

Indicates a deficiency, however, the CIRCLED "X"

Indicates that a requiredHORIZONTAL DASH "(-)"

Indicates a material defect otherDIAGONAL "(/)"

LAST NAME INITIAL IN BLACK, BLUE-BLACK INK,

FOR AIRCRAFT - Status symbols will be recorded in red.

(Maintenance Supervisor) MANHOURS

REQUIRED

ITEM

NO.

STATUS

DEFICIENCIES AND SHORTCOMINGS

INITIAL

WHEN

CORRECTED

CORRECTIVE ACTION

DA FORM 2404, FEB 2011 PREVIOUS EDITIONS ARE OBSOLETE. APD LC v1.00ES

4a. MILES

8b. TIME 9b. TIME8a. SIGNATURE (Person(s) performing inspection) equipment may be operated under specific limitations as directed by higher authority or as prescribed locally, until corrective action can be accomplished.

inspection, component replacement, maintenance operation check, or test flight is due but has not been accomplished, or an overdue MWO has not been accomplished.

OR PENCIL - Indicates that a completely satisfactory condition exists.

than a deficiency which must be corrected to increase efficiency or to make the item completely serviceable.

DEFICIENCIES AND SHORTCOMINGS

ITEM

NO.

STATUS

b c

INITIAL

WHEN

CORRECTED

CORRECTIVE ACTION

DA FORM 2404, FEB 2011 APD LC v1.00ES

ALL INSPECTIONS AND EQUIPMENT CONDITIONS RECORDED ON THIS FORM HAVE BEEN DETERMINED IN ACCORDANCE WITH DIAGNOSTIC PROCEDURES AND STANDARDS IN THE TM CITED HEREON.

EQUIPMENT INSPECTION AND MAINTENANCE WORKSHEET

For use of this form, see DA PAM 750-8; the proponent agency is DCS, G-4.

HOT STARTS

b. HOURS

ROUNDS FIRED

10.

9a. SIGNATURE

3. REGISTRATION/SERIAL/NSN

1. ORGANIZATION

2. NOMENCLATURE AND MODEL

5. DATE

6. TYPE INSPECTION

APPLICABLE REFERENCE

TM NUMBER

TM DATE

TM NUMBER

TM DATE

COLUMN a COLUMN b COLUMN c Enter TM item number.

Enter the applicable condition status symbol.

Enter deficiencies and shortcomings.

COLUMN d shortcoming listed in Column c.

Show corrective action for deficiency or

STATUS SYMBOLS

COLUMN e action initial in this column.

Individual ascertaining completed corrective Indicates a deficiency in the equipment that places "X" it in an inoperable status.

Indicates a deficiency, however, the

CIRCLED "X"

Indicates that a required

HORIZONTAL DASH "(-)"

Indicates a material defect other

DIAGONAL "(/)"

LAST NAME INITIAL IN BLACK, BLUE-BLACK INK,

FOR AIRCRAFT - Status symbols will be recorded in red.

(Maintenance Supervisor)

MANHOURS REQUIRED

TM ITEM NO.

STATUS

DEFICIENCIES AND SHORTCOMINGS

INITIAL

WHEN

CORRECTED

CORRECTIVE ACTION

DA FORM 2404, FEB 2011

PREVIOUS EDITIONS ARE OBSOLETE.

APD LC v1.00ES 4a. MILES 8b. TIME 9b. TIME 8a. SIGNATURE (Person(s) performing inspection) equipment may be operated under specific limitations as directed by higher authority or as prescribed locally, until corrective action can be accomplished.

inspection, component replacement, maintenance operation check, or test flight is due but has not been accomplished, or an overdue MWO has not been accomplished.

OR PENCIL - Indicates that a completely satisfactory condition exists.

than a deficiency which must be corrected to increase efficiency or to make the item completely serviceable.

DEFICIENCIES AND SHORTCOMINGS

TM ITEM NO.

STATUS

b c

INITIAL

WHEN CORRECTED

CORRECTIVE ACTION

DA FORM 2404, FEB 2011

APD LC v1.00ES 1.00

DA FORM 2404, FEB 2011

EQUIPMENT INSPECTION AND MAINTENANCE WORKSHEET

APD

TIME_B:

TIME_A:

MANHOURS:

ORGANIZ:

REGISTRAT:

NOMENMODEL:

TYPEINSPEC: ANNUAL PM

TMNO: 1

TMNO_1:

TMNO_2: 2

TMNO_3:

TMNO_4: 3

TMNO_5:

TMNO_6: 4

TMNO_7:

TMNO_8: 5

TMNO_9:

TMNO_10: 6

TMNO_11:

TMNO_12: 7

TMNO_13:

STAT:

STAT_1:

STAT_2:

STAT_3:

STAT_4:

STAT_5:

STAT_6:

STAT_7:

STAT_8:

STAT_9:

STAT_10:

STAT_11:

STAT_12:

STAT_13:

DEFIC: GREASED AND LUBRICATED VEHICLE

DEFIC_1:

DEFIC_2: CHECKED ALL FLUIDS

DEFIC_3:

DEFIC_4: CHECKED LIGHTS

DEFIC_5:

DEFIC_6: CLEANED BATTERY

DEFIC_7:

DEFIC_8: CHANGED OIL

DEFIC_9:

DEFIC_10: CHANGED FILTERS

DEFIC_11:

DEFIC_12: CHECKED TIRE PSI

DEFIC_13:

CORRECT:

CORRECT_1:

CORRECT_2:

CORRECT_3:

CORRECT_4:

CORRECT_5:

CORRECT_6:

CORRECT_7:

CORRECT_8:

CORRECT_9:

CORRECT_10:

CORRECT_11:

CORRECT_12:

CORRECT_13:

TMNUM_A:

TMNUM_B:

MILES:

ROUNDS:

HOURS:

HOTSTARTS:

INITIALS1:

INITIALS2:

INITIALS3:

INITIALS4:

INITIALS5:

INITIALS6:

INITIALS7:

INITIALS8:

INITIALS9:

INITIALS10:

INITIALS11:

INITIALS12:

INITIALS13:

INITIALS14:

TMDATE_B:

TMDATE_A:

DATE:

signature_BUTTON43:

signature_BUTTON44:

signature_BUTTON1:

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signature_BUTTON3:

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DateField1:

TM_B: 8

TM_B_1:

TM_B_2: 9

TM_B_3:

TM_B_4:

TM_B_5:

TM_B_6:

TM_B_7:

TM_B_8:

TM_B_9:

TM_B_10:

TM_B_11:

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TM_B_14:

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TM_B_20:

TM_B_21:

TM_B_22:

TM_B_23:

TM_B_24:

TM_B_25:

TM_B_26:

TM_B_27:

STAT_B:

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STAT_B_25:

STAT_B_26:

STAT_B_27:

DEF_B: TESTED ANIT-FREEZE

DEF_B_1:

DEF_B_2: OTHER

DEF_B_3:

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COR_B:

COR_B_1:

COR_B_2:

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COR_B_27:

INITIALS16:

INITIALS18:

INITIALS20:

INITIALS22:

INITIALS24:

INITIALS26:

INITIALS28:

INITIALS30:

INITIALS32:

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INITIALS27:

INITIALS25:

INITIALS23:

INITIALS21:

INITIALS19:

INITIALS17:

INITIALS15:

signature_BUTTON15:

signature_BUTTON17:

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File details come from the government source that posted it. Updated Feb 23, 2026.