AF IMT Form 122 "MWR Division Locker Issue Record"

What Is AF IMT Form 122?

This is a legal form that was released by the U.S. Air Force IMT (Information Management Tool) on September 1, 1982 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 1982;
  • The latest available edition released by the U.S. Air Force IMT (Information Management Tool);
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of AF IMT Form 122 by clicking the link below or browse more documents and templates provided by the U.S. Air Force IMT (Information Management Tool).

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Download AF IMT Form 122 "MWR Division Locker Issue Record"

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NAME (Last, First, MI)
RANK/GRADE
LOCKER NUMBER
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 8012, 44 U.S.C. 3101.
PRINCIPLE PURPOSE(S): To control the issue of lockers.
ROUTINE USE: To identify individuals to whom lockers are issued, to monitor the proper payment of fees, and to control periods of issue and use.
DISCLOSURE IS VOLUNTARY: However, failure to provide the information requested may result in the locker not being used.
ORGANIZATION
DUTY PHONE
HOME PHONE
HOME ADDRESS (Street, City, State)
ZIP CODE
RECEIPT NUMBER
DATE OF ISSUE
ISSUED BY
LOCKER KEY RECEIVED BY
DATE
KEY DEPOSIT
FEE
YEAR
MONTH
$
$
$
REMARKS
CHECK BLOCK OF MONTH NEXT PAYMENT IS DUE
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
AF IMT 122, 19820901, V1
MWR DIVISION LOCKER ISSUE RECORD
NAME (Last, First, MI)
RANK/GRADE
LOCKER NUMBER
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 8012, 44 U.S.C. 3101.
PRINCIPLE PURPOSE(S): To control the issue of lockers.
ROUTINE USE: To identify individuals to whom lockers are issued, to monitor the proper payment of fees, and to control periods of issue and use.
DISCLOSURE IS VOLUNTARY: However, failure to provide the information requested may result in the locker not being used.
ORGANIZATION
DUTY PHONE
HOME PHONE
HOME ADDRESS (Street, City, State)
ZIP CODE
RECEIPT NUMBER
DATE OF ISSUE
ISSUED BY
LOCKER KEY RECEIVED BY
DATE
KEY DEPOSIT
FEE
YEAR
MONTH
$
$
$
REMARKS
CHECK BLOCK OF MONTH NEXT PAYMENT IS DUE
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
AF IMT 122, 19820901, V1
MWR DIVISION LOCKER ISSUE RECORD
NAME (Last, First, MI)
RANK/GRADE
LOCKER NUMBER
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 8012, 44 U.S.C. 3101.
PRINCIPLE PURPOSE(S): To control the issue of lockers.
ROUTINE USE: To identify individuals to whom lockers are issued, to monitor the proper payment of fees, and to control periods of issue and use.
DISCLOSURE IS VOLUNTARY: However, failure to provide the information requested may result in the locker not being used.
ORGANIZATION
DUTY PHONE
HOME PHONE
HOME ADDRESS (Street, City, State)
ZIP CODE
RECEIPT NUMBER
DATE OF ISSUE
ISSUED BY
LOCKER KEY RECEIVED BY
DATE
KEY DEPOSIT
FEE
YEAR
MONTH
$
$
$
REMARKS
CHECK BLOCK OF MONTH NEXT PAYMENT IS DUE
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
AF IMT 122, 19820901, V1
MWR DIVISION LOCKER ISSUE RECORD
NAME (Last, First, MI)
RANK/GRADE
LOCKER NUMBER
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 8012, 44 U.S.C. 3101.
PRINCIPLE PURPOSE(S): To control the issue of lockers.
ROUTINE USE: To identify individuals to whom lockers are issued, to monitor the proper payment of fees, and to control periods of issue and use.
DISCLOSURE IS VOLUNTARY: However, failure to provide the information requested may result in the locker not being used.
ORGANIZATION
DUTY PHONE
HOME PHONE
HOME ADDRESS (Street, City, State)
ZIP CODE
RECEIPT NUMBER
DATE OF ISSUE
ISSUED BY
LOCKER KEY RECEIVED BY
DATE
KEY DEPOSIT
FEE
YEAR
MONTH
$
$
$
REMARKS
CHECK BLOCK OF MONTH NEXT PAYMENT IS DUE
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
AF IMT 122, 19820901, V1
MWR DIVISION LOCKER ISSUE RECORD