DD1423 W911QX21Q0192.doc

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CONTRACT DATA REQUIREMENTS LIST

(1 Data Item) Form Approved

OMB No. 0704-0188

The 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 the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-1088). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. 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:

TDP_____ TM ______ OTHER: FNCL

D. SYSTEM/ITEM

LabVIEW Development and Support for Versatile Tactical Power and Propulsion Program

E. CONTRACT/PR NO.

W911QX21P0199/0011659276

F. CONTRACTOR

Vieletech, Inc.

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Status Report

3. SUBTITLE

Hours Task Report

4. AUTHORITY (Data Acquisition Document No.)

DI-FNCL-80003

5. CONTRACT REFERENCE

PWS C.4

6. REQUIRING OFFICE

FCDD-RLW-VA

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

A

10. FREQUENCY

AT TIME OF INVOICE

12. DATE OF FIRST SUBMISSION

NLT 40 days ARO 14.

DISTRIBUTION

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION See BLK16

16. REMARKS

BLOCK 4: ALL REPORTS SHALL BE IN HARD COPY AND SHOULD BE IN MICROSOFT WORD, MICROSOFT OFFICE, MICROSOFT EXCEL, OR .PDF FORMAT.

CONTRACTOR FORMAT ACCEPTABLE.

BLOCK 13: SUBSEQUENT SUBMISSION SHALL BE MADE AT THE TIME OF EACH INVOICE SUBMISSION.

BLOCK 14: FCDD-RLW-VA REPORT COPY TO BE SENT TO:

U.S. ARMY RESEARCH LABORATORY

FCDD-RLW-VA

ATTN:STEPHEN BERKEBILE

6340 RODMAN ROAD

ABERDEEN PROVING GROUND, MD, 21005

G. PREPARED BY

Stephen Berkebile

H. DATE

15 June 2021

I. APPROVED BY

Joseph Dellinger

J. DATE

30 August 2021

DD FORM 1423-1, FEB 2001

PREVIOUS EDITION MAY BE USED.

Page 1 of Pages 1

EXHIBIT A – ATTACHMENT 1

ARMY RESEARCH LABORATORY

Report Title Goes Here

Any Subtitles Go Here

By Some Author and Another Author

Month XXXX

Prepared by

Whatever Technology Corporation

0000 Research Drive

Anywhere, ST 20006-1000

Under contract

W911QX-XX-C-XXXX

DISTRIBUTION STATEMENT GOES HERE

EXHIBIT A – ATTACHMENT 2

The findings in this report are not to be construed as an official Department of the Army position unless so designated by other authorized documents.

Citation of manufacturer's or trade names does not constitute an official endorsement or approval of the use thereof.

DESTRUCTION NOTICE: For classified documents, follow the procedures in DoD 5220.22-M, National Industrial Security Program Operating Manual, Chapter 5, Section 7. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.