If you are in the military, then you have likely filled out a dd form 1155. This document is used to make changes to your military record. There are many reasons why you might need to fill out this form, such as making a name change or updating your contact information. If you have any questions about how to fill out the dd form 1155, or what changes you can make, be sure to consult with your unit's Legal Officer. The forms and instructions can be found on the internet, but it is always best to get help from someone who knows what they are doing. Thanks for reading!
| Question | Answer |
|---|---|
| Form Name | Dd Form 1155 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | dd1155 form, dd 1155, PURCH, CERTIFYING |
ORDER FOR SUPPLIES OR SERVICES
PAGE 1 OF
1. CONTRACT/PURCH ORDER/AGREEMENT NO. |
2. DELIVERY ORDER/CALL NO. |
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3. DATE OF ORDER/CALL |
4. REQUISITION/PURCH REQUEST NO. |
5. PRIORITY |
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(YYYYMMMDD) |
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6. ISSUED BY |
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7. ADMINISTERED BY (If other than 6) |
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8. DELIVERY FOB |
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DESTINATION |
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OTHER |
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(See Schedule if |
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other) |
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9. CONTRACTOR |
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FACILITY |
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10. DELIVER TO FOB POINT BY (Date) |
11. X IF BUSINESS IS |
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(YYYYMMMDD) |
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SMALL |
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SMALL DISAD- |
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12. DISCOUNT TERMS |
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NAME |
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VANTAGED |
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AND |
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ADDRESS |
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13. MAIL INVOICES TO THE ADDRESS IN BLOCK |
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14. SHIP TO |
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15. PAYMENT WILL BE MADE BY |
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MARK ALL
PACKAGES AND
PAPERS WITH IDENTIFICATION NUMBERS IN BLOCKS 1 AND 2.
TYPE OF
ORDER
DELIVERY/ |
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This delivery order/call is issued on another Government agency or in accordance w ith and subject to terms and conditions of above numbered contract. |
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CALL |
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PURCHASE |
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Reference your |
furnish the follow ing on terms specified herein. |
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ACCEPTANCE. THE CONTRACTOR HEREBY ACCEPTS THE OFFER REPRESENTED BY THE NUMBERED PURCHASE ORDER AS IT MAY PREVIOUSLY HAVE |
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BEEN OR IS NOW MODIFIED, SUBJECT TO ALL OF THE TERMS AND CONDITIONS SET FORTH, AND AGREES TO PERFORM THE SAME. |
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NAME OF CONTRACTORSIGNATURETYPED NAME AND TITLEDATE SIGNED
(YYYYMMMDD)
If this box is marked, supplier must sign Acceptance and return the follow ing number of copies:
17. ACCOUNTING AND APPROPRIATION DATA/LOCAL USE
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20. QUANTITY |
21. |
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18. ITEM NO. |
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19. SCHEDULE OF SUPPLIES/SERVICES |
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ORDERED/ |
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22. UNIT PRICE |
23. AMOUNT |
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UNIT |
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ACCEPTED* |
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$0.00 |
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$0.00 |
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$0.00 |
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* If quantity accepted by the Government is |
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24. UNITED STATES OF AMERICA |
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25. TOTAL |
$0.00 |
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same as quantity ordered, indicate by X. |
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29. |
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If different, enter actual quantity accepted |
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DIFFERENCES |
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below quantity ordered and encircle. |
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BY: |
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CONTRACTING/ORDERING OFFICER |
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26. QUANTITY IN COLUMN 20 HAS BEEN |
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27. SHIP. NO. |
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28. D.O. VOUCHER NO. |
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30. INITIALS |
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INSPECTED |
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RECEIVED |
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ACCEPTED, AND CONFORMS TO THE |
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CONTRACT EXCEPT AS NOTED |
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PARTIAL |
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32. PAID BY |
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33. AMOUNT VERIFIED CORRECT FOR |
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FINAL |
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31. PAYMENT |
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34. CHECK NUMBER |
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DATE |
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SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE |
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36. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT. |
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COMPLETE |
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PARTIAL |
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35. BILL OF LADING NO. |
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FINAL |
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DATE |
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SIGNATURE AND TITLE OF CERTIFYING OFFICER |
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37. RECEIVED |
38. RECEIVED BY (Print) |
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39. DATE RECEIVED |
40. TOTAL CON- |
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41. S/R ACCOUNT NUMBER |
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42. S/R VOUCHER NO. |
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AT |
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(YYYYMMMDD) |
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DD FORM 1155, JAN 1998 |
PREVIOUS EDITION MAY BE USED. |