How to Fill Out DA Form 3023

DA Form 3023 at a glance

What it is: DA Form 3023, 1 July 1965, is the Gage Record.

A filled-in DA Form 3023 example: a gage checker records one gage

DA Form 3023 example filled out, example: a gage checker records one gage
A gage checker fills out DA Form 3023 for one gage. The gage is in Rack 2, Bin 3, and its Required Component Dimension is 0.500. The picture shows page 1 of the form, and none of its entries is real. All dimensions are in inches. Recheck size, recheck date and recheck by is left blank because the gage has not been rechecked. Nothing goes in No. pieces inspected and remarks because the gage has not been used.

How to fill out DA Form 3023, box by box

Gage drawing number and identification

DA Form 3023 example filled out, gage drawing number and identification

Enter the Gage Drawing No., Type and Identification No.

Enter the Gage Drawing Revision and the Value.

Component drawing number and name

DA Form 3023 example filled out, component drawing number and name

Enter the Component Drawing No., Piece Mark No. and Function of Gage.

Enter the Revision and the Component Name.

Required component dimension and actual gage dimensions

DA Form 3023 example filled out, required component dimension and actual gage dimensions

Enter the Required Component Dimension and the Actual Gage Dimensions.

Location

DA Form 3023 example filled out, location

Enter the LOCATION, and under it the Rack, Section, Bin, Drawer and Tray.

Remarks, date and gage checker

DA Form 3023 example filled out, remarks, date and gage checker

Enter the Remarks.

Enter the Date and the Gage Checker.

Gage usage and surveillance record

DA Form 3023 example filled out, gage usage and surveillance record

Enter the Identification No. In RECHECK GAGE AFTER EACH PIECES, fill in the blank before PIECES.

Date issued, issued to and gage size limit

DA Form 3023 example filled out, date issued, issued to and gage size limit

Enter the Date Issued, Issued To and Gage Size Limit.

Recheck size, recheck date, recheck by and amount of wear

DA Form 3023 example filled out, recheck size, recheck date, recheck by and amount of wear

Enter the Recheck Size, Recheck Date and Recheck By.

Enter the Amount of Wear.

No. pieces inspected and remarks

DA Form 3023 example filled out, no. pieces inspected and remarks

Enter the No. Pieces Inspected, the Cumulative No. Pieces Inspected and the Remarks.

More rules for DA Form 3023

For use of this form, see TB 43-0196: the proponent agency is DARCOM.

Sources

[1] DA Form 3023 (JULY 1965), Gage Record, Department of the Army (the Official source link on this page).

DA Form 3023 PDF Details

The DA Form 3023, or Gage Usage and Surveillance Record, is the official Army form for tracking precision measurement instruments throughout their full service lifecycle. Designed under TB 43-0196 guidelines and administered by DARCOM (the proponent agency), this form records cumulative usage, calibration checks, surveillance intervals, and inspection results to ensure every gage meets operational readiness requirements.

What Information Does DA Form 3023 Capture?

Each section of the form is designed to record specific calibration and surveillance data for authorized Army activities:

When Is DA Form 3023 Required?

Military units must complete the DA Form 3023 during each gage calibration cycle as specified in TB 43-0196. The DARCOM proponent requires authorized maintenance activities to record every usage activity and surveillance recheck on the appropriate card. This systematic procedure supports full traceability and ensures every component meets Army precision requirements throughout its service life.

How to Complete the DA Form 3023

Follow these specific instructions to complete the form accurately. First, enter the gage drawing number and current revision code. Next, fill in the component name, identification number, and the authorized activity's contact information. Record required versus actual dimensions in the appropriate field for each inspection. Document cumulative usage on the designated card, and ensure the checker signs the statement after each surveillance visit. Follow the procedure in TB 43-0196 for required recheck intervals and compliance deadlines.

Related Army Forms on FormsPal

Maintenance personnel often need additional Army documentation alongside DA Form 3023. FormsPal also provides the DA Form 2410 for equipment history records, DA Form 2125 for maintenance scheduling, and the DA Form 3645 for related maintenance activities. You can also browse related forms such as DA Form 3838 and DA Form 3355 for supporting Army maintenance documentation.

QuestionAnswer
Form NameDA Form 3023 – Gage Usage and Surveillance Record
Proponent AgencyDARCOM
TB ReferenceTB 43-0196
Form Length2 pages
Fillable?No
Avg. time to fill out5–10 minutes
Other namesGage Usage Record, DARCOM Form 3023, TB 43-0196 Surveillance Card
Required forPrecision measurement instrument tracking in Army maintenance activities