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1. TITLE
2. IDENTIFICATION NUMBER
PAYME
N
T
R
EP
OR
T
D
I - F
N
CL - 81 478
1 .
D ESCRIPTION I PUFIPUSE
3.1 Th e p a y
m
e n t r e po r t d e s c r i b e s
m
on t h l y pa y
m
e n t i n f o r
m
a t i on n e c e s s a r y to upd a t e t h e
s t a nd a r d a c c oun t i ng a nd r e po r t i ng s y s t e
m
( STA
R
S ) d a t ab a s e .
1 .
APPROVAL DATE
5. OFFICEOF PRIMARYRESPONSIBILITY(OPR) 62. DTIC APPLICABLE
(VYW4MDD)
6b. GI DEP APPLICABLE
950731
‘. APPLICATIONllNIERREbiTIONSHIP
7.1
Th i s
D
a t a I t e
m
D
e s c r i p t i on (
D
I
D
) con t a i ns t h e f o r
m
a t and c o n t e n t p r e p a r a t i on i n s t r u c t i on
f o r . t h e da t a p r odu c t ge n e r a t ed b y t h e s p e c i f i c a nd d i s c r e t e t a s k r e qu i r e
m
e n t s a s d e l i n e a t e d
i n t h e con t r a c t .
9a. APPLICABLE FORMS
9b. AMSC NUM6ER
O. PREPARATION INSTRUCTIONS
10 . 1 F
OR
MAT A
ND
C
ON
TE
N
T . Th e Pa y
m
e n t
R
e p o r t s h a l 1 be p r e s e n t ed i n t h e con t r a c t o r ’ s
f o r
m
a t a nd s h a l 1 s p e c i f y t h e f o l l ow i n g :
a .
Co n t r a c t o r ’ s n a
m
e a nd a dd r e s s
b .
Co n t r a c t nu
m
b e r ( d e l i v e r y o r d e r nu
m
b e r )
c .
D
a t e o f r e po r t
d . Sh i p
m
e n t nu
m
b e r r e l a t i v e t o c on t r a c t ( d e l i v e r y o r d e r )
e .
I
n
v
o
i
c
e
nu
m
b e r r e l a t i v e t o c on t r a c t ( de l i v e r y o r d e r )
f .
Amount of c h e c k
9 .
Ch e c k nu
m
b e r a nd d a t e o f c h e c k
h . Pho t o cop y o f a l l c h e c k s r e c e i v e d s i n c e p r e v i o u s sub
m
i s s i on s s ha l 1 b e i nc l ud e d .
1 .
DISTRIBUTION STATEMENT
D
I ST
R
I B
U
T I
ON
STATEME
N
T A : App r o v e d f o r pub l i c r e l e a s e ; d i s t r i b u t i on i s un l i
m
i t e d .
>
Form 1664 APR 89
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0102 -LF-007.3Lio0
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