434 ARW Form 2 Medical Orders Request Form

434 ARW Form 2 is a U.S. Air Force - 434th Air Refueling Wing form also known as the "Medical Orders Request Form". The latest edition of the form was released in August 7, 2014 and is available for digital filing.

Download an up-to-date 434 ARW Form 2 in PDF-format down below or look it up on the U.S. Air Force - 434th Air Refueling Wing Forms website.

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Read instructions on back before completing form. This form covers multiple order types and locations. PLEASE PRINT.
SECTION I - PERSONAL INFORMATION
2. MILITARY EMAIL
1. NAME (Last, First, MI)
4. PURPOSE/JUSTIFICATION:
SECTION II - ITINERARY
6. DEPARTURE LOCATION
7. RETURN LOCATION
Home of Record
Home of Record
Permanant Duty Station
Permanant Duty Station
5. TRAVEL DATE
Other
Other
8. INITIAL REPORT DATE
REPORT TIME
ORDER TYPE
GTR COST
PER DIEM
TRAVEL MODE
DRIVER
POV COST
RENTAL CAR
NO
COST
YES
PASSENGER (Driver's Name)
DEPARTING AIRPORT (if comm air)
ARRIVAL AIRPORT
DUTY LOCATION
UNIT
ADDRESS
CITY
State:
ZIP
10. ORDER END DATE
RETURN TRAVEL
POV COST
DRIVER
GTR COST
RETURN TRAVEL DATE
PASSENGER (Driver's Name)
DEPARTING AIRPORT (if comm air)
ARRIVAL AIRPORT
SECTION III - OTHER
11. EXPENSES
EXCESS BAGGAGE FEES
CONF/REG FEES
13. REMARKS
SECTION IV - AUTHORIZED
SIGNATURES
PRINT NAME
RANK/GRADE
SIGNATURE (Digitally Sign)
DATE
14. MEMBER SIGNATURE
Click to sign
(use if wet signature required)
15. SUPERVISOR SIGNATURE
Click to sign
(use if wet signature required)
Click to sign
16. MEDICAL ADMIN SIGNATURE
(use if wet signature required)
434 ARW FORM 2 20140807
Read instructions on back before completing form. This form covers multiple order types and locations. PLEASE PRINT.
SECTION I - PERSONAL INFORMATION
2. MILITARY EMAIL
1. NAME (Last, First, MI)
4. PURPOSE/JUSTIFICATION:
SECTION II - ITINERARY
6. DEPARTURE LOCATION
7. RETURN LOCATION
Home of Record
Home of Record
Permanant Duty Station
Permanant Duty Station
5. TRAVEL DATE
Other
Other
8. INITIAL REPORT DATE
REPORT TIME
ORDER TYPE
GTR COST
PER DIEM
TRAVEL MODE
DRIVER
POV COST
RENTAL CAR
NO
COST
YES
PASSENGER (Driver's Name)
DEPARTING AIRPORT (if comm air)
ARRIVAL AIRPORT
DUTY LOCATION
UNIT
ADDRESS
CITY
State:
ZIP
10. ORDER END DATE
RETURN TRAVEL
POV COST
DRIVER
GTR COST
RETURN TRAVEL DATE
PASSENGER (Driver's Name)
DEPARTING AIRPORT (if comm air)
ARRIVAL AIRPORT
SECTION III - OTHER
11. EXPENSES
EXCESS BAGGAGE FEES
CONF/REG FEES
13. REMARKS
SECTION IV - AUTHORIZED
SIGNATURES
PRINT NAME
RANK/GRADE
SIGNATURE (Digitally Sign)
DATE
14. MEMBER SIGNATURE
Click to sign
(use if wet signature required)
15. SUPERVISOR SIGNATURE
Click to sign
(use if wet signature required)
Click to sign
16. MEDICAL ADMIN SIGNATURE
(use if wet signature required)
434 ARW FORM 2 20140807
INSTRUCTIONS
SECTION 1 - PERSONAL INFORMATION
SECTION 11 - INTINERARY
TRAVEL MODE. Select travel mode (No Travel Authorized, Commdercial Plane, Commercial Rental Vehicle, Goverment Plane, Government
Vehicle, Personal Plane-Adv to Govt, Personal Automobile-Adv to Govt, Personal Motorcycle-Adv to Govt, Personal Plane-Not Adv to Govt,
Personal Automobile-Not Adv to Govt, Personal Motorcylce-Not Adv to Govt, Passenger in a POV). If \
SECTION III - OTHER
SECTION IV - AUTHORIZED SIGNATURES
ITEMS 14 thru 16. Enter name and obtain appropriate signature.
434 ARW Form 2, 20140807

Download 434 ARW Form 2 Medical Orders Request Form

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