SHIPPING CONTAINER TALLY 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50

REQUISITION AND INVOICE/SHIPPING DOCUMENT

1. FROM: (Include ZIP Code) SHEET NO. OF 5. REQUISITION 6. REQUISITION NUMBER
NO. SHEETS DATE

7. DATE MATERIAL REQUIRED (YYYYMMDD) 8. PRIORITY

2. TO: (Include ZIP Code) 9. AUTHORITY OR PURPOSE

10. SIGNATURE 11a. VOUCHER NUMBER & DATE (YYYYMMDD)

3. SHIP TO - MARK FOR 12. DATE SHIPPED (YYYYMMDD) b.

13. MODE OF SHIPMENT 14. BILL OF LADING NUMBER

15. AIR MOVEMENT DESIGNATOR OR PORT REFERENCE NO.

4. APPROPRIATIONS DATA AMOUNT

ITEM FEDERAL STOCK NUMBER, DESCRIPTION, AND CODING OF MATERIEL AND/OR SERVICES UNIT QUANTITY SUPPLY TYPE CON-
OF REQUESTED ACTION CON- TAINER UNIT PRICE TOTAL COST
NO.
(b) ISSUE TAINER NOS.
(a) (d) (f) (h) (i)
(c) (e) (g)

$0.00

$0.00

$0.00

$0.00

$0.00
16. TRANSPORTATION VIA AMC OR MSC CHARGEABLE TO 17. SPECIAL HANDLING
18. ISSUED BY TOTAL TYPE TOTAL 19. DATE BY SHEET TOTAL
DESCRIPTION TOTAL CONTAINERS
R CON- CON- WEIGHT (YYYYMMDD)
TAINERS CUBE RECEIVED
TAINER
E
C O
EXCEPT AS $0.00
R NOTED
A F
P E
CHECKED BY QUANTITIES DATE BY GRAND TOTAL
I S C
(YYYYMMDD)
T H E RECEIVED
U I I EXCEPT AS $0.00
L P P NOTED
A M PACKED BY BY
T E T DATE 20. RECEIVER'S
I N (YYYYMMDD) VOUCHER NO.
POSTED
O T TOTAL
N

DD FORM 1149, JAN 2016 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100

PREVIOUS EDITION IS OBSOLETE. Adobe Designer 9.0
SHIPPING CONTAINER TALLY 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50

REQUISITION AND INVOICE/SHIPPING DOCUMENT (Continuation Sheet)

SHEET NO. NO. OF SHEETS 6. REQUISITION NUMBER 11a. VOUCHER NUMBER AND DATE b. VOUCHER NUMBER AND DATE

UNIT QUANTITY SUPPLY TYPE CON-

ITEM FEDERAL STOCK NUMBER, DESCRIPTION,
OF REQUESTED ACTION CON- TAINER UNIT PRICE TOTAL COST
NO. AND CODING OF MATERIEL AND/OR SERVICES
ISSUE TAINER NOS.
(a) (b)
(c) (d) (e) (f) (g) (h) (i)

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

SHEET TOTAL $0.00

DD FORM 1149C, JAN 2016 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100
PREVIOUS EDITION IS OBSOLETE.