COMBINED ORDER FORM FOR PREPRINTED DOD BAR CODES & MSL LABELS: LATEST REV. OF MIL-STD-129P(4)

COMPANY____________________________________	ORDER BY______________________________
_____________________________________	PO NUMBER ______________DATE________
_____________________________________	PHONE _________________________________
DELIVERY REQUEST____________________SPECIAL INSTRUCTIONS____________________________
NSN________________________________________________		QTY. OF UNIT LABELS_______________
CAGE__________PN__________________________________		QTY. OF EXTERIOR LABELS__________
DESCRIPTION_______________________________________		INFO. REQUIRED ON EXTERIOR PACK
____________________________________________________		QTY._________ WT._______CLIN._______
QTY.________________ UNIT OF ISSUE________________		COMMENTS:
CONTRACT NO._____________________________________
METHOD _____________DATE_________________________		Description will be omitted from the exterior label. Any field not filled in will be left blank.

ORDER FORM FOR MSL LABEL (Generic Cargo Label) ANY FIELDS NOT FILLED IN WILL BE LEFT BLANK

Although all data fields are not listed the below should fulfill most DLA requirements.

1-TCN_______________________________________2-2aFROM/CAGE AND ADDRESS WILL BE TAKEN FROM ABOVE

3-TAC________4-TYPE SERVICE____________5-POSTAGE______6-PIECE(box/pallet) _____OF____(*if more then 1 box see below)

7-WEIGHT________ 8-DATE SHIPPED________9- CUBE (FT)_______ 10-PROJECT_________11-RDD________

12-TRANSPORTATION PRIORITY________

13-SHIP TO POE __________13a-ADDRESS LINE 1(Poe address)_______________________________________

ADDRESS LINE 2 ____________________________________ ADDRESS LINE 3______________________________________

ADDRESS LINE 4 ____________________________________ ADDRESS LINE 5_______________________________________

14-POD________ 15-FMS CASE__________ 16-ULTIMATE CONSIGNEE/MARK FOR_________________________

16a-ADDRESS LINE 1______________________________________ ADDRESS LINE 2 _________________________________

ADDRESS LINE 3_________________________________________ ADDRESS LINE 4_________________________________

ADDRESS LINE 5_________________________________________

17-NSN___________________________18- UNIT PRICE____________19- RIC CODE_________20-CONDITION CODE________

21-QTY. BOX#1____________22-UNIT OF ISSUE_____________23-DOCUMENT REQUISITION#_________________________

*IF SHIPPING MORE THAN ONE PIECE/BOX /PALLET USE BELOW.

BOX#2 QTY________WT_____CU_____ BOX#3 QTY________WT______CU______ BOX#4 QTY______WT______CU______

BOX#5 QTY________ WT_____CU_____ BOX#6 QTY________ WT______CU______ BOX#7 QTY_____WT______CU______

For additional ship to address please complete a new order form.

Call if UII, serial number , RFID, or contractor shipment barcodes are required.