Attachment_4_Data_Item_Xmittal_Form.docx

DATA ITEM TRANSMITTAL/ACCEPTANCE/REJECTION FORM

Contract : TBD

CLIN/SLIN: / TITLE:

Block 14 Distribution:

Other:

Doc. Ref. No.: Date:

From:

To: Naval Air Warfare Center Aircraft Division, ADDRESS, ATTN: COR

The above detailed CDRL item is forwarded for review and acceptance/ rejection. This item is due . The Government review period is days.

Sincerely, Signature: _____________________________________ Typed Name/Title: ______________________________

ENDORSEMENT: Date Received:

( ) Accepted.

( ) Accepted. Attached comments must be incorporated into the next scheduled submission.

( ) Rejected, comments attached. Change pages ( ) are ( ) not sufficient for correction.

Contractor is allowed ( ) 30 days or ( ) days to resubmit.

Signature:___________________________________________ Typed Name/Title:____________________________________ Code: Date:_______________

Return to Contractor Via: Date:

CC w/Encl.:

CC w/o Encl.:

N00421-16-R-0060 Attachment (4)