Attachment 0006 - Form 1379.pdf

REQUEST FOR DEPOT ENGINEERING SUPPORT

FCDD-AMR-AM FORM 1379, Page 1 of 3

Contractor Tracking No.

Contract No. Priority of Request

☐Urgent ☐Routine Date of Request

Contractor Address State, Zip

AC System

AC Type

NSN

CSI

☐Yes ☐No Part No.

Nomenclature

Serial No.

Publication No.

Publication Title

Change No.

Pub Date

Page/WP No. Paragraph/Section Figure No. Table No.

Discrepancy/suggested corrections or solutions:

Submitted by Signature Date

Email Address Phone No.

FCDD-AMR-AM FORM 1379, Page 2 of 3

Contractor Tracking No. Contract No.

Government Disposition:

Authorized by

Authorization Signature

Date

Reference TTS Reference MEO(s) Reference PAID

**The Government Disposition contained on this FCDD-AMR-AM FORM 1379 is not to be construed or interpreted as direction to perform tasks, work, or labor which could result in a monetary charge to the U.S. Government. Additionally, the contents of this Government Disposition shall not be used as direction to modify any existing contract between vendors and the U.S. Government. For questions regarding contracts and changes to contracts, consult your contracting officer. The contracting officer is the approving authority for all matters related to contracts.**

FCDD-AMR-AM FORM 1379, Page 3 of 3

INSTRUCTIONS

Contractor Tracking No. The contractor’s internal 1379 tracking number.

Contract No. The contract number issued to the contactor (required field).

Priority of Request. Request urgency.

Date of Request. Engineering support request date.

Contactor. Contractor company name.

Address. Contractor company address.

State, Zip. Contractor company state and zip code.

AC System. Aircraft system.

AC Type. Aircraft type.

NSN. National Stock Number.

CSI. Critical Safety Item.

Part No. Part number if applicable.

Nomenclature. Name of part.

Serial No. Serial number if applicable.

Publication No. Depot Maintenance Work Requirements (DMWR) or Technical Manual (TM) number.

Publication title. Depot Maintenance Work Requirements (DMWR) or Technical Manual (TM) title.

Change No. Depot Maintenance Work Requirements (DMWR) or Technical Manual (TM) change number.

Pub Date. Depot Maintenance Work Requirements (DMWR) or Technical Manual (TM) date.

Page/WP No. The page/work package the discrepancy/suggestion correction location.

Paragraph/Section. The paragraph/section the discrepancy/suggestion correction is location.

Figure No. The figure number of the discrepancy/suggestion correction.

Table No. The table number of the discrepancy/suggestion correction.

Discrepancy/suggested corrections or solutions. Detailed explanation of the issue/problem.

Submitted by. Contractor submitting form.

Signature. Contractor’s signature.

Date. Date signed.

Email Address. Contractor’s email address.

Phone No. Contractor’s phone number.

Government Disposition. Government’s recommend correction/solution to the issue/problem.

Authorized by. Government disposition approver.

Authorizing Signature. Government disposition approver signature.

Date. Government approval date.

Reference TTS. Task Tracking System number.

Reference MEO(s). MEOs pertaining to problem.

Reference PAID. PAID system number.