NOTICE OF DELEGATION OF AUTHORITY - RECEIPT FOR SUPPLIES
GRADE
AUTHORIZED REPRESENTATIVE(S)
AUTHORIZATION BY RESPONSIBLE SUPPLY OFFICER OR ACCOUNTABLE OFFICER
SIGNATURE AND INITIALS
I ASSUME FULL RESPONSIBILITY
SIGNATURE
DA FORM 1687, MAY 2009
APD LC v1.00ES
DELEGATES TO THE UNDERSIGNED HEREBY WITHDRAWS FROM THE PERSON(S) LISTED ABOVE,
THE AUTHORITY TO:
LAST NAME-FIRST NAME-MIDDLE INITIAL
REQ REC
AUTHORITY
ORGANIZATION RECEIVING SUPPLIES
DATE
LOCATION
REMARKS
UNIT IDENTIFICATION CODE
LAST NAME-FIRST NAME-MIDDLE INITIAL
DODAAC/ACCOUNT NUMBER
EXPIRATION DATE
PREVIOUS EDITIONS ARE OBSOLETE
For use of this form, see DA PAM 710-2-1. The proponent agency is DCS, G-4.
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