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ANNEX X REPORT FORMS
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
9- LINE MEDEVAC REPORT (as required)
MIST REPORT (as required)
SALTA REPORT
DETAINEE REPORT (as required)
SITUATIONAL REPORT (15 min after end of event)
CONSOLIDATED SITUATIONAL REPORT ( 60 min after end of event)
ALL ARMS CALL FOR FIRE (as required)
10 LINE EOD SPOT REPORT ( as required)
REPAIR RECOVERY REQUEST (as required)
AMMUNITION REPORT (daily NLT 0900)
SHOT REPORT
LOCATION STATUS ( leaving camp, reaching training site or destination, back to camp)
PATROL REPORT (60 min after end of patrol)
9-LINE MINE AND UXO REPORT (as required)
MISSON BACKBRIEF FORMAT ( as required)
No template: personnel status (daily NLT 0730)
No template: logistics status (daily NLT 0730)
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1. MEDEVAC REPORT
9-Line MEDEVAC Request
Para Info
1 Locaiton of PZ
2 Freq & C/S
Hints
GR
Coy Net Freq and C/S
A. Urgent
B. Urgent Surgery
C. Priority
D. Routine
E. Convience
A. None
B. Hoist
C. Veh Extraction Equipment
D. Ventilator
3
Number of patients by
Precedence
4
Special Equipment
Required
5
Number walking/stretcher A. Litter/Stretcher
B. Walking/Ambulatory
patients
6 Security of PZ
7 Method of marking PZ
8 Casulalitie
Nationality/Status
9 Details of landing site
N. No Enemy Troops
P. Possible Enemy Troops
E. Enemy troops at PZ
A. Panels
B. Pyro
C. Smoke
D. None
E. Other
A.
B.
C.
D.
E.
US Military
US Civilian
Other Militay
Other Civilian
Enemy PW
Terrain Description
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2. MIST REPORT
MIST
Para
M
I
S
T
Info
M - Mechanism of Injury
I - Injury
S - Signs and Symptoms
A - Airway
B -Breathing
C - Pulse
D - Conscious/Unconscious
E - Other Signs
T - Treatment Applied If Tourniquet applied,
indicate location and time of application.
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3. SALTA REPORT
SALTA (US Contact Report)
Para
A
Situation Enemy
B
C
D
Action Enemy
Location
Actions Own
Description of enemy size, vehicles,
weapons, etc.
Description of what En is doing
Grid
Description of own actions.
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4. DETAINEE REPORT
DETAINEE Report
Para
A
Grid
B
Time
C
Number
D
Names
E
Father’s Name
F
Int Value
Course of
G
action
H
Medic
I
General
Locn of detention
Time of Detention
Number of Detainees
Names of detainee
Father’s name of detainee (if avail)
Assessed Intelligence value for each detainee
Recommended course of action for each
detainee.
Confirm all detainees have been examined by
a medic.
General comments.
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5. SITUATIONAL REPORT
SITREP
Para
A
Enemy
B
Friendly
C
Administration
D
General
Units in contact, enemy shelling,
estimation of strength, morale,
possible Enemy action
Location of troops, by grid encoded, or by
report line, your activity, your intentions
Any immediate administrative requirement
at that time (Fuel, Ammo, etc.)
Information not covered elsewhere, i.e.
“C/S 24 CLEAR THE WOODS AT GRID
--------“
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6. CONSOLIDATED SITUATIONAL REPORT
CONSOLIDATED SITREP
Normally sent to cover a period 4-24 hours, depending on
operational tempo.
Para
Period covered by consolidated
A
Reporting Period
sitrep.
Overall assessment of En actions
B
Enemy
and general intent during the
reporting period.
Description by sub-unit of friendly actions
and status during reporting period.
C
Friendly
Current location of sub-units to be
reported. Number of personnel in unit.
General administrative requirements.
D
Administration
Commanders intent and assessment of
E
General
situation, other clarifying situation.
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7. ALL ARMS CALL FOR FIRE
All Arms Call for Fire
Send warning Order first
EG: 0 this is 31 Fire Mission, Over.
