DA Form 3758-R Calibration and Repair Requirements Worksheet

DA Form 3758-R - also known as the "Calibration And Repair Requirements Worksheet" - is a Military form issued and used by the United States Department of the Army.

The form - often mistakenly referred to as the DD form 3758-R - was last revised on December 1, 1996. Download an up-to-date fillable PDF version of the DA 3758-R below or request a copy through the chain of command.

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1. LOCAL CONTROL NO.
2. USATA CONTROL NO.
CALIBRATION AND REPAIR REQUIREMENTS WORKSHEET
For use of this form, see TB 750-25; the proponent agency is USAMC
3. TO
4. FROM (Include ZIP Code)
5. INFO
6. POC
7. TELEPHONE
SECTION A - INSTRUMENT IDENTIFICATION - APPLICATION
8. JETDS DESIGNATOR OR MFGR AND
9. NATIONAL STOCK NO./PART NO.
10. LINE ITEM NO.
MODEL NO.
11. NOMENCLATURE
12a. MILITARY PUBLICATION
12b. DATE
13a. COMMERCIAL PUBLICATION
13b. DATE
14. SYSTEM/END ITEM SUPPORTED
15. TMDE TYPE:
16. INSTRUMENT SPECIFICATIONS
17. QUANTITY FIELDED (By Theater)
a. PARAMETER
a. CONUS
GP
SP
b. EUROPE
b. RANGE
c. FAR EAST
c. ACCURACY
d. U.S. ARMY SOUTH
SECTION B - CALIBRATION SUPPORT CAPABILITY
18a. CALIBRATION CAPABILITY IS ON HAND AND
c. CALIBRATION CAPABILITY IS NOT ON HAND.
CALIBRATION IS BEING ACCOMPLISHED EVERY
d. INSTRUMENT IS NOT BEING CALIBRATED
DAYS USING CALIBRATION PROCEDURE:
e. INSTRUMENT IS BEING CALIBRATED EVERY
DAYS.
f. BY:
b. BY:
19a. TYPED NAME AND GRADE OR TITLE
b. TELEPHONE
c. SIGNATURE
d. DATE
20. RESPONSIBILITY
P (USAPSL)
P (USAPSL)
S (ACL)
S (ACL)
a. CALIBRATION:
b. REPAIR:
F (DS/GS)
F (DS/GS)
T (ATST/TSC)
T (ATST/TSC)
21. CALIBRATION PROCEDURE
22. SYSTEM CODE
23. CALIBRATION INTERVAL
24. TB 43-180 ACTION:
ADD - NEW ITEM
DELETE
ADD - NEW APPLICATION
CHANGE
25. REMARKS
26a. TYPED NAME AND GRADE OR TITLE
b. TELEPHONE
C. SIGNATURE
D. DATE
DA FORM 3758, NOV 79, IS OBSOLETE
APD LC v2.02ES
DA FORM 3758-R, DEC 1996
1. LOCAL CONTROL NO.
2. USATA CONTROL NO.
CALIBRATION AND REPAIR REQUIREMENTS WORKSHEET
For use of this form, see TB 750-25; the proponent agency is USAMC
3. TO
4. FROM (Include ZIP Code)
5. INFO
6. POC
7. TELEPHONE
SECTION A - INSTRUMENT IDENTIFICATION - APPLICATION
8. JETDS DESIGNATOR OR MFGR AND
9. NATIONAL STOCK NO./PART NO.
10. LINE ITEM NO.
MODEL NO.
11. NOMENCLATURE
12a. MILITARY PUBLICATION
12b. DATE
13a. COMMERCIAL PUBLICATION
13b. DATE
14. SYSTEM/END ITEM SUPPORTED
15. TMDE TYPE:
16. INSTRUMENT SPECIFICATIONS
17. QUANTITY FIELDED (By Theater)
a. PARAMETER
a. CONUS
GP
SP
b. EUROPE
b. RANGE
c. FAR EAST
c. ACCURACY
d. U.S. ARMY SOUTH
SECTION B - CALIBRATION SUPPORT CAPABILITY
18a. CALIBRATION CAPABILITY IS ON HAND AND
c. CALIBRATION CAPABILITY IS NOT ON HAND.
CALIBRATION IS BEING ACCOMPLISHED EVERY
d. INSTRUMENT IS NOT BEING CALIBRATED
DAYS USING CALIBRATION PROCEDURE:
e. INSTRUMENT IS BEING CALIBRATED EVERY
DAYS.
f. BY:
b. BY:
19a. TYPED NAME AND GRADE OR TITLE
b. TELEPHONE
c. SIGNATURE
d. DATE
20. RESPONSIBILITY
P (USAPSL)
P (USAPSL)
S (ACL)
S (ACL)
a. CALIBRATION:
b. REPAIR:
F (DS/GS)
F (DS/GS)
T (ATST/TSC)
T (ATST/TSC)
21. CALIBRATION PROCEDURE
22. SYSTEM CODE
23. CALIBRATION INTERVAL
24. TB 43-180 ACTION:
ADD - NEW ITEM
DELETE
ADD - NEW APPLICATION
CHANGE
25. REMARKS
26a. TYPED NAME AND GRADE OR TITLE
b. TELEPHONE
C. SIGNATURE
D. DATE
DA FORM 3758, NOV 79, IS OBSOLETE
APD LC v2.02ES
DA FORM 3758-R, DEC 1996

Download DA Form 3758-R Calibration and Repair Requirements Worksheet

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