MUST BE ON OFFICIAL LETTERHEAD

XXXX-XX Date IN REPLY REFER TO

MEMORANDUM FOR XXXX

Appointment Letter Material Potentially Presenting Explosive Hazard Inspector Certifier and Verifier

In reference to DODM 4160.28M, the following personnel are technically qualified/responsible for inspection and certification of small arms weapons and small arms barrel and receiver groups as being inert. Either the Certification Statement, “The property associated with this DTID has been inspected by the Certifier and independently re-inspected by the Verifier and to the best of our knowledge is free of materiel potentially presenting an explosive hazard (MPPEH)” will be entered on the turn-in document (DD Form 1348-1) prior to turn in, or an Inert Certificate must accompany the turn in. The certification will be signed and dated by the individual making the inspection Certification (Certifier) and the individual making the Inspection Verifier.

CERTIFIER OFFICIAL NAME Printed Name

(Signature)

Printed Rank/Grade

VERIFIER OFFICIAL NAME Printed Name

(Signature)

Printed Rank/Grade

Please address any comments and/or questions to the undersigned at ???-???-????.

OFFICIAL NAME OF PERSON HIGHER THAN HIGHEST RANK LISTED ABOVE.

ORGANIZATION