Attachment_0004_SF_364_(Report_of_Descrepancy_template).pdf

INSTRUCTIONS

DEPARTMENT OF DEFENSE: DLAR 4140.55/AR 735-11.2/NAVSUPINST 4440.127E/AFR 400-54/MCO 4430.3E, Reporting of Item and Packaging Discrepancies, and/or DLAR 4140.60/AR 12-12/NAVSUPINST 4920.9B/AFR 67-7/MCO 4140.1B, Processing Discrepancy Reports Against Foreign Military Sales Shipments.

CIVILIAN AGENCIES: See FPMR handbook cited in 19(2)(a).

REPORT OF DISCREPANCY (ROD)

SHIPPING PACKAGING

1. DATE OF PREPARATION 2. REPORT NUMBER

3. TO (Name and address, include ZIP Code) 4. FROM (Name and address, include ZIP Code)

5a. SHIPPER'S NAME 5b. NUMBER AND DATE OF INVOICE 6. TRANSPORTATION DOCUMENT NUMBER (GBL., Waybill, TCN, etc.)

7a. SHIPPER'S NUMBER (Purchase Order/Shipment, Contract, etc.)

7b. OFFICE ADMINISTERING CONTRACT 8. REQUISITIONER'S NUMBER (Requisition, Purchase Request, etc.)

9. SHIPMENT, BILLING, AND RECEIPT DATA 10. DISCREPANCY DATA

AC-

TION

CODE

11.

2NSN/PART NUMBER AND

NOMENCLATURE

(a)

UNIT

OF

ISSUE

(b)

QUANTITY

SHIPPED/

BILLED

(c)

QUANTITY

RECEIVED

(d)

QUAN-

TITY

(a)

UNIT

PRICE

(b)

TOTAL

COST

(c)

CODE

(d)

12. REMARKS (Continue on separate sheet of paper if necessary)

1 DISCREPANCY CODES 2 ACTION CODES

CONDITION OF MATERIAL

C1 - In condition other than that indicated on release/receipt document C2 - Expired shelf life C3 - Damaged parcel post shipment

SUPPLY DOCUMENTATION

D1 - Not received D2 - Illegible or mutilated D3 - Incomplete, improper or without authority (Only when receipt cannot be properly processed)

MISDIRECTED MATERIAL

M1 - Addressed to wrong activity

OVERAGE/DUPLICATE SHIPMENTS

O1 - Quantity in excess of that on receipt document O2 - Quantity in excess of that requested (Other than unit of issue pack) O3 - Quantity duplicates shipment

PACKING DISCREPANCY

P1 - Improper preservation P2 - Improper packing P3 - Improper marking P4 - Improper unitization

PRODUCT QUALITY DEFICIENCIES

Q1 - Deficient material (Applicable to Grant Aid and FMS shipments)

SHORTAGE OF MATERIAL

S1 - Quantity less than that on receipt document S2 - Quantity less than that requested (Other than unit of issue pack) S3 - Non-receipt of parcel post shipments ITEM TECHNICAL DATA MARKINGS (i.e., Name Plates, Log Books, Operating Handbooks, Special Instructions, etc.)

T1 - Missing T2 - Illegible or mutilated T3 - Precautionary operational markings missing T4 - Inspection data missing or incomplete T5 - Serviceability operating data missing or incomplete T6 - Warranty data missing WRONG ITEM (Identify requested item as a separate copy in Item 9 above) W1 - Incorrect item received W2 - Unacceptable substitute

OTHER DISCREPANCIES

Z1 - See remarks

1A - Disposition instructions requested (Reply on reverse) 1B - Material being retained (See remarks) 1C - Supporting supply documentation requested 1D - Material still required expedite shipment (Not applicable to FMS) 1E - Local purchase material to be returned at supplier's expense unless disposition instructions to the contrary are received within 15 days (Reply on reverse) (Not applicable to FMS) 1F - Replacement shipment requested (Not applicable to FMS) 1G - Reshipment not required. Item to be re-requisitioned 1H - No action required. Information only.

