Are you an employee of the United States government? Do you need to submit Form DD 619-1 in order to receive certain official documents? Whether it's for a loan, payment instruction, or affidavit processing, this form must be advanced-processed with particular care. In this blog post, we discuss the importance of understanding how to properly fill out Form DD 619-1 and the consequences if not done correctly. Get all your questions answered about what is required to complete this important form so that your document requests are not denied or cause any other delays!
| Question | Answer |
|---|---|
| Form Name | Form Dd 619 1 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | form 619 1 form, dd 619 1, form 619 1, form accessorial |
CONTAINS INFORMATION SUBJECT TO THE PRIVACY ACT OF 1974, AS AMENDED.
STATEMENT OF ACCESSORIAL SERVICES PERFORMED
OMB No.
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
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE ABOVE ORGANIZATION.
DISTRIBUTION: 1. ORIGINAL COPY TO CARRIER. |
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3. ADDITIONAL COPIES MAY BE MADE FOR CARRIER'S USE. |
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2. COPY TO PROPERTY OWNER. |
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1. GOVERNMENT BILL OF LADING |
2. DATE OF PICKUP AT ORIGIN |
13. |
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NUMBER |
(YYYYMMDD) |
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a. STORED AT (City and State) |
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b. SIT SERVICES WERE PROVIDED |
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AT (X as applicable) |
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3.a. NAME OF OWNER (Last, First, Middle Initial) |
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DESTINATION |
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OTHER |
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c. DATE IN |
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d. DATE OUT |
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e. NUMBER |
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f. NET WEIGHT |
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(YYYYMMDD) |
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(YYYYMMDD) |
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OF DAYS |
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b. SSN |
c. RANK OR GRADE |
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4. ORIGIN OF SHIPMENT |
5. DESTINATION OF SHIPMENT |
g. THIS SHIPMENT WAS ORDERED INTO AND OUT OF SIT ON DATES |
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INDICATED HEREON AND AUTHORIZED BY SIT CONTROL NUMBER: |
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6.a. ORDERING ACTIVITY/ |
b. LOCATION |
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INSTALLATION NAME |
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SIT IN EXCESS OF 90 DAYS WAS AUTHORIZED (X) |
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YES |
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NO |
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h. SIGNATURE OF TRANSPORTATION OFFICER |
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i. DATE |
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(YYYYMMDD) |
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7.a. NAME OF CARRIER |
b. NAME OF AGENT (Last, First, Middle Initial) |
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8. SIGNATURE OF CARRIER'S REPRESENTATIVE |
9. DATE |
14. REWEIGH CERTIFICATION |
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(YYYYMMDD) |
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a. ORIGINAL GROSS |
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b. REWEIGH GROSS |
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c. ORIGINAL TARE |
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d. REWEIGH TARE |
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10. CARRIER'S SHIPMENT REFERENCE NO. |
11. AGENT OR DRIVER CODE |
e. ORIGINAL NET |
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0 |
f. REWEIGH NET |
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0 |
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g. THIS SHIPMENT WAS ORDERED FOR REWEIGH AND SERVICES WERE |
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12. REMARKS |
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ACCOMPLISHED AS SHOWN ABOVE. |
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(1) SIGNATURE OF TRANSPORTATION OFFICER |
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(2) DATE |
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(YYYYMMDD) |
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15. ADDITIONAL SERVICES |
(1) NUMBER |
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(2) UNIT PRICE |
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(3) CHARGE |
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a. LABOR - NUMBER OF MAN- |
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HOURS (Describe services in |
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0.00 |
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"Remarks") |
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b. PIANO/ORGAN OR |
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0.00 |
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EXCESS CARRY SERVICES |
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c. OTHER (Describe in |
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0.00 |
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"Remarks") |
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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 |
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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 |
PREVIOUS EDITION MAY BE USED. |
Adobe Professional 7.0 |