Form 6409 PDF Details

In times of disaster relief operations, the coordination and logistics of shipping items to and from the affected areas are crucial for a swift response. The Disaster Requisition Form 6409, along with its related forms, plays a pivotal role in this logistical ballet. Designed for authorized personnel, this form facilitates the requisition of goods, services, and the acknowledgment of their receipt at disaster sites. It includes sections for the basic information of the disaster relief operation, shipping details to ensure materials reach their intended location, and the requester's information to maintain accountability. Furthermore, it outlines item descriptions, including quantity, unit of measure, and status, to make sure that the needs of the operation are clearly communicated. For the process to be complete, an approver must verify that the requested items align with the Service Delivery Plan, a step that underscores the form's importance in efficient disaster relief coordination. Notably, the form is adaptively designed to cater to different needs such as shipments, returns, and transfers by checking the appropriate boxes. Lastly, once the form is filled and approved, it must be forwarded to logistic support, marking a critical step in delivering aid to disaster-stricken areas. This procedural document underscores the organized effort required to manage resources effectively during times of crisis.

QuestionAnswer
Form NameForm 6409
Form Length7 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 45 sec
Other namesred cross 6409 form, american red cross 6409 form, greene 6409 red cross, example red cross form 6409

Form Preview Example

Disaster Requisition (Form 6409)

I) Basic Information

 

DR #:

 

–

 

DR Name:

 

 

 

 

 

 

 

 

 

 

 

Today’s Date:

 

 

Requisition #:

 

 

 

 

 

 

 

 

SCREM Trip #:

 

 

 

 

Requisition Type (This requisition is for):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Shipment

 

 

Return

 

 

Transfer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

II) Ship to Information (To be filled by the Requester)

 

 

 

 

 

 

 

 

 

 

Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone #:

 

 

 

 

Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City:

 

 

 

 

 

 

 

 

 

 

State:

 

 

 

 

 

 

Zip:

 

 

Special Instructions:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Drop Trailer:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Check the box if items are needed only if sourced as an in-kind donation)

 

 

 

 

IKD:

 

 

 

 

 

 

 

 

 

 

III) Requester’s Information (To be filled by the Requester)

 

 

 

 

 

 

 

 

 

 

Prepared by (Print name):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Prepared by (Signature):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Group:

 

 

 

 

 

 

 

 

 

 

 

 

 

Activity:

 

 

 

 

 

 

 

IV) Description of Item(s)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Quantity

 

Unit (U) of

 

Total Qty

 

 

 

 

 

 

 

 

 

Need by

 

 

Stock No.

 

Measure

 

 

Each

 

 

 

Item Description

 

Status

 

 

 

 

 

(Q)

 

(EA/PK/CS/BK)

 

(Q x U = E)

 

 

 

 

 

 

 

 

 

(Date)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

V) The following information must be filled in by the APPROVER ONLY

I hereby verify that the items requested above are in concurrence with the Service Delivery Plan.

Approved by (Print name & title):

Approved by (Signature):

Please send original completed form to LOG Supply on the disaster relief operation. LOG Supply should fax the form to DLC at 202-303-0225 or email at DLC@usa.redcross.org.

Disaster Requisition (Form 6409)

Rev. 9/2010

 

 

Disaster Requisition (Form 6409)

Instructions for completing the form

Use the Disaster Requisition (Form 6409) to ship items to and from disaster relief operations, Disaster Field Supply Centers (DFSCs) or other related disaster sites. An authorized person must complete this form. The Disaster Requisition

(Form 6409) is located on the disaster services form pages on CrossNet.

Use a different Disaster Requisition (Form 6409) for each shipping address. Use and attach multiple forms if all items do not fit on one form.

The person who requisitions the purchase of goods or services should not be the person who approves the purchase.

Use the instructions below to complete all the sections of this form:

I) Basic Information

DR #: Enter the DR # and year

DR Name: Enter the DR Name

Today’s Date: Enter date in mm-dd-yy format

Requisition #: Enter a unique Requisition #. This block is to be filled by NHQ DLC personnel only.

