Form Dd 619 1 PDF Details

The DD Form 619-1 is an essential document under the purview of the Privacy Act of 1974, specifically designed to record the accessorials services performed, encompassing storage-in-transit delivery and reweighing activities. This form is a critical aspect of logistical operations within the Department of Defense, serving to meticulously document the auxiliary services provided during the transportation of goods and properties. It holds significant information such as the Government Bill of Lading, dates reflecting the pickup and delivery, storage-in-transit details including duration and net weight of the shipment, the consignee's statement of delivery, loss or damage if any, and details regarding additional services such as labor or specific handling instructions. Its use is mandated to ensure transparency, efficiency, and accountability in the movement and storage of goods, safeguarding the interests of the property owners and the carriers involved. With an estimated completion time of five minutes, the form aims to streamline the reporting process while adhering to the regulatory requirements set forth by the Office of Management and Budget (OMB), highlighting the government's commitment to reducing administrative burdens. The DD Form 619-1 is a testament to the structured and regulated process of managing government property and logistics, emphasizing the significance of accurate and detailed record-keeping in operational success.

QuestionAnswer
Form NameForm Dd 619 1
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesform 619 1 form, dd 619 1, form 619 1, form accessorial

Form Preview Example

CONTAINS INFORMATION SUBJECT TO THE PRIVACY ACT OF 1974, AS AMENDED.

STATEMENT OF ACCESSORIAL SERVICES PERFORMED

(STORAGE-IN-TRANSIT DELIVERY AND REWEIGH)

OMB No. 0702-0022 OMB approval expires

MAY 31, 2011

The public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services, Executive Services Directorate, Information Management Division, 1155 Defense Pentagon, Washington, DC 20301-1155 (0702-0022). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE ABOVE ORGANIZATION.

DISTRIBUTION: 1. ORIGINAL COPY TO CARRIER.

 

3. ADDITIONAL COPIES MAY BE MADE FOR CARRIER'S USE.

 

 

 

2. COPY TO PROPERTY OWNER.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1. GOVERNMENT BILL OF LADING

2. DATE OF PICKUP AT ORIGIN

13. STORAGE-IN-TRANSIT (SIT)

 

 

 

 

 

 

 

 

 

 

 

NUMBER

(YYYYMMDD)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

a. STORED AT (City and State)

 

b. SIT SERVICES WERE PROVIDED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AT (X as applicable)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.a. NAME OF OWNER (Last, First, Middle Initial)

 

 

 

 

 

 

 

 

DESTINATION

 

 

 

OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

c. DATE IN

 

d. DATE OUT

 

e. NUMBER

 

f. NET WEIGHT

 

 

 

 

(YYYYMMDD)

 

(YYYYMMDD)

 

 

OF DAYS

 

 

 

 

 

 

 

b. SSN

c. RANK OR GRADE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4. ORIGIN OF SHIPMENT

5. DESTINATION OF SHIPMENT

g. THIS SHIPMENT WAS ORDERED INTO AND OUT OF SIT ON DATES

 

 

 

 

INDICATED HEREON AND AUTHORIZED BY SIT CONTROL NUMBER:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6.a. ORDERING ACTIVITY/

b. LOCATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSTALLATION NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIT IN EXCESS OF 90 DAYS WAS AUTHORIZED (X)

 

 

 

YES

 

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

h. SIGNATURE OF TRANSPORTATION OFFICER

 

i. DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(YYYYMMDD)

7.a. NAME OF CARRIER

b. NAME OF AGENT (Last, First, Middle Initial)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8. SIGNATURE OF CARRIER'S REPRESENTATIVE

9. DATE

14. REWEIGH CERTIFICATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(YYYYMMDD)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

a. ORIGINAL GROSS

 

 

b. REWEIGH GROSS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

c. ORIGINAL TARE

 

 

d. REWEIGH TARE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10. CARRIER'S SHIPMENT REFERENCE NO.

11. AGENT OR DRIVER CODE

e. ORIGINAL NET

 

0

f. REWEIGH NET

 

 

 

 

0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

g. THIS SHIPMENT WAS ORDERED FOR REWEIGH AND SERVICES WERE

12. REMARKS

 

 

 

ACCOMPLISHED AS SHOWN ABOVE.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1) SIGNATURE OF TRANSPORTATION OFFICER

 

(2) DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(YYYYMMDD)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15. ADDITIONAL SERVICES

(1) NUMBER

 

(2) UNIT PRICE

 

(3) CHARGE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

a. LABOR - NUMBER OF MAN-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOURS (Describe services in

 

 

 

 

 

 

 

 

 

 

 

0.00

 

 

 

 

"Remarks")

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b. PIANO/ORGAN OR

 

 

 

 

 

 

 

 

 

 

 

 

0.00

 

 

 

 

EXCESS CARRY SERVICES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

c. OTHER (Describe in

 

 

 

 

 

 

 

 

 

 

 

 

0.00

 

 

 

 

"Remarks")

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16. CONSIGNEE'S STATEMENT OF DELIVERY AND LOSS OR DAMAGE

Notice is hereby given to the carrier to whom this statement of accessorial services performed is surrendered that the shipment was received in condition as shown below and that claim, if any, will be made for the value of such loss and/or damage as indicated.

a. DESCRIPTION OF LOSS OR DAMAGE

b. ACTUAL OR ESTIMATED WEIGHT

17. WAIVER

a. INVENTORY NUMBERS

b. SIGNATURE

 

 

Unpacking and removal of packing material, boxes/cartons, and other debris is hereby waived.

18. CERTIFICATION. I have received the property described on this form:

a.FROM (Name of Transportation Company)

b.AT (Actual Point of Delivery)

in apparent good order and condition except as noted above.

c. SIGNATURE OF CONSIGNEE OR AUTHORIZED AGENT

d. DATE OF DELIVERY (YYYYMMDD)

DD FORM 619-1, MAY 2008

PREVIOUS EDITION MAY BE USED.

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