Section J-13N DD Form 1694 Request for Deviation-Waiver.pdf
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FORM WILL NOT WORK CORRECTLY WITHOUT JAVASCRIPT
** PLEASE ENABLE JAVASCRIPT **
PREVIOUS EDITION IS OBSOLETE
DD FORM 1694, APR 2017
Page of AEM LiveCycle Designer
REQUEST FOR VARIANCE
(RFV)
5. VARIANCE PRE OR POST-PRODUCTION:
6. BASELINE AFFECTED:
7. SYSTEM INFORMATION
10.a. OTHER EXTERNAL SYSTEM AFFECTED?:
11. IDENTIFICATION OF VARIANCE
11.a. VARIANCE CLASSIFICATION:
16. RECURRENCE
16.a. RECURRING VARIANCE?:
21. CONTRACT INFORMATION
22. CONTRACTING OFFICER
23. ORIGINATING ACTIVITY
BELOW TO BE COMPLETED BY THE APPROVING ACTIVITY
25.a. RECOMMENDATION:
26.a. DISPOSITION: (Configuration Approval Authority)
27. LIST OF ATTACHMENTS
9.0.0.2.20120627.2.874785 DD1694, "Request for Variance"
| CurrentPage: |
| PageCount: |
| topRightLastUpdated: |
| Enter the date using the format DD-Mon-YYYY: |
| Enter RFV NUMBER: |
| Enter PROCURING ACTIVITY NO. (PAN): |
| Enter DISTRIBUTION STATEMENT: |
| titleOfVar: |
| Enter Pre-Production: |
| Enter Post-Production: |
| Check functional: |
| Check Allocated: |
| Check product: |
| Enter MODEL/TYPE DESIGNATION: |
| Enter SYSTEM/CONFIG. ITEM NOMENCLATURE: |
| Enter END ITEM CAGE CODE: |
| Enter AFFECTED ITEM NOMENCLATURE: |
| Enter PART NUMBER(S) OF AFFECTED ITEM(S): |
| Check yes if OTHER EXTERNAL SYSTEM AFFECTED: |
| Check no if OTHER EXTERNAL SYSTEM AFFECTED: |
| Enter IF YES, LIST OTHER SYSTEMS OR CONFIGURATION ITEMS AFFECTED: |
| Check if VARIANCE CLASSIFICATION is critical: |
| Check if VARIANCE CLASSIFICATION is major: |
| Check if VARIANCE CLASSIFICATION is minor: |
| Enter DEFECT NO. (if applicable): |
| Enter DOCUMENT DEFINING DEFECT NO./CLASS (if applicable): |
| descriptOfVar: |
| needForVar: |
| correctActTaken: |
| effectOnPerform: |
| Check yes if there is a RECURRING VARIANCE: |
| Check no if there is a RECURRING VARIANCE: |
| IF YES, Enter a RATIONALE: |
| Enter EFFECTIVITY: (Quantity Affected, Lot Numbers Affected, Serial Numbers, Dates): |
| Enter PER UNIT COST IMPACT: |
| Enter TOTAL COST IMPACT: |
| Enter EFFECT ON SCHEDULE IF APPROVED/DISAPPROVED: |
| Enter the CONTRACT INFORMATION SUPPLIER: |
| Enter the CONTRACT INFORMATION CONTRACT NO. AND LINE ITEM: |
| Enter the CONTRACTING OFFICER Name: |
| Enter the CONTRACTING OFFICER telephone number: |
| Enter the CONTRACTING OFFICER E-MAIL address: |
| Enter the ORGINATING ACTIVITY PERSON'S NAME: |
| Enter the ORGINATING ACTIVITY PERSON'S TELEPHONE NUMBER: |
| Enter the ORGINATING ACTIVITY PERSON'S CAGE CODE: |
| Enter the ORGINATING ACTIVITY PERSON'S E-MAIL ADDRESS: |
| Enter the ORGINATING ACTIVITY PERSON'S ADDRESS: (Street, City, State, Zip Code): |
| Enter the ORGINATING ACTIVITY PERSON'S SUBMITTING AUTHORITY: |
| APPROVING ACTIVITY NAME AND TITLE: |
| SIGN THE ORIGINATING ACTIVITY PERSON'S SIGNATURE: |
| Check Approval: |
| Check Approval with Modification: |
| Check Disapproval: |
| APPROVING ACTIVITY MODIFICATION DESCRIPTION: |
| APPROVING ACTIVITY SIGNATURE: |
| Enter the date using the format DD-Mon-YYYY: |
| Check if Approved: |
| Check if Approved with Modification: |
| Check if Disapproved: |
| Enter MODIFICATION DESCRIPTION: |
| Enter NAME AND TITLE: |
| Enter SIGNATURE: |
| Add List Of Attachments: |
| AddAttachment: |
| ViewAttachment: |
| RemoveAttachment: |
File details come from the government source that posted it. Updated .