1
2
3ATC MAINTENANCE PERSONNEL CERTIFICATION
AND RELATED TRAINING RECORD
For use of this form, see TC 3-04.81; the proponent agency is TRADOC.
1. NAME (last, first, MI)
2. GRADE/RANK
SECTION I. QUALIFICATION AND CERTIFICATION RECORD
4. THEORY
5. PERFORMANCE
6. CERTIFICATION
3. SYSTEM/
SUBSYSTEM/
a. Qual
b. Date
c.
a. Qual
b. Date
c.
a. Date
b. Date
2
1
1
EQUIPMENT
Meth
Qual
Init
Meth
Qual
Init
Acquired
Revoked
PREVIOUS EDITIONS ARE OBSOLETE.
DA FORM 3479-9, OCT 2010
Page 1 -
APD LC v1.00ES
ATC MAINTENANCE PERSONNEL CERTIFICATION
AND RELATED TRAINING RECORD
For use of this form, see TC 3-04.81; the proponent agency is TRADOC.
1. NAME (last, first, MI)
2. GRADE/RANK
SECTION I. QUALIFICATION AND CERTIFICATION RECORD
4. THEORY
5. PERFORMANCE
6. CERTIFICATION
3. SYSTEM/
SUBSYSTEM/
a. Qual
b. Date
c.
a. Qual
b. Date
c.
a. Date
b. Date
2
1
1
EQUIPMENT
Meth
Qual
Init
Meth
Qual
Init
Acquired
Revoked
PREVIOUS EDITIONS ARE OBSOLETE.
DA FORM 3479-9, OCT 2010
Page 1 -
APD LC v1.00ES
SECTION II. CHANGE OF STATION ANNUAL REVIEW AND VALIDATION RECORD
7. DUTY
8. DATE OF
9. TYPE OF
10. MAINT CHIEF'S
STATION
ACTION
ACTION
SIGNATURE
DA FORM 3479-9, OCT 2010
Page 2 -
APD LC v1.00ES
SECTION III. RELATED TRAINING RECORD AND EXAMINATION RESULTS
13. TRAINING OR EXAMINATION
11. SYSTEM/
12.
14.
15.
4
SUBSYSTEM/
COURSE
d.Date
3
a.Type
b.Number
c.Results
REMARKS
INIT
EQUIPMENT
NUMBER
Comp
1
Enter RTRN for resident training, PEXAM for performance examination, EXP for experience, CEXAM for concepts (theory)
examination, PC for prior certification, and NTRN for nonresident training.
2
If other than regular certification, enter I for interim.
3
Enter C if action pertains to concepts (theory) or P if action pertains to performance.
4
Enter P for passed or F for failed.
DA FORM 3479-9, OCT 2010
Page 3 -
APD LC v1.00ES
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