Completing DA Form 2407 (or DA Form 5504)

TB 9-2320-363-15

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 Freightliner vehicle chassis serial number found on the vehicles

identification plate.

b) Use the following information to complete blocks 3, 4, 5:.

Block 5

Block 6

Block 3

M915A3

2320-01-432-4847

Truck, Tractor,

Line Haul

M916A2

2320-01-431-1163

Truck, Tractor

LET

3805-01-431-1165

M917A1

Truck, Dump

3805-01-432-8249

M917A1

Truck, Dump

W/MCS

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