DA Form 3643 at a glance
What it is: DA Form 3643 is the form for Daily Issues of Petroleum Products.
Who signs: (3) Enter the signature of the attendant. (5) Enter the signature of the recipient (individual receiving the product).
A filled-in DA Form 3643 example: one day of diesel issues to two vehicles
How to fill out DA Form 3643, box by box
1. Vehicle / equipment bumper or serial no., 2. unit, post, camp or station, 3. page no. and 4. no. of pages
(1) Enter the vehicle / equipment bumper or serial number of the issuing vehicle or equipment.
(2) Enter the issuing unit, post, camp, or station.
(3) Enter the page number.
(4) Enter the number of pages indicating total number of pages used for that day.
2. Product
(2) Enter product type being issued (one product per DA Form 3643).
Section I - Unit activity: 1. Vehicle / equipment bumper or serial no. or aircraft tail no. or document no., a. Issues, b. Receipts and c. Defuels
(1) Enter the vehicle / equipment bumper or serial number or aircraft tail number or document number.
a. Issues: (2a) Enter the quantity of product issued (in gallons).
b. Receipts: (2b) Enter the quantity of product received (in gallons).
(2c) Enter the quantity of defuels received (in gallons).
3. Organization and service: d. Customer DODAAC and e. Customer organization and service
(3d) Enter the DODAAC of the customer unit or organization or enter assigned number from the RO from a customer account setup for commercial, contractor, or coalition partner accounts.
(3e) Enter customer unit information or name with Service designator at the end in parenthesis.
AF - Air Force; N - Navy; MC - Marine Corps; Con - Contractor; Col - Coalition Partner.
No Service designator is required for Army organizations.
4. Printed name and rank / grade of recipient and 5. Signature of recipient
(4) Enter printed name, rank or grade of recipient (individual receiving the product).
(5) Enter the signature of the recipient (individual receiving the product).
The row will be locked once signed.
6. Total issues, 7. Total receipts and 8. Total defuels
(6) Enter total issues for the day. Totals will be added automatically from column a.
(7) Enter total receipts for the day. Totals will be added automatically from column b.
(8) Enter total defuels for the day. Totals will be added automatically from column c.
Section II - Attendant: 1. Printed name, 2. Rank / grade, 3. Signature and 4. Date
(1) Enter the printed name of the attendant.
(2) Enter the rank and grade of the attendant.
(3) Enter the signature of the attendant.
The form will be locked once signed.
(4) Enter the actual date of the issues and receipts (YYYYMMDD).
More rules for DA Form 3643
For use of this form, see AR 703-2; the proponent agency is DCS, G-4.
Sources
[1] DA Form 3643 (DEC 2024), Daily Issues of Petroleum Products, U.S. Army (the Official source link on this page).