Technical Exhibit M - DA_FORM_2765-1 Template.pdf
PDF 64 KB Posted
- Solicitation number
- W91ZLK-25-R-0002
About this file
This is DA Form 2765-1, "Request for Issue or Turn-In" (December 2023 version), which is a template form used by the Department of the Army for requesting issuance of supplies or turning in items.
The form is a structured document with multiple data fields organized in sections A through V, including spaces for document identification numbers, stock numbers, quantities, routing identifiers, supplementary addresses, fund codes, project codes, priority designators, and various date fields. The form also includes spaces for cost details, item descriptions, publication data, and tracking information for when items are issued, received, or due out. This appears to be Technical Exhibit M of solicitation W91ZLK-25-R-0002 for Facilities Infrastructure and Logistics Operations Support Services at Aberdeen Proving Ground, likely provided as a reference document for contractors to understand the forms they may need to process as part of the contract performance.
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Text version
PRI-
ORITY
UNIT
OF
ISSUE
PRI-
ORITY
SUPPLEMENTARY
SVC UNIT
OF
ISSUE
TOTAL PRICE
N
SVC
DOC
IDENT
DOC
IDENT
STOCK NUMBER
FIINFSC ADDM
S
QUANTITY SVC REQUISTIONER DATE SERIAL DEM
SUF
SUPPLEMENTARY
ADDRESS
S I G
FUND PROJECT ADV
STAT.
M
S FIINFSC ADD
QUANTITY
ROUT
IDENT DOCUMENT NUMBER
A B
C
EDITING DATA
RI-TODOC IDENT SUF
1 2 3
D
DOCUMENT NUMBER
4 5 6
E
F
DOC IDENT
DEM
ANDDATEREQUISITIONER SERIALSVC
9 10 11 12 13
FUND
ROUTING
IDENTIFIER
2 3
M S
STOCK NUMBER
NIINFSC ADD
4 5 6
QUANTITYUNIT OF
ISSUE
7 8
SVC
15. SUPPLEMENTARY
ADDRESS
SIG-
NAL
DISTRIBUTION PROJECT
PRIORITY
REQ DEL DATE
FUNDED
G
ROUTIN
G'IDENT
STOCK
K
DOCUMENT NUMBER
INIT
INIT
SIGNATURE
REQUISTIONER DATE SERIAL
D E
M SVC ADDRESS
S I G
DISTRI-
BUTION
PROJECT ADV
STAT.
ROUTING
IDENT DOLLARS CENTS
SEND TO: REQUEST IS FROM:
NON-FUNDED
I
EXP
H
NON-EXP
J
COST DETAIL ACCOUNT NUMBER
L
UNIT PRICE
M
ITEM DESCRIPTION
O
PUBLICATION DATA
P
ISSUED
Q
DATE POSTED
T
DATE AVAILABLE
U
DATE RECEIVED
APD
AEM
v1.00ES
V
DUE OUT
R
RECEIVED
S
MCS CODE
1 2 3 4 5 6 7 8 9 10 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 30 31 32 33 34 35 36 37 38 39 40 41 42 43 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80
ADVICE
DISTRI-
BUTION
REQ DEL
DATE
FUND
REQ DEL
DATE
TRANSACTION
D
A FO
R M
2765-1, D
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PR
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BSO
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PRI-
ORITY
UNIT
OF ISSUE
PRI-
ORITY
SUPPLEMENTARY
SVC
UNIT
OF
ISSUE
TOTAL PRICE
N
SVC
DOC
IDENT
DOC IDENT
STOCK NUMBER
FIIN
FSC
ADD
M & S
QUANTITY
SVC
REQUISTIONER
DATE
SERIAL
DEM SUF
SUPPLEMENTARY ADDRESS
S I G
FUND
PROJECT
ADV STAT.
M & S
FIIN
FSC
ADD
QUANTITY
ROUT
IDENT
DOCUMENT NUMBER
A B C
EDITING DATA
RI-TO
DOC IDENT
SUF
D
DOCUMENT NUMBER
E F
DOC IDENT
DEM
AND
DATE
REQUISITIONER
SERIAL
SVC
FUND
ROUTING IDENTIFIER
M & S
STOCK NUMBER
NIIN
FSC
ADD
QUANTITY
UNIT OF ISSUE
SVC
15. SUPPLEMENTARY
ADDRESS
SIG-
NAL
DISTRIBUTION
PROJECT
PRIORITY
REQ DEL DATE
FUNDED
G
ROUTIN G'IDENT
STOCK
K
DOCUMENT NUMBER
INIT
INIT
SIGNATURE
REQUISTIONER DATE
SERIAL
D E M
SVC
ADDRESS
S I G
DISTRI- BUTION
PROJECT
ADV STAT.
