as for conventional ammunition, except as follows:
GMLR malfunction reports are sent to MICOM at Redstone Arsenal, Alabama.
GMLR malfunction reports are made using DA Form 4379-1-R.
DETAILED REPORTS
A detailed written report will follow the preliminary report within 10 days of the malfunction. The detailed report
must contain the following information:
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"). Study the example given in Figure 2-1 and Figure 2-2 as you read the description of each block that
follows.
Block 1
Enter the report number, which consists of the unit symbol, the number of reports submitted, and the two-digit
calendar year. In the example, the unit symbol is W1EAA, this is the first malfunction of the year, and the year is
1991. The report number is "W1EAA-1-91." Use this report number in all correspondence on this malfunction.
Block 2
Enter the complete nomenclature for the item that malfunctioned. Include, as applicable, the caliber, type, model,
national stock number (NSN), Department of Defense Identification Code (DODIC), lot number, and serial
number (if available).
Block 3
Provide the information that follows, as appropriate. If necessary, continue on the back of the form.
For small arms and fixed and semifixed conventional ammunition (including mortar rounds), enter the
fuze type, model, and lot number. Also, enter the headstamp of the cartridge case (the manufacturer's
symbol and the year of manufacture).
For separate-loading conventional ammunition, enter the projectile caliber, type, model, NSN, DODIC,
lot number, and kind of filler. Enter the type and lot number of the booster or burster. Enter the
propelling charge caliber, type, model, NSN, DODIC, lot number, and weight, including the number of
increments used with the round that malfunctioned. Note the physical condition of the propelling charge
bag or bags and the wrappings. Provide the pressure and velocity of the round that malfunctioned, if
available. Enter the fuze type, model, NSN, DODIC, and lot number, and state whether the fuze was
properly assembled and seated with a fuze wrench prior to loading. Finally, list the primer type, model,
NSN, DODIC, and lot number.
MM0167
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