Dd Form 428 PDF Details

The DD Form 428, known as the Communication Service Authorization, plays a crucial role in facilitating communication services for official use within various governmental or military departments. This document serves as a formal authorization, allowing specific communications companies to establish or perform services as detailed within the contract to which this authorization is attached. The form encompasses a wide range of information, including multiple authorizations, circuit or bill numbers with corresponding dates, and detailed contact information for both the submitting and billing parties. Additionally, it includes the address and contact details of the communications company, descriptions of the services to be rendered including non-recurring and monthly rates, and the particulars of the officer responsible for payment. Significantly, the form ensures transparency and accuracy by requiring signatures from both the authorizing official and the accepting contracting firm, solidifying the agreement on services and payments. Created to streamline the process of securing essential communication services, the DD Form 428 underscores the importance of clear, concise, and direct communication between government entities and external service providers.

QuestionAnswer
Form NameDd Form 428
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesYYYYMMDD, CONTRACTING, dd form 428, OBSOLETE

Form Preview Example

COMMUNICATION SERVICE AUTHORIZATION

1. AUTHORIZATION

 

 

2. AUTHORIZATION

 

3. CIRCUIT OR BILL NUMBER

 

 

 

 

 

 

 

 

 

a. NUMBER

 

b. DATE (YYYYMMDD)

a. NUMBER

b. DATE (YYYYMMDD)

 

 

 

 

 

 

 

 

 

 

 

 

4. FROM (Include ZIP Code)

 

 

 

5. SUBMIT BILLS FOR CERTIFICATION TO (Include ZIP Code)

 

 

 

 

 

 

 

 

 

6. TO (Communications Company)

 

 

 

7. TELEPHONE NUMBER TO CONTACT FOR DETAILS

 

 

 

 

 

 

(Include Area Code)

 

 

 

a. COMPANY NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8. AUTHORIZATION. In accordance with provisions of the contract

 

 

 

 

 

indicated above of which this authorization forms a part, authority

b. ADDRESS

 

 

 

 

 

 

is hereby given to Communications Company indicated in Item 6 to

(1) STREET

 

 

 

 

 

 

establish or perform services for official use as prescribed below at:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(2) CITY

 

(3) STATE

(4) ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9. SERVICE(S)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NON-RECURRING

d. RATE PER MONTH

 

 

 

 

 

 

 

 

 

DESCRIPTION

 

NUMBER

CHARGE

PER UNIT

 

TOTAL

 

 

a.

 

b.

c.

(1)

 

(2)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10. DISBURSING OFFICER MAKING PAYMENT

 

11. DISTRIBUTION

 

 

 

 

 

 

 

 

 

 

a. NAME (Last, First, Middle Initial)

b. GRADE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12. AUTHORIZING OFFICIAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

a. SIGNATURE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b. TITLE

 

 

c. GRADE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13. ACCEPTANCE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

a. NAME OF CONTRACTING FIRM

 

 

b. SIGNATURE OF CONTRACTOR'S REPRESENTATIVE

 

c. DATE SIGNED

 

 

 

 

 

 

 

 

 

(YYYYMMDD)

 

 

 

 

 

 

 

 

 

 

DD FORM 428, MAY 1999

PREVIOUS EDITION IS OBSOLETE.

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