PARA
Target Location (GRID)
A
Bearing from Observer to target (in Mils)
B
Description of Target
C
D
Type of fire Required (Destroy, Neutralize, Smoke,
Supress)
Time and Duration of Fire
1. Adjust RIGHT or LEFT to bring fire into
the direction.
If corrections required:
2. Then Bracket target until rounds are on
target ADD or DROP.
E
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8. 10 LINE - EOD SPOT REPORT (UXO/IED)
10 Line – EOD SPOT REPORT (UXO/IED)
Used to report initial sittings of IEDs/UXOs.
Para
DTG when unit discovered item/s
1
Unit Call Sign
2
Type/Description of Ordnance
UXO- dropped, projected, placed, thrown.
3
IED- Disguised, static, moveable, thrown, placed on TGT
Description: length, width, height, colour, markings, wires.
Location of UXO/IED (Grid, with description of
4
surrounding)
Location of Link Up with responding force.
5
Contact Method (C/S, Freq, POC)
6
Tactical Sitrep: current threat environment
7
Collateral Damge/Potential Collateral Damage (to
8
equipment, assests, facilities)
Protective Measures taken to protect troops/equipment
9
Recommended priority.
10
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9. REPAIR RECOVERY REQUEST
REPAIR RECOVERY REQUEST
Para A-K completed by unit requesting Repair/Recovery support
Para
A
DTG of Call
Requisites Rank, Name and
B
C/S
C
Repair Recovery Number
D
Unit Owning Equipment
Vehicle Type, C/S, CFR
E
Type and CFR
F
Faults
G
Assistance Required
H
Equipment Mobility
I
Location of RV or Casualty
Tactical Situation and
Recommended Route
CREW WITH EQUIPT
J
K
(Direct Tow, Suspended Tow,
Lowbed)
YES/NO
Return details (Para L-O) completed my Maint Pl
L
M
N
O
C/S of Maintenance Assets
ETA at Higher and
Casualty
EST Time of Return
Remarks
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10. AMMUNITION REPORT
ADREP
For ammunition paragraphs indicate qty of ammunition required for
resupply. .
Para
A
Ammunition Required
B
Rations Required
C
Water Required
D
POL Required
E
Misc Stores
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11. SHOT REPORT
SHOTREP
Para
A
B
C
D
E
Time
Number of Rounds
Weapon Type
Bearing and Distance
Action Taken
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12. LOCATION STATUS
LOCSTAT (Location Status)
Para
A
B
Location of Reporting C/S (Grid Ref)
Location of all formations, units and sub units for whom
reporting C/S is responsible
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13. PATROL REPORT
PATROL REPORT
Patrol reports normally should be submitted in electronic or hard copy
form using the BG patrol report form. Where time or location does not
permit this to occur the below Performa will be used to submit patrol
reports via radio or landline.
Para
C/S
A
Patrol leader
B
Patrol size
C
Composition of patrol
D
Task/Mission
E
Departure Date-Time Group (DTG)
F
Return DTG
G
Routes out and in
H
Terrain
I
Info Enemy SALUTEHIM
J
Map correction
K
Miscellaneous information
L
Results of encounters with the en/OPFOR
M
Condition of patrol:
N
Support received and/or requested
O
Communications
P
Friendly/Neutrals:
Q
Conclusions and recommendations
R
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14. 9 LINE MINE AND UXO REPORT
9 Line – MINE &UXO REPORT
Used to report real military munitions and other UXOs. Not to be used to
for initial reports of IEDs.
Para
DTG when unit discovered item/s
1
Reporting activity and locn of MINE/UXO
2
Contact Method (C/S, Freq, POC)
3
Type of ordnance, qty, markings (length, width, height,
4
colour, markings, etc)
NBC Contaminated area
5
Resources Threatened (FOB, Mil Convoy, etc)
6
Impact on Mission
7
Protective Measures (Evac, sandbags, etc)
8
Recommended Priority (See Notes)
9
Priorities:
IMMEDIATE (Stop mission/unit manoeuvre/threaten critical assets)
URGENT (Slows unit mission and manoeuvre capability)
MINOR (Reduces unit mission and manoeuvre capability)
NO THREAT
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15. MISSON BACKBRIEF FORMAT
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