A0005 GFM DI-PSSS-80727A CDRL for FD2030-22-31003 signed.pdf

CONTRACT DATA REQUIREMENTS LIST Form Approved OMB No. 0704-0188(1 Data Item)

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

TDP TM OTHER X

D. SYSTEM / ITEM F. CONTRACTOR

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

Government Furnished Material (GFM) by National Stock Number (NSN)

3. SUBTITLE

N/A

4. AUTHORITY

DI-PSSS-80727A

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS

6. REQUIRING OFFICE

7. DD 250 REQ

NO

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

See Block 16

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Block 9: Distribution Statement D: Distribution authorized to the Department of Defense and US DOD Contractors only, critical technology (19 March 2020). Other requests shall be referred to 848 SCMG/EN, Tinker Air Force Base, Oklahoma.

Control Warning Notice: Warning - This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, USC, Sec 2751 Et Seq) or the Export Administration Act of 1979, Title 50, USC, App 240 I Et Seq, as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DOD Directive 5230.25.

Destruction Notice for Unclassified Documents: destroyed by any method that will prevent disclosure of contents or reconstruction of the document.

Destruction Notice for Classified Documents: Follow the procedures in DOD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM), Section 5-705, or DOD 5220.0 I M, Information Security Program , Vol 3, Protection of Classified Information.

Blocks 10-13 The first report should be submitted within five (5) business days after the close of the first reporting period (previous month's last calendar date). Subsequent reports shall be submitted within five (5) business days of the close of the reporting period (previous month's last calendar date). Format shall be IAW DI-PSSS-80727A.

COORDINATORS:

0 4 0

0 6 015. TOTAL

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page 14 of 19DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 24 Jul 2020

PREVIOUS EDITION MAY BE USED.

AFLCMC/LPSIB

E. CONTRACT / PR NO.

FD2030-22-305Ffd

F100-PW-220 Balance Segment Assembly

AFLCMC/LPSIB

16 March 22

A0005

AFSC/PCO

DCMA/ACO

FD2030-22-31003

1459161135C Cross-Out

1459161135C Cross-Out