CTMD Form 4-6 "Maintenance Log" - Connecticut

What Is CTMD Form 4-6?

This is a legal form that was released by the Connecticut Military Department - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2021;
  • The latest edition provided by the Connecticut Military Department;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of CTMD Form 4-6 by clicking the link below or browse more documents and templates provided by the Connecticut Military Department.

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CTMD Form 4-6
(New 3/2021)
CONNECTICUT MILITARY DEPARTMENT
INSTRUCTIONS FOR MAINTENANCE LOG
PURPOSE: To record and log routine maintenance inspections of state owned equipment. Such
actions include, but are not limited to routine inspections, preventive care and repairs.
AUTHORITY: Chapter 4 of CTMD General Order 2018-3.
INSTRUCTIONS:
UNIT/SECTION INFORMATION: Provide the name and location of your organization into
which the property is assigned.
ITEM INFORMATION: Provide a brief description of the state-owned property as well as the
name of the manufacturer, model, serial number and state tag number. Provide the date the item
was acquired by your organization
RECORD OF MAINTENANCE:
Date: Date maintenance is performed
Action: One word description of the action taken such as, inspection, prevention, repair
Excellent –requires no service
Condition:
Good –require minor maintenance
Poor –requires significant maintenance, but functions
Unserviceable –needs significant maintenance and no longer functions
Deficiencies: Provide a short description of the areas needing repair or maintenance
Corrective Action: List the actions that need to be taken to repair or improve the item
User Initials: Initials of the individual who performed the action
SEND THIS FORM & SUPPORTING DOCUMENTATION TO:
Connecticut Military Department
State Property Officer
360 Broad Street Room #223
Hartford, Connecticut, 06105-3706
(860) 548-3247 (fax)
Page 1 of 2
CTMD Form 4-6
(New 3/2021)
CONNECTICUT MILITARY DEPARTMENT
INSTRUCTIONS FOR MAINTENANCE LOG
PURPOSE: To record and log routine maintenance inspections of state owned equipment. Such
actions include, but are not limited to routine inspections, preventive care and repairs.
AUTHORITY: Chapter 4 of CTMD General Order 2018-3.
INSTRUCTIONS:
UNIT/SECTION INFORMATION: Provide the name and location of your organization into
which the property is assigned.
ITEM INFORMATION: Provide a brief description of the state-owned property as well as the
name of the manufacturer, model, serial number and state tag number. Provide the date the item
was acquired by your organization
RECORD OF MAINTENANCE:
Date: Date maintenance is performed
Action: One word description of the action taken such as, inspection, prevention, repair
Excellent –requires no service
Condition:
Good –require minor maintenance
Poor –requires significant maintenance, but functions
Unserviceable –needs significant maintenance and no longer functions
Deficiencies: Provide a short description of the areas needing repair or maintenance
Corrective Action: List the actions that need to be taken to repair or improve the item
User Initials: Initials of the individual who performed the action
SEND THIS FORM & SUPPORTING DOCUMENTATION TO:
Connecticut Military Department
State Property Officer
360 Broad Street Room #223
Hartford, Connecticut, 06105-3706
(860) 548-3247 (fax)
Page 1 of 2
RESET FORM
CTMD Form 4-6
(New 3/2021)
CONNECTICUT MILITARY DEPARTMENT
MAINTENANCE LOG
UNIT/SECTION INFORMATION:
Organization:
Location:
ITEM INFORMATION:
Item Description
Item Type:
Vehicle
Equipment
IT/Computer
Communications
Other
Manufacturer
Model
Serial Number
State TAG Number
Date Acquired
RECORD OF MAINTENANCE:
Date
Action
Condition
Deficiencies
Corrective Action
User Initials
Page 2 of 2
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