Block
8
9a
9b
9C
9d
l0a
Explanation
Requisitioner’s Number. Enter the requisi-
tioning activity’s number (requisition or
purchase order number). Entry of the
applicable requisition document number is
mandatory in all cases.
NSN/Part Number and Nomenclature.
When the item received is different from the
item shown on shipping documents or
different from the item requisitioned, enter
each item on a separate line.
Unit of Issue. Enter the unit of issue as billed
or indicated on the shipping document for
each item listed in item 9a. This entry is not
applicable to packaging discrepancies.
Quantity Shipped/Billed. Enter the quantity
of items shipped or billed. When Discrep-
ancy code C1 applies, enter the quantity and
the Supply Condition code of the item when
shipped. This entry is not applicable to
packaging discrepancies.
Quantity Received. Enter the quantity of
item received.
Discrepancy Quantity. Enter the discrepant
quantity. When Discrepancy code C 1
applies, enter the quantity and the Supply
Condition cede of the item received. If total
quantity received is classified under more
than one condition code, enter each
separately with the applicable condition
code.
NOTE: When overage material (expired shelf life)
is received and discrepancy code Q1 or C2 applies,
enter the
Remarks:
a.
b.
c.
d.
e.
f.
g.
following information under item 12
Manufacturer’s name
Contract or purchase order number, if not
shown in item 7a
Date of manufacture, pack or expiration
M/batch number
Location of material
Name, address, and telephone number (if
available) of contact person
Nature of complaint, stating in detail why
material is unsatisfactory
Block
10b
10c
10d
11
12
Explanation
Discrepancy Unit Price. Enter the unit price
as billed or shown on shipping document.
This entry is not applicable to packaging
discrepancies.
Discrepancy Total Cost. For shipping
discrepancies, enter the total money value
of material. For packaging deficiencies,
enter cost of corrective action.
Discrepancy Code. Select the proper
Discrepancy code listed on the face of the
Standard Form 364 and enter in this block.
When proper code is not listed, use code Z1
and describe the discrepancy in block 12.
Action Code. Enter requested action to be
taken from codes listed on the face of the
form. When action is other than that covered
by the listed action codes, use code 1Z and
explain action requested in block 12. Action
code 1D or 1F is not used on reports pre-
pared to cover shipments of DOD stock-
funded items or GSA material. Material still
required must be reordered. Action code 1E
applies only to local purchase items.
Remarks. Use this block for supplemental
information where the combination of
discrepancy codes and action codes needs
clarification. Use this block when shipping
and packaging discrepancies need
explanation. Also, use this block when a
breakout of cost to reports for time and
materials is required. Include specific data
such as appearance, lot or batch number,
manufacturer or packaging data, inspector
number and inspection date, probable cause
of improper packaging, and suggested
corrective action. When reporting shortages
or nonreceipt of items shipped by parcel post
from GSA include a statement in block 12 to
cover all packages received that were shown as
shipped in item 5 of GSA Form 1348-1.
Include telephone number (DSN and
commercial) of the individual to be contacted
for additional information if different from
that entered in block 14a When medical
material that requires refrigeration or frozen
storage is involved, provide the information
requested on the special instruction sheet that
is included within shipments of such material.
Provide photos when it will assist the shipping
activity in determining the cause of the
discrepancy or deficiency.
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