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WORf REQUEST AND JOB ORDER 
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TECHNICAL SERVICE ITEM 
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TRANS 
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MED 
Reference No. 
DESCRIPTION OF WORK TO BE PERFORMED 
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Authorized by.......r..........._ Keceived by 
FILL IN ABOVE AS WORK REQUEST 
ROUTING AND FLOW 
Assigned to— 
□ A—Automotive_- 
□ I—Armament and Inst— 
□ C—ClotMng and -Equip.-- 
□ E—Electric____ 
O M—Machine—___ 
□ P—Paint_.———_— 
□ --- 
□ —- 
□ - 
□ 
Date In 
“5 
Sign 
Date out 
/ ^ 
Sign 
Final Inspection 
A. 
higher echelon for 
[repair or reclam 
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amarion.Jt.its 
Completion Data 
Date Received 
Obganization or 
Warehouse 
Received by— 
J~] Salvage—___ 
i-. 
In Organization__ 
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□ ^’arehouse..__ 
□-....... 
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SHIPPIN(?'INSTRUCTION FOR EVACUATING EQUIPMENT 
Shaped to 
Address —. 
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W. D., A. G. O. Form No. 811 
9 February 1944 
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Government* printing office e9-16—38707-2 
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Account 
Code No 
' 
Priority 
Job Order No.__ 
- 
INSTRUCTIONS FOR WORK TO BE PERFORMED 
QUANTITY 
NUMBER 
WORK TO BE PERFORMED OR NOMENCLATURE 
CONTROL OFFICE DATA 
Per-..— Inspector. 
Date received--- Total time (man-hours) 
Estimated hours -___ File date_ 
