How to Fill Out DD Form 1222: Request for and Results of Tests

DD Form 1222, Request for and Results of Tests, is the Department of Defense form you use to send a material sample to a laboratory and receive certified results back on the same document. To fill out DD Form 1222, download the current July 1, 2024 edition from the DoD Executive Services Directorate at esd.whs.mil, open it in Adobe Acrobat Reader rather than a browser, and complete the 23 blocks of Section A that identify who you are, which lab is receiving the sample, what the material is, and which specification it must be tested against.¹ Section B stays blank when you ship; the laboratory completes it after running the analysis.²

Getting the Current Form

The official PDF lives on the DoD Washington Headquarters Services forms site under the DD Forms 1000–1499 index. Save it to your computer before you start typing. The fillable fields and digital signature blocks are unreliable inside a web browser. If the electronic version is not available, your Military Service or DoD Component Forms Management Officer can issue hard copies.³ The form is prescribed by DoDM 4140.27, Volumes 1 and 2.²

Section A, Block by Block

Section A is the requester’s half. Every field here exists so the lab can open your package, know what it is looking at, and test the right parameters against the right standard. Errors in Section A are the most common reason samples come back untested.

Who Is Sending It and Who Is Testing It

Block 1 (From) identifies the submitting office or contractor. Block 2 (To) identifies the receiving laboratory. Block 3 records the prime contractor’s full name, address, and contract number. Block 4 identifies the manufacturing plant if it differs from the prime contractor, with its address and purchase order number; write “Same” if the plant and prime contractor are the same entity.²

What the Sample Is and Why You’re Testing It

Block 5 identifies the end item or project. Block 9 (Material to Be Tested) is the field labs pay closest attention to. Enter the complete nomenclature exactly as the contract states it, including type, class, grade, and size. If the description runs long, continue in Block 16. Block 12 captures the governing specification or drawing number along with its revision letter and any amendment, so the lab knows which version of the standard to apply.²

Block 7 (Reason for Submittal) explains why the sample exists. Typical entries are First Article, Production Lot Acceptance, Shelf-Life Extension, and Special. The category matters because each one can trigger a different testing scope. Block 18 is the lot or batch number. Block 19 is the date of manufacture in YYYYMMDD format. These three fields together let the lab connect its findings to a specific production run.²

Quantities and Source

Block 10 (Quantity Submitted) is the number of physical samples in the package. Block 11 (Quantity Represented) is the total population those samples stand in for. One vial can represent an entire production lot. Block 13 records where the material was purchased or otherwise sourced. Block 6 is the sample number used to track the submission; either you or the lab can assign it.²

Shipping, Signatures, and Distribution

Block 14 (Shipment Method) records how the sample is traveling: Surface Mail, Air Mail, Hand Carried, Courier, or Other. Block 8 is the date you ship. Block 15 captures both the sample collection date and your name, and it supports a digital signature. Block 20 identifies the engineering support activity. Block 22 is for remarks, special instructions, or waivers. Block 23 lists every person or office that should receive the final test report; if a name belongs on the results distribution, it belongs in Block 23.²

Block 21: Shelf-Life Extension Only

Block 21 (MQCSS/QSL Review) applies only when you are submitting a shelf-life extension sample. Before you ship, check the Quality Status List at shelflife.dla.mil to confirm that lot or batch has not already been tested. Mark Block 21 to show the review is done. For every shelf-life extension sample, a completed DD Form 1222 should accompany the shipment unless your testing facility tells you otherwise.⁴ For any other reason for submittal, leave it alone.

Packaging the Form with the Sample

The form travels with the sample. Attach the completed DD Form 1222 securely to the outside of the sample container so it stays legible on arrival, and use protective packaging that won’t let a leak destroy the paperwork. If the material is flammable, corrosive, or otherwise hazardous, federal shipping rules take over. Under 49 CFR 171.2, no one may offer a hazardous material for transportation unless it is properly classified, described, packaged, marked, and labeled, and DoD offerors must follow 49 CFR Parts 100–180 when shipping by commercial carrier. Military shipments moving on military vehicles are generally exempt from federal jurisdiction but still must comply under DoD and Service-level policy.⁵

Each person who handles the sample should be identifiable from the paperwork, and the container should remain sealed until the lab performs intake inspection. When the submission demands a stricter custody trail than Blocks 6, 15, and 18 provide, DD Form 3108, CBRN Sample Documentation and Chain of Custody, is the DoD instrument that records signed transfers between individuals.⁶

What the Lab Fills In (Section B)

You don’t touch Section B. When your sample arrives, the lab enters the date received in Block 1 using YYYYMMDD format and assigns its own Lab Report Number in Block 3. Cite that report number in any follow-up correspondence. Block 4 holds the actual findings: every test performed, quantitative results, pass or fail against each parameter, and the specification requirements applied. Block 4 supports a digital signature so the authorized lab official can certify results electronically. Block 2 is the date results are reported.² For shelf-life extension testing, labs also post results to the Quality Status List so other activities can see the outcome without waiting for a paper copy.⁴ The completed form then goes out to every address listed in Block 23.

If the Sample Fails

A failure on the returned form triggers the contract’s quality-assurance provisions. Under FAR 46.407, contracting officers should reject supplies that do not conform to contract requirements, and the contractor ordinarily gets an opportunity to correct or replace the nonconforming material within the delivery schedule at no additional cost. In rare cases, a contracting officer may accept nonconforming material when doing so is in the government’s best interest, but that acceptance requires a contract modification with an equitable price reduction or other consideration.⁷ Until a disposition decision is made, the material stays quarantined.

How Long to Keep the Completed Form

A completed DD Form 1222 becomes part of the contract file. FAR 4.805 sets the baseline retention period at six years after final payment or contract cancellation, with longer retention allowed when there is a business need. Some DoD components apply longer periods; the Defense Logistics Agency and the Department of the Navy, for example, use a 10-year retention period under their DFARS supplements.⁸ Keep your own copy separately. If a dispute over material quality or contract performance surfaces years later, the lab-certified DD Form 1222 is the primary documentary evidence. Records tied to an active investigation or litigation must be held until the matter is fully resolved, whatever the standard clock says.

1
Department of Defense. DD Form 1222 Request for and Results of Tests
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Washington Headquarters Services. DD Form 1222 Request for and Results of Tests
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Department of Defense. DD Forms 1000-1499
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Washington Headquarters Services. DoDM 4140.27 Volume 2
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Federal Motor Carrier Safety Administration. How to Comply with Federal Hazardous Materials Regulations
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Washington Headquarters Services. CBRN Sample Documentation and Chain of Custody
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Acquisition.GOV. Nonconforming Supplies or Services
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Defense Pricing and Contracting. FAR and FMR Records Retention Policy