text: Appendix A
  ROAD CLEARANCE REQUEST [ROADCLRREQ]
  REPORT NUMBER: R050
  GENERAL INSTRUCTIONS: Use to request road clearance and movement authority for the movement of
  outsized or overweight vehicles or for the movement of convoys over a controlled or restricted road network.
  This report is similar to USMTF # D827 ROADCLRREQ. Reference: ATP 4-16.
  LINE 1 – DATE AND TIME ______________________________________________(DTG)
  LINE 2 – UNIT ____________________________________________________________(unit making report)
  LINE 3 – REFERENCE ___________________________________________________________(data to identify request being
  referenced)
  LINE 4 – UNIT _________________________________________________________________(identifier or designator of
  component unit or agency
  requesting clearance on making
  move)
  LINE 5 – PRIORITY _______________________________________________(mission priority requested for
  movement)
  LINE 6 – CONVOY NAME _____________________________________(designated convoy name)
  LINE 7 – COUNT OF SERIALS __________________________________(count of serials in convoy)
  LINE 8 – SERIAL TIME ________________________________________(convoy serial time interval)
  LINE 9 – COUNT OF MARCH GROUPS __________________________(count of march groups in convoy)
  LINE 10 – MARCH GROUP TIME _______________________________(convoy march group interval)
  LINE 11 – HAZARDOUS CARGO ________________________________(hazardous cargo: YES or NO)
  LINE 12 – START TIME ________________________________________(latest DTG lead vehicle is planned
  to pass start point)
  LINE 13 – RATE OF MARCH ___________________________________(estimated rate of march)
  LINE 14 – START POINT _______________________________________(UTM or six-digit grid coordinate
  with MGRS grid zone designator of
  starting point)
  LINE 15 – START POC _________________________________________(name of start point of contact at
  requesting unit)
  LINE 16 – LOCATION _________________________________________(UTM or six-digit grid coordinate
  with MGRS grid zone designator of
  starting point POC)
  LINE 17 – FREQUENCIES ______________________________________(start POC’s primary and secondary
  frequencies)
  LINE 18 – PHONE NUMBERS ___________________________________(start POC’s primary and secondary
  phone numbers)
  LINE 19 – ARRIVAL TIME _____________________________________(estimated arrival DTG of moving
  unit)
  LINE 20 – END POINT _________________________________________(location of ending point using
  UTM accurate to 100 meters; same
  as line 16)
  LINE 21 – END POC ___________________________________________(name of end POC at requesting
  unit)
  LINE 22 – LOCATION _________________________________________(UTM or six-digit grid coordinate
  with MGRS grid zone designator of
  end point POC)
  LINE 23 – FREQUENCIES ______________________________________(end POC’s primary and secondary
  frequencies)
  LINE 24 – PHONE NUMBERS ___________________________________(end POC’s primary and secondary
  phone numbers)
  **Continued on next page.