How to Fill Out DA Form 4283?
DA Form 4283 instructions are provided below. A step-by-step overview of all procedures associated with the form can be found in DA Pam 420-6, Directorate of Public Works Resource Management System released in May 1997.
The form itself consists of two parts - Part A and Part B. Part A is completed by requestor per instructions below. Part B is completed by the DPW in compliance with local procedures.
- Box 1 - Customer ID - requires one to three numeric characters per local DPW policy. The code is used for identifying the user, occupant, owner of the facility or the organizational activity submitting a work request.
- Box 2 - Document Serial Number - is for code made up of five alphanumeric characters. This code can be generated either digitally, by a requestor or assigned by the DPW. The code is used to identify each unique document of in a series and when used in conjunction with the installation number, customer identification, document type, and fiscal year will identify a single document of a particular type.
- Box 3 - Fiscal Year - is to be filled with the last digit of the fiscal year (for example, 6 will stand for 'Fiscal Year 2006').
- Box 4 - Type - must be left blank. The box will be completed by the DPW Work Reception.
- Box 5 - Short Job Description - requires up to a phrase of up to 30 characters that will provide a concise summary statement of the work to be performed.
- Box 6 - Date - requires the date the work request was completed in DDMMYY format.
- Box 7 - Installation Abbreviation - is to be filled with up to eight characters for the locally assigned abbreviation of the installation's officially designated name.
- Box 8 - Facility Number - is to be filled with a code of five characters which represent the unique serial number assigned to a real property facility within an installation for identification through its life cycle.
- Box 9 - Remarks - must include the email address of the Primary POC and an Alternate POC for the requested work.
- Box 10 - Installation Name - requires the official name of an Army real estate holding and the principal function as stated in the real property inventory.
- Box 11 - Customer Name - is for the name or description of the user, occupant, owner of a facility, or the organizational activity authorized to submit a request for work.
- Box 12 - POC Name - is for the name of the person responsible for specific work information about requested work.
- Box 13 - POC Phone Number - is self-explanatory and must be no more than 12 alphanumeric characters long.
- Box 14 - Work Description - requires a description of the procedures with impact and justification. Part A must then be signed by the authorized requestor in Box 16 with their full name specified in Box 15.