1Z - Other action requested (See remarks)

13. FUNDING AND ACCOUNTING DATA

14a. TYPED OR PRINTED NAME, TITLE, AND PHONE NUMBER OF PREPARING OFFICIAL 14b. SIGNATURE

15. DISTRIBUTION ADDRESSEES FOR COPIES

364-103 7540-00-159-4442 (Previous edition is obsolete.) STANDARD FORM 364 (REV. 2-80) (EG) Prescribed by GSA FPMR 101-26.8

16. FROM: 17. DISTRIBUTION ADDRESSEES FOR COPIES

18. TO:

Use window envelope to mail this document. Insert name and address, including ZIP Code, starting one typing space below the left dot. Each address line must NOT extend beyond right dot. Address must not exceed four single space typing lines.

19. IN ACCORDANCE WITH NOTICE OF DISCREPANCY ON FACE OF THIS FORM:

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HAS

BEEN

a. MATERIAL

WILL

BE SHIPPED

DOCUMENT NUMBER

NO RECORD OF SHIPMENT. RESUBMIT REPORT TO

PROPER OFFICE UNDER APPROPRIATE REGULATION.

b.

AN ADJUSTMENT IN

BILLING HAS BEEN/WILL

BE PROCESSED AS A:

c. CREDIT DEBIT INVOICE/BILL ATTACHEDd.

PROOF OF DELIVERY (Parcel Post Shipments) OR EVIDENCE OF

SHIPMENT ENCLOSED.

e.

AN ADJUSTMENT IN BILLING FOR THE REPORTED DISCREPANCY WILL NOT BE PROCESSED FOR THE FOLLOWING REASON WHICH IS CITED IN THE

INDICATED REGULATION.

f.

(1) REASON FOR NOT PROCESSING

(a) DISCREPANCY WAS NOT REPORTED WITHIN THE TIME FRAMES

ALLOWED AND/OR

(b) DOLLAR VALUE DOES NOT MEET THE CRITERIA PRESCRIBED IN THE REGULATION OR AGREEMENT INDICATED IN 19f(2)

(2) PRESCRIBING REGULATION

(a) CHAPTER 5 OF THE GSA HANDBOOK, DISCREPANCIES OR

DEFICIENCIES IN GSA OR DOD SHIPMENTS, MATERIAL, OR

BILLINGS (FPMR 101-26.8)

(b) CHAP. 2 AND/OR 7 OF DOD 4000.25-7-M, MILITARY STANDARD

BILLING SYSTEM (MILSBILLS) AND/OR DD 1513, U.S. DOD OFFER

AND ACCEPTANCE, AS APPLICABLE.

20. THE FOLLOWING DISPOSITION IS TO BE MADE OF THE REFERENCED MATERIAL:

PROCESS FOR DISPOSAL IN ACCORDANCE

WITH SERVICE/AGENCY DIRECTIVES

a. REPRESENTATIVE WILL CALL FOR DISCUSSION

CONCERNING DISPOSITION IN:

b.

DAYS

RETAIN MATERIAL AT NO CHARGE.c. MATERIAL WILL BE PICKED UP IN:d.

DAYS

SHIP MATERIAL (Specify location):e.

GBL APPROPRIATION CHARGEABLE:(1)

CHARGES COLLECT - VIA:(2) FREIGHT EXPRESS PARCEL POST ($ __________ postage advanced herewith.

NOTE: Please enclose postage. Material cannot be returned Parcel Post collect.)PARCEL POST LABEL ATTACHED(3) (4) FREIGHT PREPAID

OTHER (Specify)f.

IF MATERIAL IS STILL REQUIRED,

SUBMIT NEW REQUISITION21.

REPLACEMENT WITH SATISFACTORY MATERIAL

WILL BE MADE ON OR BEFORE:22.

DATE

23. REMARKS (Continue on separate sheet of paper if necessary)

24a. TYPED OR PRINTED NAME AND PHONE NUMBER OF

PREPARING OFFICIAL

24b. SIGNATURE 24c. DATE

Fold here

STANDARD FORM 364 BACK (REV. 2-80)