17. DATE
7.
MILITARY INTERDEPARTMENTAL PURCHASE REQUEST
13. MAIL INVOICES TO
(Payment will be made by)
ACCTG STA
DODAAD
ACRN
BEEN ACCOMPLISHED.
QTY
DESCRIPTION
11. GRAND TOTAL
1.
ESTIMATED
TOTAL
PRICE
ARE NOT INCLUDED IN THE INTERSERVICE SUPPLY SUPPORT PROGRAM AND REQUIRED INTERSERVICE
3. CONTROL SYMBOL NO.
PAGE OF PAGES
1
2. FSC 4. DATE PREPARED 5. MIPR NUMBER 6. AMEND NO.
TO:
8.
FROM:
(Agency, name, telephone number of originator)
9. ITEMS ARE
HAS HAS NOT
(Federal stock number, nomenclature, specification and/or drawing No., etc.)
b
c
UNIT
d
ESTIMATED
UNIT
PRICE
e
f
ITEM
NO.
a
SEE ATTACHED PAGES FOR DELIVERY SCHEDULES, PRESERVATION AND PACKAGING INSTRUCTIONS, SHIPPING
INSTRUCTIONS AND INSTRUCTIONS FOR DISTRIBUTION OF CONTRACTS AND RELATED DOCUMENTS.
12. TRANSPORTATION ALLOTMENT
(Used if FOB Contractor’s plant)
PAY OFFICE DODAAD
14. FUNDS FOR PROCUREMENT ARE PROPERLY CHARGEABLE TO THE ALLOTMENTS SET FORTH BELOW, THE AVAILABLE BALANCES OF WHICH
ARE SUFFICIENT TO COVER THE ESTIMATED TOTAL PRICE.
APPROPRIATION
LIMIT/
SUBHEAD
SUPPLEMENTAL ACCOUNTING CLASSIFICATION AMOUNT
15. AUTHORIZING OFFICER
(Type name and title)
16. SIGNATURE
DD Form 448, JUN 72 (EG) PREVIOUS EDITION IS OBSOLETE.
10.
SCREENING
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$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
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