SCREM Trip #: This is to be filled in by SCREM

Requisition Type: Check the appropriate box for the type of

requisition: Shipment, Return or Transfer

II)Ship to Information (to be filled by the Requester)

Ship to Contact Information: Enter the contact name, phone

#and the complete shipping address for where the items are being shipped.

Special Instructions: Enter any special instructions (up to 60 characters), e.g., specific instructions for the driver Drop Trailer (Checkbox): Check if a drop trailer is being requested

IKD (Checkbox): Check if items are needed only if sourced as an in-kind donation

III)Requester’s Information (to be filled by the Requester)

Prepared by (Print name): Enter the Requester’s Name. Please write legibly.

Prepared by (Signature): Enter the Requester’s Signature (digitally typed or digital signature is acceptable)

Group: Enter the Requester’s Group

Activity: Enter the Requester’s Activity

IV) Description of Item(s)

Stock No.: Enter the Stock No. for the item if known

Quantity: Enter the # of Units of Measure

Unit of Measure: Enter the Unit of Measure (EA-Each; PK- Pack; CS-Case; BX-Box)

Total Qty (Each): Enter the number Quantity x Unit of measure = Total Each

Item Description: Enter the description of the item

Need by: Enter the date and time for when the items are needed

Status: Enter the order fulfillment status of the item (this block is for disaster relief operation and SCREM use only)

V) Approver

Checkbox: Certifies items are in concurrence with the Service Delivery Plan

Approved by (Print name and title): Enter the Name and Title of the Approver

Approved by (Signature): Enter the Signature of the Approver (digitally typed or digital signature is acceptable)

When you have completed the information on this form and received approval, forward to LOG Supply on the disaster relief operation. LOG Supply should then fax the form to DLC at 202-303-0225 or email at

DLC@usa.redcross.org.

Disaster Requisition (Form 6409)

Rev. 9/2010

 

 

Disaster Requisition Receipt (Form 6409-B)

I) Basic Information

 

DR #:

–

 

 

DR Name:

 

 

 

Today’s Date:

 

 

Requisition #:

 

 

 

 

 

 

 

 

 

 

II) Description of Item(s)

 

 

 

 

 

 

 

 

 

 

 

Quantity

 

Unit (U) of

 

Total Qty

 

 

 

 

 

Stock No.

 

Measure

 

Each

 

Item Description

Status

 

 

 

(Q)

(EA/PK/CS/BK)

 

(Q x U = E)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

III) Acknowledgement by person receiving items

 

 

 

 

 

 

I hereby certify that I have received all of the items listed above.

 

 

 

 

 

 

(If all the items listed above have not been received, please provide an explanation in the space below)

 

 

Received by (Print name):

 

 

 

 

 

 

 

 

 

Received by (Signature):

 

 

 

 

 

 

 

 

 

Date:

 

 

 

 

 

 

 

Time of arrival:

 

 

Group:

 

 

 

 

 

 

 

Activity:

 

Disaster Requisition Receipt (Form 6409-B)

Rev. 9/2010

 

 

Disaster Requisition Receipt (Form 6409-B)

Instructions for completing the form

Use the Disaster Requisition Receipt (Form 6409-B) to acknowledge receipt of materials requested on the Disaster Requisition (Form 6409) by Groups/Activities on the disaster relief operation.

Disaster Requisition Receipt (Form 6409-B) is for field use only.

Use the instructions below to complete all the sections of this form:

I) Basic Information

DR #: Enter the DR # and year

DR Name: Enter the DR Name

Today’s Date: Enter date in mm-dd-yy format

Requisition #: Enter a unique Requisition #.

