Dispatcher's signature.
The operator fills in the following:
Operator's signature.
Time in, miles, hours.
Total time equipment was used, total miles, hours.
Destination section.
Fuel, oil added.
Remarks.
The person named in the "Report To" section of the form signs the form in the "Released By" section.
The operator returns the completed form to the dispatcher.
DA Form 2404 (Maintenance Request) - Used to report battlefield damage, repair, and/or replacement
actions by unit level maintenance. It is also used by anyone performing inspections, maintenance
services, diagnostic checks, technical evaluation, and PMCS. Operators use this form to list faults they
cannot fix; it is also used as a temporary record of required and completed maintenance. DA Form 5988-
E, when generated by ULLS, replaces the requirement for a DA Form 2404.
Status Symbol entries on DA Form 2404 are made as follows:
X indicates a deficiency in the equipment that places it in an inoperable status.
CIRCLED "X": indicates a deficiency; however, the equipment may be operated under specific
limitations as directed by higher authority as prescribed locally until correction action can be
accomplished.
HORIZONTAL DASH "-": indicates that a required inspection, component replacement,
maintenance operation check, or test flight is due but has not been accomplished, or an overdue
Modification Work Order (MWO) has not been accomplished.
DIAGONAL "/": indicates a material defect other than a deficiency that must be corrected to
increase efficiency or to make the item completely serviceable.
LAST NAME INITIAL IN BLACK OR BLUE-BLACK INK, OR PENCIL: indicates that a completely
satisfactory condition exists.
FOR AIRCRAFT: status symbols are recorded in red.
Status symbols can be changed at the discretion of the commander or the maintenance/motor officer.
When the commander or the maintenance/motor officer disagrees with an assigned status symbol,
he/she takes the following actions:
In column d, write "status symbol changed."
On the next open line, enter the new status symbol and fault.
Sign in block 9a and initial column e.
The commander or the maintenance/motor officer are the only persons who can CIRCLE X or change
status symbols. Other entries on DA Form 2404 are made as follows:
Block 1: unit to which equipment belongs.
Block 2: name and model of equipment.
Block 3: serial number or registration number of equipment.
Block 6: type of PMCS performed (daily, weekly, etc.).
Block 7: TM number, TM date (if manual has changes, print latest change number after TM number).
Blocks 4, 5, 8a, and columns a, b, and d: Left blank until the deficiency or fault is found. When the
deficiency or fault is corrected or downgraded to a CIRCLE X, entries will be made in blocks 4 and 5
at the end of the dispatch or operation.
Block 4a and 4b: miles, hours. Enter the applicable meter reading as of the date in block 5.
Block 5: current calendar date.
Column a: TM item number. If TM has no number for deficiency or fault, enter page, paragraph, or
sequence number. Faults not covered by the PMCS, leave blank.
Column b: status symbol that applies.
Column c: deficiencies or shortcomings. Briefly describe the fault. Continue inspection to make sure
no other faults exist.
Column d: list corrective action taken.
After the PMCS is completed and all faults that cannot fixed by the operator are listed, the form is turned
over to the maintenance supervisor.
5-4
QM 5094
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