DD Form 1911 Materiel Courier Receipt

DD Form 1911 - also known as the "Materiel Courier Receipt" - is a United States Military form issued by the Department of Defense.

The form - often incorrectly referred to as the DA form 1911 - was last revised on April 1, 2010. Download an up-to-date fillable PDF version of the DD 1911 below or request a copy through the chain of command.

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SHIPPER'S CONTROL/DOCUMENT NO.
MATERIEL COURIER RECEIPT
SHIPPER
SUPPLY ACCOUNT NUMBER
DESTINATION
SUPPLY ACCOUNT NUMBER
SHIPMENT DESCRIPTION
I certify by my signature that I have received the materiel listed on this form and am aware of
the applicable safety and security requirements.
LINE NUMBER
QUANTITY
SERIAL NUMBERS
REMARKS
SHIPMENT TRANSFERS
LOCATION OF TRANSFER
DATE (YYYYMMDD)
FIRST
RECIPIENT'S PRINTED NAME (Last, First, Middle Initial)
ORGANIZATION OR ACCOUNT NO.
SIGNATURE
LOCATION OF TRANSFER
DATE (YYYYMMDD)
SECOND
RECIPIENT'S PRINTED NAME (Last, First, Middle Initial)
ORGANIZATION OR ACCOUNT NO.
SIGNATURE
LOCATION OF TRANSFER
DATE (YYYYMMDD)
THIRD
RECIPIENT'S PRINTED NAME (Last, First, Middle Initial)
ORGANIZATION OR ACCOUNT NO.
SIGNATURE
LOCATION OF TRANSFER
DATE (YYYYMMDD)
FOURTH
RECIPIENT'S PRINTED NAME (Last, First, Middle Initial)
ORGANIZATION OR ACCOUNT NO.
SIGNATURE
LOCATION OF TRANSFER
DATE (YYYYMMDD)
FIFTH
RECIPIENT'S PRINTED NAME (Last, First, Middle Initial)
ORGANIZATION OR ACCOUNT NO.
SIGNATURE
DD FORM 1911, APR 2010
PREVIOUS EDITION IS OBSOLETE
.
Reset
Adobe Professional 8.0
SHIPPER'S CONTROL/DOCUMENT NO.
MATERIEL COURIER RECEIPT
SHIPPER
SUPPLY ACCOUNT NUMBER
DESTINATION
SUPPLY ACCOUNT NUMBER
SHIPMENT DESCRIPTION
I certify by my signature that I have received the materiel listed on this form and am aware of
the applicable safety and security requirements.
LINE NUMBER
QUANTITY
SERIAL NUMBERS
REMARKS
SHIPMENT TRANSFERS
LOCATION OF TRANSFER
DATE (YYYYMMDD)
FIRST
RECIPIENT'S PRINTED NAME (Last, First, Middle Initial)
ORGANIZATION OR ACCOUNT NO.
SIGNATURE
LOCATION OF TRANSFER
DATE (YYYYMMDD)
SECOND
RECIPIENT'S PRINTED NAME (Last, First, Middle Initial)
ORGANIZATION OR ACCOUNT NO.
SIGNATURE
LOCATION OF TRANSFER
DATE (YYYYMMDD)
THIRD
RECIPIENT'S PRINTED NAME (Last, First, Middle Initial)
ORGANIZATION OR ACCOUNT NO.
SIGNATURE
LOCATION OF TRANSFER
DATE (YYYYMMDD)
FOURTH
RECIPIENT'S PRINTED NAME (Last, First, Middle Initial)
ORGANIZATION OR ACCOUNT NO.
SIGNATURE
LOCATION OF TRANSFER
DATE (YYYYMMDD)
FIFTH
RECIPIENT'S PRINTED NAME (Last, First, Middle Initial)
ORGANIZATION OR ACCOUNT NO.
SIGNATURE
DD FORM 1911, APR 2010
PREVIOUS EDITION IS OBSOLETE
.
Reset
Adobe Professional 8.0

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