Form Da 3953 PDF Details

Have you ever had to file a Form Da 3953? If not, you're in for a treat! This form is used to apply for an exemption from the Connecticut state income tax. In order to complete this form, you will need to provide information about your income and your residence. You will also need to indicate which exemptions you are claiming. The deadline for completing and submitting this form is April 15th.

You'll find info about the type of form you want to complete in the table. It can show you the time you will need to fill out form da 3953, exactly what fields you need to fill in and several additional specific facts.

QuestionAnswer
Form NameForm Da 3953
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesdd form 3953, form 3953 fillable, how to form da 3953, fillable da form 3953

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Attachments Menu

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PURCHASE REQUEST AND COMMITMENT

 

1. PURCHASE INSTRUMENT NO.

 

2.

REQUISITION NO.

 

3. DATE

 

 

 

 

 

PAGE

 

 

OF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For use of this form, see DFAS-IN 37-1; the proponent agency is ASA(FM&C).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PAGES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

TO:

 

 

 

 

 

 

5.

THRU:

 

 

 

 

 

 

 

 

 

 

6.

FROM:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

It is requested that the supplies and services enumerated below or on attached list be

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7.

PURCHASED FOR

 

 

 

 

 

 

 

 

 

 

8. DELIVERED TO

 

 

 

 

 

 

 

 

 

 

 

 

 

9. NOT LATER THAN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Date)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The supplies and services listed below cannot be secured through normal supply channels or other Army supply

 

10.

NAME OF PERSON TO CALL FOR ADDITIONAL

11. TELEPHONE NUMBER

sources in the immediate vicinity, and their procurement will not violate existing regulations pertaining to local

 

 

INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

purchases for stock, therefore, local procurement is necessary for the following reason: (Check appropriate box and

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

complete item.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12. LOCAL PURCHASES AUTHORIZED AS THE NORMAL

 

13. REQUISITIONING DISCLOSES NONAVAILABILITY

 

 

 

 

 

FUND CERTIFICATION

 

 

 

 

 

 

 

 

 

 

 

 

 

MEANS OF SUPPLY FOR THE FOREGOING BY

 

 

 

 

OF ITEMS AND LOCAL PURCHASE IS AUTHORIZED BY

 

The supplies and services listed on this request are properly chargeable to

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

the following allotments, the available balances of which are sufficient to

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

cover the cost thereof, and funds have been committed.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMERGENCY SITUATION PRECLUDES USE OF REQUISITION CHANNELS FOR SECURING ITEM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

19. ACCOUNTING CLASSIFICATION AND AMOUNT

 

 

 

 

 

 

 

 

14.

 

15.

16.

 

 

 

 

 

17.

 

18.

 

ESTIMATED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ITEM

DESCRIPTION OF SUPPLY OR SERVICES

QUANTITY

 

UNIT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

UNIT PRICE

 

TOTAL COST

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

a

 

 

 

b

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20.

TYPED NAME AND TITLE OF

 

21. SIGNATURE

 

 

22.

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CERTIFYING OFFICER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

23.

DISCOUNT TERMS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

24.

PURCHASE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ORDER NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

26.

DELIVERY REQUIREMENTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

25. THE FOREGOING ITEMS ARE REQUIRED NOT LATER THAN AS INDICATED ABOVE FOR THE FOLLOWING PURPOSE

 

ARE MORE THAN 7 DAYS REQUIRED TO INSPECT AND ACCEPT THE REQUESTED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GOODS OR SERVICES

 

 

YES

 

 

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IF YES, NUMBER OF DAYS REQUIRED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

27. TYPED NAME AND GRADE OF INITIATING

28.

SIGNATURE

 

 

 

 

 

 

 

 

29.

DATE

34.

TYPED NAME AND GRADE

35. SIGNATURE

 

 

36.

DATE

OFFICER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OF APPROVING OFFICER OR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DESIGNEE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30. TELEPHONE NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

31. TYPED NAME AND GRADE OF SUPPLY

32.

SIGNATURE

 

 

 

 

 

 

 

 

33.

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OFFICER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DA FORM 3953, MAR 1991

 

 

 

 

 

 

 

 

 

EDITION OF AUG 76 IS OBSOLETE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APD LC v2.05ES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Attachments Menu

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

37. OBLIGATION RECORD

 

 

 

 

 

 

 

 

 

 

 

 

38. AMOUNT OF COMMITMENT $

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE

REFERENCE

OBLIGATED

UNOBLIGATED

REMARKS

DATE

REFERENCE

 

OBLIGATED

UNOBLIGATED

 

REMARKS

 

NUMBER

INCURRED

BALANCE

NUMBER

 

INCURRED

BALANCE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

39.PROCUREMENT DATA Item

BIDDER NO.

Qty

 

Unit

DISCOUNT

BUSI-

DAYS

NESS

10 20 30 NI Lg Sm

DELIVERY

TIME

DESTINATION

FOB

POINT

PAGE 2, DA FORM 3953, MAR 1991

APD LC v2.05ES

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In the DISCOUNT TERMS, PURCHASE ORDER NUMBER, DELIVERY REQUIREMENTS, THE FOREGOING ITEMS ARE REQUIRED, ARE MORE THAN DAYS REQUIRED TO, YES, TYPED NAME AND GRADE OF, SIGNATURE, TELEPHONE NUMBER, IF YES NUMBER OF DAYS REQUIRED, DATE, TYPED NAME AND GRADE OF APPROVING, SIGNATURE, DATE, and TYPED NAME AND GRADE OF SUPPLY area, put in writing your details.

dd form 3953 DISCOUNT TERMS, PURCHASE ORDER NUMBER, DELIVERY REQUIREMENTS, THE FOREGOING ITEMS ARE REQUIRED, ARE MORE THAN  DAYS REQUIRED TO, YES, TYPED NAME AND GRADE OF, SIGNATURE, TELEPHONE NUMBER, IF YES NUMBER OF DAYS REQUIRED, DATE, TYPED NAME AND GRADE OF APPROVING, SIGNATURE, DATE, and TYPED NAME AND GRADE OF SUPPLY fields to insert

You could be asked for particular vital particulars to be able to prepare the OBLIGATION RECORD, AMOUNT OF COMMITMENT, DATE, REFERENCE NUMBER, OBLIGATED INCURRED, UNOBLIGATED BALANCE, REMARKS, DATE, REFERENCE NUMBER, OBLIGATED INCURRED, UNOBLIGATED BALANCE, REMARKS, PROCUREMENT DATA, BIDDER NO, and Item segment.

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