G. PREPARED BY
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item)
16. REMARKS
C. CATEGORY:
TDP ________ TM _______ OTHER _________________________
Form Approved
OMB No. 0704-0188
15. TOTAL
PREVIOUS EDITION MAY BE USED.
DD FORM 1423-1, AUG 96 (EG)
Page ____ of ____ Pages
A. CONTRACT LINE ITEM NO. B. EXHIBIT
D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR
1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE
4. AUTHORITY
(Data Acquisition Document No.)
5. CONTRACT REFERENCE 6. REQUIRING OFFICE
7. DD 250 REQ
8. APP CODE
9. DIST STATEMENT
REQUIRED
10. FREQUENCY
11. AS OF DATE
12. DATE OF FIRST SUBMISSION
13. DATE OF SUBSEQUENT
SUBMISSION
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
Draft
Final
Reg Repro
17. PRICE GROUP
18. ESTIMATED
TOTAL PRICE
H. DATE
J. DATEI. APPROVED BY
The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect
of this collection of information, including suggestions for reducing the burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations
and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no
person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your
form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.
Designed using Perform Pro, WHS/DIOR, Aug 96