II) Description of Item(s)

Stock No.: Enter the Stock No. for the item if known

Quantity: Enter the # of Units of Measure

Unit of Measure: Enter the Unit of Measure (EA-Each; PK- Pack; CS-Case; BX-Box)

Total Qty (Each): Enter the number Quantity x Unit of Measure = Total Each

Item Description: Enter the description of the item

Status: This is to be filled in by supply on a disaster relief operation

III)Acknowledgement by person receiving item

Checkbox: Certifies receipt of items

Received by (Printed name): Enter the name of the recipient

Received by (Signature): Enter the signature of the recipient (digitally typed or digital signature is acceptable) Date: Enter date in mm-dd-yy format

Time of Arrival: Enter arrival time

Group: Enter the Requester’s Group

Activity: Enter the Requester’s Activity

Disaster Requisition Receipt (Form 6409-B)

Rev. 9/2010

 

 

Disaster Requisition

Bill of Lading for Disaster Relief Operations (Form 6409-C)

I) Basic Information

 

DR #:

–

DR Name:

 

 

 

 

 

Today’s Date:

 

Requisition #:

 

 

 

 

SCREM Trip #:

 

 

 

II) Origin Location

 

 

 

 

 

 

 

 

 

 

 

Where are these items being shipped from:

 

 

DFSC

 

 

DRO Warehouse

 

Vendor/ Donor

 

 

 

 

 

 

 

 

 

 

 

 

Origin Name:

 

 

 

 

 

 

 

 

 

 

 

Origin Address:

 

 

 

 

 

 

 

 

 

 

 

City:

 

 

 

 

State:

 

 

 

 

Zip:

III) Ship to Information (Ship to information must match the information on the Disaster Requisition (Form 6409))

 

Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone #:

 

Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City:

 

 

 

 

 

 

 

 

 

State:

 

 

 

Zip:

 

IV) Shipping Information

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Transportation Mode:

 

Land

 

 

Sea

 

 

Air

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Type of Transaction:

 

 

 

Delivery

 

Distribution

 

 

Disposal

 

 

 

 

 

 

 

Transport Subcontractor (If any):

 

 

 

 

 

 

 

 

 

 

 

 

 

Trailer #:

 

 

 

 

 

 

 

 

 

 

Trailer Tracker #:

 

License Plate #:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

V) Product Information

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Stock No.1

Quantity

 

 

Unit (U) of

 

Total Qty

 

 

 

 

 

 

 

Measure

 

 

Each

 

 

Item Description

 

 

 

(Q)

 

 

(EA/PK/CS/BK)

(Q x U = E)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1Stock No. must match the Stock No. on the Disaster Requisition (Form 6409)

Disaster Requisition, Bill of Lading for Disaster Relief Operations (Form 6409-C)

Rev. 9/2010

Page 1 of 2

 

Disaster Requisition

Bill of Lading for Disaster Relief Operations (Form 6409-C)

VI) Certification of items loaded (Acknowledgement by person issuing items out of the origin location)

I certify that I have issued all the items listed above to the shipper and all items are in good condition.

Issued by (Print name):

Issued by (Signature):

Date:

VII) Acknowledgement by carrier

I certify that I have received all the items listed above and all items are in good condition.

Received by (Print name):

Received by (Signature):

Date:

Time of departure:

VIII) Acknowledgement by person receiving items

I certify that I have received all of the items listed above.

(If all the items listed above have not been received, please provide an explanation in the space below)

Received by (Print name):

Received by (Signature):

Date:

Time of arrival:

Explanation for not receiving all items listed above. Items were:

Lost

 

Other reason (Please specify)

 

Damaged

 

 

The receiver in Section VIII must send original completed form to the Logistics/Supply activity on the disaster relief operation. Supply should fax the form to DLC at 202-303-0225.

Disaster Requisition, Bill of Lading for Disaster Relief Operations (Form 6409-C)

Rev. 9/2010

Page 2 of 2

 

Disaster Requisition

Bill of Lading for Disaster Relief Operations (Form 6409-C)

Instructions for completing the form

The Bill of Lading for Disaster Relief Operations (Form 6409-C) must be completed by the Disaster Field Supply Center (DFSC), DRO warehouse or other warehouse that will be shipping out disaster product via a carrier. This form requires signatures from the carrier and recipient. This form must accompany the shipment.

Use the instructions below to complete all the sections of this form:

I) Basic Information

DR #: Enter the DR # and year

DR Name: Enter the DR Name

Today’s Date: Enter date in mm-dd-yy format

Requisition #: Enter a unique Requisition #. This block is to be filled by NHQ DLC personnel only.

