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Appendix A GOVERNMENT FORMS
Figure A-1. DA Form 2407 - Completed

TB-5-5420-279-14 Dry Support Bridge Launcher M1975 (NSN 5420-01-469-7478) and Dry Support Bridge Sections M19 (NSN 5420-01-470-5823) Manual
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d. Completing DA Form 2407 (or DA Form 5504). DA PAM 738-750 governs the
preparation of DA Form 2407 (or DA Form 5504). In addition to the instructions
provided in DA PAM 738-750, the following information will assist you in filling out the
form for the purpose of claims under these vehicles warranty. Refer to figure A-1 for an
example of a completed DA Form 2407 (or DA Form 5504)
(1) Section I (to be filled out by originating organization).
a) Block 1. Enter the DSB vehicle serial number found on the vehicles identification
plate.
b) Use the following information to complete blocks 3, 5, 6:.
Block 3
Block 5
Block 6
Truck, Tractor,
M915A3
2320-01-432-4847
Line Haul
c) Block 16. Enter "Warranty Claim Action" and give a complete description
of the failure.
(2) Section II (to be filled in by the support activity). Fill in Section II by following the
steps below:
a) Block 17. Fill in the name and address of the facility that made the repair.
b) Block 18. Check the appropriate box.
A-2






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