DA Form 4316 Application for Building Insurance

DA Form 4316 or the "Application For Building Insurance" is a Department of the Army-issued form used by and within the United States Military.

The form - often incorrectly referred to as the DD form 4316 - was last revised on June 1, 2004. Download an up-to-date fillable DA Form 4316 down below in PDF-format or look it up on the Army Publishing Directorate website.

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APPLICATION FOR BUILDING INSURANCE
For use of this form, see AR 215-1; the proponent agency is OACSIM
1.
FROM:
TO:
2.
(Activity, installation, and address)
ARMY CENTRAL INSURANCE FUND
Family and Morale, Welfare and Recreation Command
ATTN: IMWR-FM-I
4700 KING STREET
(Summit Centre)
ALEXANDRIA, VA 22302-4406
PART A - ADMINISTRATIVE DATA
3. STANDARD NAF NUMBER
4. DATE OF REQUEST
5. REQUESTED EFFECTIVE DATE
6. TYPE OF FUND
7. DESCRIPTION OF ACTIVITY OR ACTIVITIES HOUSED IN THE BUILDING
(Continue in remarks block, if necessary)
9. LOCATION
8. BUILDING NO.
10. CURRENT REPLACEMENT VALUE
11. ACTUAL CASH VALUE
12. NO. OF LANES, IF BOWLING CENTER
PART B - CONSTRUCTION DATA
13. TYPE
14. MATERIALS
PERMANENT
FRAME
CONCRETE
OTHER (Specify)
TEMPORARY
QUONSET TYPE
MASONRY
15. NO. OF FLOORS
16. TOTAL FLOOR SPACE
17. YEAR BUILT
18. SPRINKLER SYSTEM INSTALLED
(Sq.ft.)
YES
NO
19. FIRE ALARM
20. FLUE & HOOD ALARM
21. SMOKE DETECTORS
22. AUTOMATIC EXTINGUISHER
YES
NO
YES
NO
YES
NO
YES
NO
23. DISTANCE TO NEAREST
24. DISTANCE TO NEAREST
25. PERCENTAGE OF FLOOR
26. PERCENTAGE OF FLOOR
SPACE OCCUPIED BY THE
SPACE OCCUPIED BY
FIRE HYDRANT (In feet)
FIRE STATION (In miles)
ACTIVITY IN BLOCK 2.
OTHER TENANTS
27. CONSTRUCTION FUNDS
28. VALUE OF BUILDING IMPROVEMENTS PAID
FROM NONAPPROPRIATED FUNDS
APPROPRIATED
NONAPPROPRIATED
UNKNOWN
29. REMARKS
30. FUND MANAGER OR DESIGNEE (Typed name, title, and telephone number)
31. SIGNATURE
APD LC v1.01ES
DA FORM 4316, JUN 2004
EDITION OF NOV 97 IS OBSOLETE.

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