DD Form 1423.doc

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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA. 22202-4302. Respondants 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 address. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

A

C. CATEGORY:

TDP _«TDP» IF = "True" "X" " "

_ TM _ «TM» IF = "True" "X" " "

_ OTHER __«OTHER» IF = "True" "X" " "

D. SYSTEM/ITEM

C-130 Support

E. CONTRACT/PR NO.

F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

STATUS REPORT

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80368

5. CONTRACT REFERENCE

PWS PARA. 3.1.2, 4.8.1, 4.9

6. REQUIRING OFFICE

560 ACSS/GFLB

7. DD 250 REQ

LT

9. DIST

STATEMENT

C

10. FREQUENCY

SEE BLOCK 16

12. DATE OF 1ST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

8. APP CODE

A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT SUBMISSION SEE BLOCK 16

16. REMARKS

BLOCK 9: DISTRIBUTION AUTHORIZED TO US GOVERNMENT AGENCIES AND THEIR CONTRACTORS; CRITICAL TECHNOLOGY: 24 JUL 06. OTHER REQUESTS SHALL BE REFERRED TO 560 ACSS/GFLB.

BLOCK 10, 11, 12, 13: CONTRACTOR SHALL DELIVER THE MONTHLY REPORT NOT LATER THAN THE 20TH DAY OF THE FIRST MONTH FOLLOWING THE REPORTING PERIOD.

BLOCK 14: DATA SHALL BE DELIVERED ELECTRONICALLY IN MICROSOFT OFFICE FORMAT TO ALL ADDRESSEES IN BLOCK 14. APPLICABLE E-MAIL ADDRESSES ARE AS FOLLOW: MELISSA.JOHNSON@ROBINS.AF.MIL; THOMAS.COURSON@ROBINS.AF.MIL; AND ROBERT.JONES3@ROBINS.AF.MIL.

560 ACSS/GFLB

330 ACSSS/GFKA

235 BYRON ST.

SUITE 19A

ROBINS AFB, GA

31098-1670

G. PREPARED BY

Melissa Johnson

H. DATE

17. PRICE GROUP

� MERGEFIELD PRICEGP �«PRICEGP»