CDRL A0002 Deficiency Report signed.pdf

CONTRACT DATA REQUIREMENTS LIST Form Approved CMB 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 222202-2302, 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 the Contract. PR No. listed in Block E.

A. Contract Line Item No. B. Exhibit A C. Category

D. System/Item.

F100-PW-220/229 Balance Segment Assembly E. Contract/PR NO.

FD2030-22-31003

F. Contractor

1. Data Item No.

A0002

2. Title of Data Item:

Deficiency Report (DR)

3. Subtitle:

None

4. Authority (Data Acquisition Document No.)

DI-ALSS-81535

5. Contract Reference

PWS 1.1.1.2

6. Requiring Office

AFLCMC/LPSIB

7. DD 250 Req N/A

1. Dist Statement Required

N/A

10. Frequency As Required

12. Date of First Submission See Block 16

14. Distribution

8. APP Code N/A

11. As of Date

N/A

13. Date of Subsequent Submission See Block 16

a. Addressee b. Copies

D r a f t

Final

Reg Re pr o

16. REMARKS

As defined by T.O. 00-35D-54, submit a report whenever a material or a quality deficiency occurs utilizing SF Form 368.

Ref: Block 14a: Complete address for distribution:

AFLCMC/LPSIB

3001 Staff Dr., Ste. 2AE1/107B Tinker AFB, OK. 73145-3031

DCMA/ACO (See the face contract)

AFLCMC/LPSIB 1

PCO 1

DCMA/ACO 1

15. TOTAL 3

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

DD Form 1423-1, JUN 90 Previous editions are obsolete Page 1 of 1 Pages 16 March 22 16 March 22

CONTRACT DATA REQUIREMENTS LIST