Admin Number: Enter the bumper number/materiel control number or administrative number
assigned to the item of equipment.
(21) Reimbursable Customer: For DSU/GSU/AVIM/Depot use.
(22) Work Performed By: Enter code for level of work from Table B-24 (Maintenance Management
(23) Signature: The commander or the commander's designated representative will sign for all priority
01 through 10 requests. This signature approves the use of the PD.
(24) Describe Deficiencies or Symptoms.
- Using the information in column "c" of DA Form 2404, briefly describe the fault or symptoms.
For example, print "Engine does not develop full power" or "Equipment uses two quarts of oil
daily," etc. Do not ask for general or specific repair of parts to be replaced; for example, do
not tell support to "replace the hydraulic system" or "repair as needed."
- When the form is asking for work on more than one item with the same NSN, list the number
of items, their serial numbers (if they have serial numbers), and anything else support will
need. INOP equipment (equipment reported on the Materiel Condition Status Report),
components/subsystems of reportable equipment, or command maintenance significant
equipment) must have its own separate forms.
- When the form is for components or assemblies with a recoverability code of A, D, F, H, or L,
give the end item NSN. Put the NSN on the last line of Block 25. You will find recoverability
codes in the RC code column on the AMDF. You will also find the codes listed as part of the
item's Source, Maintenance, and Recoverability (SMR) code in the parts manual.
- If you need more room, use a DA Form 2407-1.
- When the form is requesting standard repair after a battle damage expedient has been
applied, print "BDAR" in bold letters before describing the fault or symptoms. NOTE: The end
item's Battlefield Damage and Assessment Repair (BDAR) TM and AR 750-1 describe when
and how BDAR repairs will be made.
(25) Remarks. When the item in Block 7 needs onsite or deferred maintenance, support will note that
action here. Shop office NCO will make one of these entries for onsite or deferred work:
- Maintenance request received on (date), signature of shop office NCO.
- Onsite repair scheduled for (date), signature of shop office NCO.
- Owner to return item on (date) for repair, signature of shop office NCO.
- Block 35a will be completed by support only when onsite repair is started or the deferred item
is brought back to support. The receipt copy will be sent to the support unit. The owning unit
keeps all other copies until the onsite repair is started or deferred item is taken back to
Section VII - Action Signatures.
(34a) Submitted By: The person sending in the DA Form 2407 enters first initial and last name in this
(34b) The person signing the forms enters the original ordinal date the form was given to support.
Verification that Before-, During-, and After-Operation PMCS on Equipment has been
Correctly Done and Correctly Annotated On DA Form 2404 (Equipment Inspection and
Maintenance Work Sheet). DA Form 2404 (Figure 4-2) is used to report any faults or malfunctions
discovered by an equipment operator. It is also used by organizational maintenance personnel to record periodic
maintenance services and spot-check inspections. This form is a temporary record of needed and completed
repairs. DA Form 2404 should be destroyed after uncorrected faults have been recorded on DA Forms 2402 and
2407 or action has been taken to request repair parts. However, if equipment is not combat-ready because of
needed repairs, DA Form 2404 should be kept on file until the equipment has been repaired.
Purpose. DA Form 2404 has three major purposes. Operators and crews, firstline leaders, maintenance
supervisors, and commanders are equally responsible for keeping information current and correct on the DA
Form 2404. This form is the central record for managing and controlling maintenance as follows:
It is a record of faults found during an inspection. These faults include PMCS, maintenance activity
inspections, diagnostic checks, and spot-checks (unless otherwise noted).
It shows faults and repairs required for ECOD reports.
It shows Battlefield Damage and Assessment Repair (BDAR) performed.