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# DLA Official Forms

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Form Information
| Form Number:       | DLA2063                                                                                                                                                                                 |
|--------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Form Title:        | DLA Energy Request for Customer QR Code (spreadsheet attached, and RE)                                                                                                                  |
| Form Version:      | JAN 2024                                                                                                                                                                                |
| Status:            | Active                                                                                                                                                                                  |
| Functional Area:   | Energy                                                                                                                                                                                  |
| Opr:               | BASS                                                                                                                                                                                    |
| Safeguards:        | Yes (CUI when filled)                                                                                                                                                                   |
| Electronic:        | Yes                                                                                                                                                                                     |
| Form Link:         | Documents/FormsSite/forms/DL2063 (with attachment-RE).pdf                                                                                                                               |
| Type:              | Modified                                                                                                                                                                                |
| Prescribed:        | DLA Energy P-29                                                                                                                                                                         |
| Description:       | To be used by DLA-Energy external and internal customers to request customer QR codes which will be used to allow for fuel purchase through the Electronic Point of Sales System (EPoS) |
| Records Retention: | 5335.07 Equipment Administrative and Operational Records.  Temporary. Cutoff at end of CY. Destroy when 3 years old or no longer needed.                                                |
| Form Audience:     |                                                                                                                                                                                         |

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