Da Form 4846 – Fill Out and Use This PDF

EXCESS COST COMPUTATION

DATE

For use of this form, see AR 55-71; the proponent agency is DCSLOG.

TO:

FROM:

NAME OF SHIPPER

SOCIAL SECURITY NUMBER

SECTION A - DOMESTIC DOOR-TO-DOOR SHIPMENT OF PERSONAL PROPERTY EXCESS DISTANCE

SHIPMENT MADE FROM -

COUNTY

WEIGHT

DISTANCE

TARIFF

SHIPMENT MADE TO -

COUNTY

RATE PER CWT - $

$

ADD TRANS CHG W/APPLICABLE (TARIFF #

-ITEM

)

$

PER CWT

$+

$

ADD TRANS CHG W/APPLICABLE (TARIFF #

-ITEM

)

PER CWT

$+

OTHER CHARGES

$+

COST

$

SHIPMENT AUTHORIZED FROM -

COUNTY

WEIGHT

DISTANCE

TARIFF

SHIPMENT AUTHORIZED TO -

COUNTY

RATE PER CWT - $

$

ADD TRANS CHG W/APPLICABLE (TARIFF #

-ITEM

)

$

PER CWT

$+

ADD TRANS CHG W/APPLICABLE (TARIFF #

-ITEM

)

$

PER CWT

$+

COST

$

MEMBER'S PORTION

$

AMOUNT COLLECTED

$

(If Applicable)

AMOUNT TO BE COLLECTED $

OR AMOUNT OF REFUND DUE MEMBER BY FINANCE

CENTER $

SECTION B - DOMESTIC DOOR-TO-DOOR SHIPMENT OF PERSONAL PROPERTY IN EXCESS OF WEIGHT ALLOWANCE

1. GROSS WEIGHT

2. TARE WEIGHT

_

3. NET WEIGHT OF PROPERTY SHIPPED

4. LESS AUTH WEIGHT OF PROFESSIONAL BOOKS (If Applicable)

_

5. LESS 10% FOR PACKING

_

6. NET WEIGHT (Constructive)

7. AUTHORIZED WEIGHT ALLOWANCE

_

8. NET EXCESS WEIGHT SHIPPED

9. PACKING FOR EXCESS WEIGHT (11.11% x Net Excess Weight)

+

10. TOTAL PACKED EXCESS WEIGHT

TOTAL PACKED EXCESS WEIGHT (10)

x

$

(Cost of Shipment)

NET WT OF PROPERTY SHIPPED (3)

÷

=

$

(Member's Portion)

(If Applicable)

AMOUNT TO BE COLLECTED $

OR AMOUNT OF REFUND DUE MEMBER BY FINANCE

CENTER $

SECTION C - TGBL OR DOMESTIC DOOR-TO-DOOR ON DELIVERY/DIVERSION OF INBOUND SHIPMENTS

Check One -

SIT DELIVERY MADE TO

DIVERSION MADE TO

COUNTY

WEIGHT

DISTANCE

TARIFF

SIT DELIVERY/DIVERSION CHARGE PER CWT $

$

SIT DELIVERY AUTHORIZED TO -

COUNTY

DISTANCE

TARIFF

SIT DELIVERY CHARGE PER CWT- $

$ -

MEMBER'S PORTION

$

AMOUNT COLLECTED

$

(If Applicable)

AMOUNT TO BE COLLECTED $

OR AMOUNT OF REFUND DUE MEMBER BY FINANCE

CENTER $

NAME, GRADE AND TITLE

SIGNATURE

NOTE: Excess cost collected in the field is an estimate. The final computation will be made by the Finance Center.

A NOTATION OF THIS REMITTANCE

HAS

HAS NOT BEEN ENTERED ON THE GBL.

INCLOSURES (Identify)

SHIPMENT MADE FROM:

SHIPMENT MADE TO:

DISTANCE

TARIFF

TRANSPORTATION COST $

ADDITIONAL SERVICES:

(1) UNBLOCKING

$

(4) TRL & CONTENTS INS

$

(2) REBLOCKING

$

(5) PER EFFECTS INS

$

(3) ACT OF GOD INSURANCE

$

(6) PACKING

$

(7) OTHER

$

$+

$

TOTAL COST

SHIPMENT AUTH FROM:

SHIPMENT AUTH TO:

DISTANCE

TARIFF

AUTHORIZED COST (GOV'T PAYS $0.74 PER MILE)

$-

MEMBER'S PORTION

$

AMOUNT COLLECTED

$

(If Applicable)

AMOUNT TO BE COLLECTED $

OR AMOUNT OF REFUND DUE MEMBER BY FINANCE

CENTER $

SECTION E - PACKING & CRATING AND/OR TRANSPORTATION - DIRECT PROCUREMENT SHIPMENT

PACKING AND CRATING

1.

GROSS WEIGHT

2.

STENCILED WEIGHT ON CONTAINER

_

3.

NET WEIGHT ON CONTAINER

4.

LESS AUTH WEIGHT OF PROFESSIONAL BOOKS (If Applicable)

_

5.

LESS 20% ALLOWANCE FOR INTERIOR PACKING

_

6.

NET WEIGHT (Constructive)

7.

AUTHORIZED WEIGHT ALLOWANCE

_

8.

EXCESS WEIGHT

9.

PACKING FOR EXCESS WEIGHT (25% x Excess Weight)

+

10. TOTAL EXCESS WEIGHT

EXCESS COST PACKING AND CRATING

TOTAL EXCESS WEIGHT (10)

x

$

(COST OF SHIPMENT)

÷

=

$

(MEMBER'S PORTION)

NET WT ON CONTAINER (3)

EXCESS TRANSPORTATION COST

TOTAL EXCESS WEIGHT (10)

x

$

(COST OF SHIPMENT)

÷

$

(MEMBER'S PORTION)

NET WT ON CONTAINER (3)

=

MEMBER'S PORTION PACKING & CRATING

$

(If Applicable)

MEMBER'S PORTION TRANSPORTATION CHARGE

$+

AMOUNT COLLECTED FROM MEMBER

$

(If Applicable)

AMOUNT TO BE COLLECTED $

OR AMOUNT OF REFUND DUE MEMBER BY FINANCE

CENTER $

SECTION F - PACKING & CRATING AND/OR TRANSPORTATION CHARGE DIRECT PROCUREMENT METHOD

ENLISTED PERSONNEL BELOW GRADE E-4 (Including E-4's with less than two years service)

PACKING AND CRATING

AUTHORIZED GROSS WEIGHT

x

$

(COST OF SHIPMENT)

TOTAL GROSS WT SHIPPED

÷

=

$

(GOVERNMENT'S PORTION)

TRANSPORTATION

AUTHORIZED GROSS WEIGHT

x

$

(COST OF SHIPMENT)

TOTAL GROSS WT SHIPPED

÷

=

$

(GOVERNMENT'S PORTION)

TOTAL COST OF SHIPMENT

$

CHECK APPLICABLE

P&C PLUS TRANS OR

TRANS ONLY

GOVERNMENT COST OF SHIPMENT $-

CHECK APPLICABLE

P&C PLUS TRANS OR

TRANS ONLY

AMOUNT COLLECTED FROM MEMBER $

(If Applicable)

AMOUNT TO BE COLLECTED $

OR AMOUNT OF REFUND DUE MEMBER BY FINANCE

CENTER $