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Block 10 - NAME/LOCATION: Enter in sequence
the complete titles of all the intermediate duty stations
to which the member will report in carrying out the PCS
orders. If there are more than five intermediate duty
stations, continue the itinerary or sequence on the
reverse side of the form in section I.
Block 11 - MDTVL: Enter appropriate two-digit
mode of travel cede contained on the reverse side of the
form (sections I/II additional instructions) that reflects
the method of transportation used in the execution of the
PCS orders. The first character of the code should come
from column (a) and the second character from column
(b). The MDTVL code must be provided for the
intermediate duty stations and ultimate PDSs; example:
PA = Travel by Private Auto.
Block 12 - NATURE OF DUTY: Enter the reason
member is reporting to the intermediate duty station. See
Nature of Duty in Abbreviations section on reverse side
of form; example: temporary duty under instruction
(TEMDUINS).
Block 13 - CLCVN DATE: Enter the class
convening date for the course of instruction.
Block 14 - DURATION TD/TDI: Enter the
estimated number of days or weeks ordered to the
associated TEMDUINS intermediate duty station or the
estimated number of days or weeks at the TEMDU
intermediate duty station; example: GRAD DATE less
CLCVN DATE= DURATION OF TDI (21 FEB 93 TO
11 DEC 93 = 73 DAYS).
Block 15 - LEAVE PERIODS: Provide an estimate
of any leave periods anticipated before, during, and/or
between intermediate duty assignments.
Block 16 - ULTIMATE PERMANENT DUTY
STATION: Enter the complete name of the ultimate
activity to which the member is ordered to report.
Block 17 - HOME PORT Enter the home port of
the ultimate duty station.
Block 18 - DEPLOYED: If the ultimate duty
station is deployed (ship, squadron or mobile unit),
provide the geographical location by checking the
appropriate block.
PART II - DEPENDENTS’ ITINERARY
Block 19 - MARITAL STATUS: Indicate if the
member is single or married.
Block 20 - WILL DEPENDENTS MOVE: Indicate
if dependents will accompany member in the PCS move.
Block 21 - NUMBER OF DEPENDENTS MOV-
ING BY AGE GROUP: Indicate the number of
dependents by age group. Spouse should be included in
the 12 years and over group.
Block 22 - DESIGNATED PLACE: If the member
is ordered to an overseas duty on PCS orders, indicate
whether dependents will be awaiting entry approval or
established permanent residency. Provide the actual
location (city/state) of the new permanent resident
determined by the member and his or her dependents.
Block 23 - DATE: Provide anticipated month/year
of dependents’ movement.
Block 24 - FROM:
Provide the location
(city/state/country) where travel commences.
Block 25 - TO: Provide the location (city/
state/country) where travel terminates. Include all
movements to locations that are leave points and ports
of embarkation and debarkation.
Block 26 - MDTVL: Enter two-digit mode of
travel code contained on reverse side of form (sections
I/H, additional instructions) that reflects method of
transportation used by the dependents. MDTVL code
constructed in the same manner as described in member
itinerary, block 11.
PART III - HOUSEHOLD GOODS
Block 27 - SHIP. NO.: Provides space for three
separate shipments.
Block 28 - DATE SHIPPED FROM OLD PDS:
Enter the month/year of the HHG shipment from the old
PDS.
Block 29 - EST ARRIVAL AT NEW PDS: Enter
month/year HHG are expected to arrive at the new PDS.
The required delivery date (RDD) determined by the
transportation counselor per information supplied by the
member and provisions of the DOD regulations maybe
used.
Block 30 - METHOD: Enter C for commercial
shipment or D for the do-it- yourself method. Reverse
side of form (section III) contains these codes.
Block 31 - SHIP FROM: Enter R if HHG were
shipped from residence or S if shipped from storage.
Reverse side of form (section III) contains these codes.
Block 32 - CITY/STATE/CNTRY ORIGIN:
Location from which HHG are being shipped.
Block 33 - CITY/STATE/CNTRY DESTINATION:
Location where HHG are to be shipped.
9-12
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