The local ammunition officer of the combat force concerned uses the DA Form 4379-R to compile the
preliminary report. The same form is used to submit the written detailed report within 10 days. The
preliminary report will include all available information.
At Continental United States (CONUS) installations, reports of conventional ammunition malfunctions
are transmitted to AMCCOM. In overseas commands, preliminary reports are relayed to the
commander or a designated representative, who forwards the reports to AMCCOM.
The preliminary report for a conventional ammunition malfunction should contain all information
available that is requested on the DA Form 4379-R. Do not delay the report if some information is not
The preliminary report for a GMLR malfunction is prepared and submitted in the same way as for
conventional ammunition, except as follows:
GMLR malfunction reports are sent to MICOM at Fort Lee, Virginia.
GMLR malfunctions are reporting on DA Form 4379-1-R (Missile and Rocket Malfunction
Remember guided missiles and large rockets include:
All guided missiles and large rockets with non-nuclear, nuclear, or chemical capability; either in
complete round configuration or in separately packaged items for issue in complete round
Solid and liquid propellant.
Explosive components for guided missiles and large rockets.
A detailed written report bearing the same report number as the preliminary report will follow the
preliminary report within 10 days of the malfunction. The detailed report must contain the following
A completed DA Form 4379-R or DA Form 4379-1-R, as appropriate.
Pictorial evidence, if available.
Eyewitness accounts or statements, if available.
Any other pertinent information, such as copies of records and reports concerning the
ammunition involved in the malfunction.
Preparing the DA Form 4379-R
When preparing the DA Form 4379-R, make entries in all of the blocks. If a block is not applicable to
the report, enter "NA". If the requested information is not available within the specified reporting time,
enter "UNK" (for "unknown").