21Q0035_SOL_ATT1.pdf

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved OMB No. 0704-0188

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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA. 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A ____TDP ____ TM _____ OTHER __X___ADMIN/MANAGEMENT DATA

D. SYSTEM/ITEM E. CONTRACT/PR NO.

F. CONTRACTOR

High Density Packaging User Group Membership

N00164-21-X-YYYY High Density Packaging User Group International, Inc.

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A001

Test Reports

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

SOW Para 4.1.2

6. REQUIRING OFFICE

DI-TMSS-81586A JXM

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION 14. DISTRIBUTION

LT WHEN

AVAILABLE

N/A

b. COPIES

(e-mail)

8. APP CODE A 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

Final

N N/A N/A Reg Repro

Website access to latest test reports, project results, and discussion items.

Deliver to:

Commanding Officer Naval Surface Warfare Center Mick Miller Bldg. 3287E, Code JXMP Crane, IN 47522

DISTRIBUTION STATEMENT A: Approved for public release; distribution is unlimited.

DESTRUCTION NOTICE – For classified documents, follow the procedures in DoD 5220.22-M, Industrial Security Manual, Section 11 -19 or DoD 5200.1-R, Information Security Program Regulation, Chapter IX. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.

GOVERNMENT DOCUMENTATION SHALL BE DESTROYED UPON COMPLETION OF THE

CONTRACT OR PURCHASE ORDER, USE OF GOVERNMENT DOCUMENTATION FOR

COMMERCIAL PURPOSES IS FORBIDDEN.

NSWC M. Miller 1 1

15. TOTAL

1 1

G. PREPARED BY

Mick Miller

H. DATE

10/06/20

I. APPROVED BY

N. Abrams

J. DATE