Attachment_16_-_Korea_Demilitarization_Certificate.pdf

SP4500-18-R-0000 Korea HW Attachment 16

Certification of Demilitarization

Disposal Turn-In Document: QTY:

National Stock Number or Description:

Certification Statement:

I CERTIFY THAT THE ITEMS(S) LISTED HEREON HAS/HAVE BEEN DEMILITARIZED IN

ACCORDANCE WITH DoD MANUAL 4160.28, VOLUME 3, “DEFENSE DEMILITARIZATION:

PROCEDURAL GUIDANCE,” CATEGORY , PARAGRAPH AND/OR THE

FOLLOWING APPLICABLE REGULATION:

Signature (Certifier): Date

Printed Name/Grade/Rank:

Title:

Phone (COM/DSN/FAX):

Address:

Signature (Verifier): Date

Printed Name/Grade/Rank:

Title:

Phone (COM/DSN/FAX):

Address:

Reference: DoD Manual 4160.28, Volume 3, "Defense Demilitarization:

Procedural Guidance," current edition