RECORD FIRE SCORECARD

[Pages:1]RECORD FIRE SCORECARD

For use of this form see, FM 3-22.9; proponent agency is TRADOC

DATA REQUIRED BY PRIVACY ACT OF 1974

AUTHORITY: PRINCIPAL PURPOSE(S): ROUTINE USE(S): DISCLOSURE:

10 USC 3012(g)/Executive Order 9397. Facilitates individual's transition to distant target and provides feedback. Evaluate individual proficiency: SSN is used for positive identification purpose only. Voluntary. Individuals not providing information cannot be rated/scored on mass basis.

1. NAME (LAST, FIRST, MIDDLE INITIAL)

2. SSN

3. GRADE

4. UNIT

5. ROSTER NO.

6. TABLE 1 - SUPPORTED FIGHTING POSITION

7. TABLE 2 - PRONE UNSUPPORTED POSITION

RD

RANGE TIME (M) (SEC)

HIT

MISS

NO FIRE

1

50

3

2

200

6

3

100

4

4

150

5

5

300

8

6

250

7

7

50

3

8

200

6

9

150

5

10 250

7

TOTAL

RD

RANGE TIME (M) (SEC)

HIT

MISS

NO FIRE

11 100 8

12 200

13 150 10

14 300

15 100

9

16 250

17 200

6

18 150

5

19

50

6

20 100

TOTAL

RD

RANGE TIME (M) (SEC)

HIT

MISS

NO FIRE

1

100

5

2

250

8

3

150

6

4

50

8

5

200

6

150

12

7

200

8

50

8

9

150

10 100

8

TOTAL

RD

RANGE TIME (M) (SEC)

HIT

MISS

NO FIRE

11 150

8

12 300

9

13 100 10

14 200

15

150

12

16 250

17 100 8

18 150

19 200 9

20 100

TOTAL

8. SCORE

9. QUALIFICATION SCORES/RATINGS (Check One)

TABLE 1 2

HIT

MISS NO FIRE

36-40 EXPERT

30-35 SHARPSHOOTER

23-29 MARKSMAN

22-BELOW UNQUALIFIED

TOTAL 11. REMARKS

10. FIRER'S QUALIFICATION SCORE

12. NIGHT FIRE EXERCISE DATE HIT MISS GO

NO GO

13. NBC FIRE EXERCISE DATE HIT MISS

GO NO GO

14. CHECK WHICH AIMING DEVICE WAS USED

IRON SIGHT BACK UP IRON SIGHT MGS

AN/PAS-13 (DAY) AN/PAS-13 (NIGHT)

15. DATE SIGNED (YYYYMMDD)

16. SCORER'S SIGNATURE

17. DATE SIGNED (YYYYMMDD)

18. OFFICER'S SIGNATURE

DA FORM 3595-R, NOV 2002

DA FORM 3595-R, JUN 89, IS OBSOLETE.

USAPA V1.00ES

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