SCREM Trip #: This is to be filled in by SCREM

II) Origin Location

Where are these items being shipped from: Check DFSC, DRO Warehouse or Vendor/Donor

Origin Contact Information: Enter the originating name, and the complete originating address.

III) Ship to Information

Ship to Contact Information: Enter the contact name, phone

#and the complete shipping address for where the items are being shipped.

IV) Shipping Information

Transportation Mode: Check Land, Sea or Air

Type of Transaction: Check Delivery, Distribution or Disposal

Transport Subcontractor (if any): Fill in if applicable

Trailer #: Enter Trailer #

Trailer Tracker #: Enter Trailer Tracker #

License plate #: Enter License plate # of the trailer

V) Product Information

Stock No.: Enter the Stock No. for the item if known

Quantity: Enter the # of Quantity

Unit of Measure: Enter the Unit of Measure (EA-Each; PK- Pack; CS-Case; BX-Box)

Total Qty (Each): Enter the number Quantity x Unit of Measure = Total Each

Item Description: Enter the description of the item

VI) Certification of items loaded

Checkbox: Certifies issuance of items

Issued by (Print name): Enter the name of the issuer

Issued by (Signature): Enter the signature of the issuer (digitally typed or digital signature is acceptable)

Date: Enter date in mm-dd-yy format

VII) Acknowledgement by carrier

Checkbox: Certifies delivery of items

Received by (Print name): Enter the name of the recipient

Received by (Signature): Enter the signature of the recipient (digitally typed or digital signature is acceptable) Date: Enter date in mm-dd-yy format

Time of Departure: Enter departure time

VIII) Acknowledgement by person receiving item Checkbox: Certifies receipt of items

Received by (Print name): Enter the name of the recipient

Received by (Signature): Enter the signature of the recipient (digitally typed or digital signature is acceptable) Date: Enter date in mm-dd-yy format

Time of Arrival: Enter arrival time

Explanation for not receiving all items listed above: Check Lost, Damaged or other Reason (please specify)

The receiver in Section VIII must send original completed form to the Logistics/Supply activity on the disaster relief operation. The Logistics/Supply activity must then fax the form to DLC at 202-303-0225.

Disaster Requisition, Bill of Lading for Disaster Relief Operations (Form 6409-C)

Rev. 9/2010

 

 

How to Edit Form 6409 Online for Free

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Step 1: Firstly, access the editor by pressing the "Get Form Button" at the top of this page.

Step 2: As you launch the editor, you will notice the document made ready to be filled in. Apart from filling out different blank fields, you can also perform some other things with the Document, including writing any textual content, modifying the original textual content, inserting graphics, putting your signature on the document, and more.

This form will require specific information; in order to ensure correctness, take the time to take note of the tips listed below:

1. Fill out the red cross form 6409 with a group of essential fields. Collect all of the important information and be sure nothing is left out!

Filling out section 1 of red cross 6409 form

2. Once your current task is complete, take the next step – fill out all of these fields - Unit U of Measure, EAPKCSBK, Each, Q x U E, Item Description, Date, Status, V The following information must, I hereby verify that the items, and Approved by Print name title with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Writing part 2 in red cross 6409 form

3. Completing Approved by Print name title, Please send original completed, Disaster Requisition Form, and Rev is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

Please send original completed, Disaster Requisition Form, and Rev inside red cross 6409 form

4. This next section requires some additional information. Ensure you complete all the necessary fields - I Basic Information, DR Name Todays Date, Requisition, II Description of Items, Unit U of Measure, EAPKCSBK, Stock No, Quantity, Total Qty, Each, Q x U E, Item Description, and Status - to proceed further in your process!

Stage no. 4 of completing red cross 6409 form

Regarding Unit U of Measure and I Basic Information, make sure that you review things in this section. The two of these could be the most important ones in the page.

5. As a final point, this last part is precisely what you have to finish before finalizing the form. The blank fields in this instance are the following: III Acknowledgement by person, Date Time of arrival, Group, and Activity.

Stage number 5 for completing red cross 6409 form

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