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U.S. DEPARTMENT OF HOMELAND SECURITY U.S. COAST GUARD CG-6071 (Rev. 04-05)

Women's Special Uniform Order
PRIVACY ACT STATEMENT

AUTHORITY: Collection of this information is authorized by 10 USC, sections 503, 505, 12102, and Executive Order 9397. PRINCIPAL PURPOSE: Information collected will be used to assist in the qualification process. ROUTINE USES: Blanket routine use of disclosures as described in CI M1020.6 (series) and CI 1000.1 (series) DISCLOSURE: Voluntary, however, failure to provide the information may delay the enlistment process or initiate action for discharge.

Date Name Grade/Rank

Unit Address Garment Recipient SSN Sex Age Garments Description

Qty

Coat, Women's, Serge, Dress Blue Coat, Women's, All-weather with Removable Liner Top, ODU Shirt, Women's LB Cotton/polyester, Long Sleeve, with Epaulets Shirt, Women's LB Cotton/polyester, Short Sleeve, with Epaulets Slacks, Women's Dress, Serge Blue Skirt, Women's, Service Dress Trousers ODU Measurements ALL MEASUREMENTS ARE REQUIRED TO ENSURE PROPER FIT! Record measurements to the nearest quarter (0.25) inch. Height Weight Neck Circumference Across Shoulder Shoulder Upper Chest Circumference Upper Abdomen Bust Lower Abdomen Waist Right Sleeve Length Biceps (Flexed) Left Sleeve Length Left Arm Inseam Right Arm Inseam Back Coat Length Wrist Thigh Leg Inseam Hips Leg Outseam
Shoulder Profile Normal Shoulders Sloping Shoulders Square Shoulders Back Profile Normal Back Sway Back Posture Profile Normal Posture Head Forward or Stooping Posture Seat Profile Normal Seat Flat Seat Full Seat

Comments Sub-garments worn for measurements: Other comments:

U.S. DEPT. OF HOMELAND SECURITY, USCG, CG-6071 (Rev. 04-05)

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