Fillable Printable Unit Demilitarization Certification And Verification Certificate
Fillable Printable Unit Demilitarization Certification And Verification Certificate
Unit Demilitarization Certification And Verification Certificate
SIGNATURE OF INDIVIDUAL CERTIFYING THE DEMILITARIZATION
SIGNATURE OF INDIVIDUAL VERIFYING
(witnessing)
THE DEMILITARIZATION
APD LC v1.00
DA FORM 7578, JAN 2006
UNIT DEMILITARIZATION CERTIFICATION AND VERIFICATION CERTIFICATE
For use of this form, see AR 700-144; the proponent agency is DCS, G-4.
I,
(Name, Grade and Unit of Certifying Individual)
I,
(Name, Grade and Unit of Verifying Individual)
When an NSN is not available, the commercial and government entity (CAGE) code and the item's part
number (P/N) will be used.
Note: Use as many lines as needed and number consecutive pages.
NSN or CAGE and P/N
ITEM NAME QUANTITY
WARNING:
SIGNING A FALSE DEMILITARIZATION CERTIFICATE CONSTITUTES A FELONY AND MAY
S
UBJECT THE INDIVIDUAL TO CRIMINAL PROSECUTION.
certify that I performed the demilitarization of the items in the quantities identified below in accordance
with DOD 4160.21-M-1.
verify that I witnessed the demilitarization of the items in the quantities identified below in accordance
with DOD 4160.21-M-1.
