Dd Form 250, Material Inspection And Receiving Report
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1Form Approved
MATERIAL INSPECTION AND RECEIVING REPORT
OMB No. 0704-0248
The public reporting burden for this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection
of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-0248). Respondents should be aware
that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB
control number.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE ABOVE ORGANIZATION.
SEND THIS FORM IN ACCORDANCE WITH THE INSTRUCTIONS CONTAINED IN THE DFARS, APPENDIX F-401.
1. PROCUREMENT INSTRUMENT IDENTIFICATION
ORDER NO.
6. INVOICE NO./DATE
7. PAGE OF
8. ACCEPTANCE POINT
(CONTRACT) NO.
2. SHIPMENT NO.
3. DATE SHIPPED
4. B/L
5. DISCOUNT TERMS
TCN
CODE
10. ADMINISTERED BY
9. PRIME CONTRACTOR
CODE
11. SHIPPED FROM (If other than 9) CODE
FOB:
CODE
12. PAYMENT WILL BE MADE BY
CODE
CODE
13. SHIPPED TO
14. MARKED FOR
DESCRIPTION
16. STOCK/PART NO.
15.
17. QUANTITY
18.
19.
20.
(Indicate number of shipping containers - type of
ITEM NO.
SHIP/REC'D*
UNIT
UNIT PRICE
AMOUNT
container - container number.)
21. CONTRACT QUALITY ASSURANCE
22. RECEIVER'S USE
Quantities shown in column 17 were received in
a. ORIGIN
b. DESTINATION
apparent good condition except as noted.
CQA
ACCEPTANCE of listed items
CQA
ACCEPTANCE of listed items has
been made by me or under my supervision and
has been made by me or under my supervision and
they conform to contract, except as noted herein or
they conform to contract, except as noted herein or
SIGNATURE OF AUTHORIZED
DATE RECEIVED
GOVERNMENT REPRESENTATIVE
on supporting documents.
on supporting documents.
TYPED NAME:
TITLE:
SIGNATURE OF AUTHORIZED
SIGNATURE OF AUTHORIZED
DATE
DATE
MAILING ADDRESS:
GOVERNMENT REPRESENTATIVE
GOVERNMENT REPRESENTATIVE
TYPED NAME:
TYPED NAME:
TITLE:
TITLE:
COMMERCIAL TELEPHONE
MAILING ADDRESS:
MAILING ADDRESS:
NUMBER:
* If quantity received by the Government is the
same as quantity shipped, indicate by (X) mark; if
different, enter actual quantity received below
COMMERCIAL TELEPHONE
COMMERCIAL TELEPHONE
quantity shipped and encircle.
NUMBER:
NUMBER:
23. CONTRACTOR USE ONLY
DD FORM 250, AUG 2000
PREVIOUS EDITION IS OBSOLETE
.
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