Unit Ration Card and Monitor System Application Form

UNIT RATION CARD AND MONITOR SYSTEM APPLICATION
( For use of this form, see USFK REG 60-1; the proponent agency is FKJ1)
(SEE PRIVACY ACT STATEMENT ON REVERSE SIDE)
DATE RECEIVED BY IA : DATE RECEIVED BY J1:
UNIT INF ORMATION
1. UNIT NAME
2. UIC/PAS CO DE(S)
3. UN IT ADDRESS (INCLUDING APO)
4. LOCATION/INSTALLATION
5. UNIT RATION CARD HOLDER (Indi vidual who will responsible for and accountabl e for the unit ration card)
PRIMARY ALTERNATE
NAME
NAME
GRADE/RANK/DEROS
GRADE/RANK/DEROS
EMAIL
EMAIL
PHONE NUMBER
PHONE NUMBER
POC SIGNATURE POC SIGNATURE
6. UNI T MONITORING POC (AT LEAST 1 POC REQUI RED)
(Individual who will responsible for viewing, managing and responding to ration violations within the unit.)
NAME
NAME
GRADE/RANK/DEROS
GRADE/RANK/DEROS
EMAIL
EMAIL
PHONE NUMBER
PHONE NUMBER
POC SIGNATURE POC SIGNATURE
7. UNI T COMMANDER POC (Commander, Di rect or, Manager of the unit)
NAME
GRADE/RANK DEROS
PHONE NUMBER EMAIL
UNIT COMMANDER SIGNATURE
AP PLICATI ON DETAILS
8. REASO N F O R SUBMIS SI O N
FILLED BY FKJ1 PERSONNEL SYSTEMS BRANCH
UNIT NAME IN PIMSK ACTION COMPLETED BY
DATE
INITIAL
UPDATE
DELETE
USFK FORM 42-4-E, AUG 2011
PREVIOUS EDITION IS OBSOLETE. PAGE 1 OF 2
Page 1/2
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