ROUTING IDENT
DOLLARS
CENTS
SEND TO:
REQUEST IS FROM:
NON-FUNDED
I
EXP
H
NON-EXP
J
COST DETAIL ACCOUNT NUMBER
L
UNIT PRICE
M
ITEM DESCRIPTION
O
PUBLICATION DATA
P
ISSUED
Q
DATE POSTED
T
DATE AVAILABLE
U
DATE RECEIVED
APD AEM v1.00ES V
DUE OUT
R
RECEIVED
S
MCS CODE
1 2 3 4 5 6 7 8 9 10 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 30 31 32 33 34 35 36 37 38 39 40 41 42 43 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80
ADVICE
DISTRI-
BUTION
REQ DEL
DATE
FUND
REQ DEL DATE
TRANSACTION
DA FORM 2765-1, DEC 2023
PREVIOUS EDITIONS ARE OBSOLETE.
REQUEST FOR ISSUE OR TURN-IN
For use of this form, see AR 710-4. The proponent agency is DCS, G-4.
1.01
DA FORM 2765-1, APR 1976
Request for Issue or Turn-In
APD
| DOC: |
| ROUT: |
| TBT: |
| FSC: |
| FIIN: |
| ADD: |
| UNIT: |
| QUANT: |
| SVC: |
| REQUEST: |
| DATE: |
| INC: |
| DEM: |
| SVC_A: |
| ADDRESS: |
| SIG: |
| FUND: |
| DIS: |
| TRI: |
| BUTION: |
| PROJECT: |
| PRI: |
| REQ: |
| BLANK: |
| COUNTER: |
| REQU: |
| C_C: |
| DOC_A: |
| DOC_B: |
| DOC_C: |
| RI_a: |
| RI_B: |
| RI_C: |
| SUF: |
| IDE_A: |
| IDE_B: |
| IDE_C: |
| ROUT_A: |
| ROUT_B: |
| ROUT_C: |
| FSC_A: |
| FSC_B: |
| FSC_C: |
| FSC_D: |
| MS: |
| NI_A: |
| NI_B: |
| NI_C: |
| NI_D: |
| NI_E: |
| NI_F: |
| NI_G: |
| NI_H: |
| NI_I: |
| ADD_A: |
| ADD_B: |
| UNIT_A: |
| UNIT_B: |
| QU_A: |
| QU_B: |
| QU_C: |
| QU_D: |
| QU_E: |
| SVC_B: |
| RE_A: |
| RE_B: |
| RE_C: |
| RE_D: |
| RE_E: |
| DAT_A: |
| DAT_B: |
| DAT_C: |
| DAT_D: |
| SER_A: |
| SER_B: |
| SER_C: |
| SER_D: |
| DE: |
| SVC_D: |
| SUP: |
| SIGNAL: |
| COST: |
| UNIT_PR: |
| TOTAL_PR: |
| ITEM: |
| FUND_A: |
| FUND_B: |
| DIS_A: |
| DIS_B: |
| DIS_C: |
| PRO_A: |
| PRO_B: |
| PRO_C: |
| PRI_A: |
| PRI_B: |
| REQ_A: |
| REQ_B: |
| REQ_C: |
| FUNDED: |
| NON: |
| EXP: |
| NON_EXP: |
| PUB: |
| AD_A: |
| AD_B: |
| AD_C: |
| AD_D: |
| AD_E: |
| AD_F: |
| AD_G: |
| AD_H: |
| AD_I: |
| AD_J: |
| AD_K: |
| AD_L: |
| AD_M: |
| AD_N: |
| AD_O: |
| AD_P: |
| MCS: |
| ISS: |
| DUE: |
| RECE: |
| POST: |
| AVA: |
| RECEIV: |
| INIT: |
| INIT_A: |
| Signature: |
| designer__defaultHyphenation: |
File details come from the government source that posted it. Updated .