DA Form 4283 at a glance
What it is: DA Form 4283 is the Facilities Engineering Work Request; for use of this form, see DA Pam 420-11.
Who signs: The signature on DA Form 4283, JUL 2026 is the signature of the Authorized Requestor.
Part A of DA Form 4283 is completed by the requestor per the completion instructions.
A filled-in DA Form 4283 example: a requestor asks for a door repair
How to fill out DA Form 4283, box by box
Customer ID, Document Serial Number and Fiscal Year
On DA Form 4283, the Customer ID is one to three alphanumeric characters per local DPW policy. It is 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 alphanumeric 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: enter the last digit of the fiscal year; i.e., '3' for Fiscal Year 2003.
Type, Short Job Description and Date
Type: leave blank; DPW Work Reception will complete it. Date: the date Work Request was completed (format 15 JUL 03).
Short Job Description: up to 30 alphanumeric characters that provide a description with a concise summary statement of the work to be performed.
Installation Abbreviation and Building/Facility Numbers
Installation Abbreviation: up to eight alphanumeric 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 alphanumeric 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
Remarks: at a minimum, include email address of the Primary POC and an Alternate POC for requested work.
Installation Name, Customer Name, POC Name and POC Phone Number
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 alphanumeric characters.
POC Name: name of the person responsible for specific work information about requested work consisting of up to 15 alphanumeric characters (format Last Name, First Name).
POC Phone Number: phone number for POC of this particular work request consisting of up to 12 alphanumeric characters.
Work Description
Work Description: description of work to include impact and justification.
Authorized Requestor
Authorized Requestor (type or print): the name of the individual who is authorized to request work.
Part B (Approving Official Only)
Part B of DA Form 4283, the Facilities Engineering Work Request, is completed by the DPW in accordance with local procedures.
Sources
[1] DA Form 4283 (JUL 2026), Facilities Engineering Work Request, Department of the Army (the Official source link on this page).