Da Form 4283 – Fill Out and Use This PDF

The DA Form 4283, known as the Facilities Engineering Work Request, plays a crucial role for anyone seeking to request facilities engineering work within Army installations. This form is divided into two parts: Part "A" for customer documentation and Part "B" for the Department of Public Works (DPW) to complete, ensuring a comprehensive approach to detailing the work requested, its justification, and the necessary approval steps. If you need to submit a request for facilities engineering work, make sure you understand how to fill out this form accurately by clicking the button below.

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Da Form 4283 PDF Details

The DA Form 4283, officially known as the Facilities Engineering Work Request, is a comprehensive document utilized within the Army's organizational structure to initiate and document requests for various engineering work projects. This crucial form serves as a bridge between the requesting entity, often a department or individual within the Army, and the Department of Public Works (DPW). It meticulously captures essential details about the work requested, including the identification of the customer through specific codes, a short job description for a clear understanding of the task at hand, and the identification of the facility in question by its unique number. The form is split into two distinct parts, with Part "A" completed by the requester who must provide detailed information such as the point of contact (POC) names, phone numbers, and a thorough work description along with a justification for the request. Part "B" is filled out by the DPW in accordance with local procedures, assigning priority, estimating start and completion dates, and delineating funding sources among other procedural details. This ensures a systematic approach to handling work requests, from approval through to completion, while also considering the environmental impact of the proposed work. The DA Form 4283 not only facilitates a smooth operational flow within Army facilities but also ensures accountability and a structured process for addressing and executing engineering and maintenance tasks.

Question	Answer
Form Name	Da Form 4283
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	da 4283 fillable, form 4283, da4283, blank da 4283

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FACILITIES ENGINEERING WORK REQUEST

PART A	CUSTOMER	DOCUMENT
(See requestor	ID	SERIAL
(See requestor	ID	NUMBER
instructions)		NUMBER
instructions)

INSTALLATION
ABBREVIATION
OF FACILITIES		1

REMARKS

INSTALLATION NAME

For use of this form, see DA Pam 420-6; the proponent agency is OACSIM.

FY	TYPE				SHORT JOB DESCRIPTION					DATE
										DATE


									DA	MON		YR
				BUILDING/FACILITY NUMBERS
				BUILDING/FACILITY NUMBERS
2		3	4			6	7	8	9		10
2		3	4		5	6	7	8	9		10

CUSTOMER NAME	POC NAME	POC PHONE NUMBER

WORK DESCRIPTION (Description and justification of work request)

AUTHORIZED REQUESTOR (Type or print)

AUTHORIZED REQUESTOR SIGNATURE

APPROVAL ACTION CODE:

SPECIAL INTEREST CODE:

DATE

PART B

WORK REQUEST PRIORITY:

ESTIMATED WORK START DATE:

MON

(Approving Official Only)

PROGRAM INDICATOR CODE:

ESTIMATED WORK COMPLETION

DATE:

ENVIRONMENTAL IMPACT

WORK TO BE PERFORMED

WORKCLASS

APPROVAL AMOUNTS

SOURCE OF FUNDS

YES

IN-HOUSE

FUNDED

UNFUNDED

DIRECT

ENVIRONMENTAL

AUTOMATIC REIMBURSEMENT

CONSIDERATION

SELF-HELP

EIS / EIA

FUNDED REIMBURSEMENT

CONTRACT

INITIATED

ACCOUNT PROCESSING CODE

EIS / EIA

TROOP

TOTAL

COMPLETED

DESIGN APPROVAL (Please type or print name)

DATE

APPROVAL AUTHORITY (Please type or print name)

APPROVAL ACTION

DATE

MON

DESIGN APPROVAL SIGNATURE

APPROVAL AUTHORITY SIGNATURE

APPROVED

DISAPPROVED

DA FORM 4283, SEP 2003

DA FORM 4283, AUG 1978, IS OBSOLETE.	APD LC v1.03ES
	Page 1 of 2

COMPLETION INSTRUCTION FOR DA Form 4283 - FACILITIES ENGINEERING WORK REQUEST

(Part "A" completed by requestor per instructions below)

(Part "B" completed by the DPW in accordance with local procedures)

PART "A"

CUSTOMER ID: One to three alpha numeric characters per local DPW policy.

A code used to identify the user, occupant, owner of a facility, or the organizational activity submitting a work request.

DOCUMENT SERIAL NO: Must be five alpha numeric characters. Based on local procedures, this number may be generated and entered by the requestor or computer generated and assigned by DPW. It is a number which indicates a place in a series and when used in conjunction with installation number, customer identification, document type, and fiscal year, it uniquely identifies one document of a particular type.

FISCAL YEAR: The last digit of the fiscal year; i.e., '3' for Fiscal Year 2003.

TYPE: Leave blank; DPW Work Reception will complete

SHORT JOB DESCRIPTION: Up to 30 alpha numeric characters that provide a description with a concise summary statement of the work to be performed.

DATE: The date Work Request was completed (Format - 15 JUL 03).

INSTALLATION ABBREVIATION: Up to eight alpha numeric characters for the locally assigned abbreviation of the installation's officially designated name; e.g., Fort Benjamin Harrison abbreviated as Fort Ben.

FACILITY NUMBER: A code of five alpha numeric characters which represent the unique serial number assigned to a real property facility within an installation for identification through its life cycle, e.g. P0001.

REMARKS: At a minimum, include email address of the Primary POC and an Alternate POC for requested work.

INSTALLATION NAME: The official name of an Army real estate holding and the principal function as defined in the real property inventory, e.g., Fort Lee.

CUSTOMER NAME: The name or description of the user, occupant, owner of a facility, or the organizational activity authorized to submit a request for work consisting of up to 15 alpha numeric characters.

POC NAME: Name of the person responsible for specific work information about requested work consisting of up to 15 alpha numeric characters (Format - Last Name, First Name)

POC PHONE NUMBER: Phone number for POC of this particular work request consisting of up to 12 alpha numeric characters.

WORK DESCRIPTION: Description of work to include impact and justification.

AUTHORIZED REQUESTOR: The name of the individual who is authorized to request work.

SIGNATURE: Signature of Authorized Requestor.

DA FORM 4283, SEP 2003	APD LC v1.03ES
	Page 2 of 2

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Da Form 4283 – Fill Out and Use This PDF

Da Form 4283 PDF Details

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