J-4_SWMFTS_Data_Item_Transmittal_Form.docx

DATA ITEM TRANSMITTAL/ACCEPTANCE/REJECTION FORM

Contract N61340XXFXXXX

CLIN/SLIN: _____/____ TITLE:

Block 14 Distribution:

Other:

Doc. Ref. No.: Date:

From:

To: NAWCTSD, 12211 Science Drive, GT22200, Orlando, FL 32826-3275 ATTN:

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: ____________________________________

FIRST ENDORSEMENT: Date Received:

( ) Accepted.

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

(This block is for use with periodically submitted items only.)

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

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

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

VIA: Date:

VIA: PD Date:

SECOND ENDORSEMENT:

( ) Accepted.

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

( ) Rejected, comments attached. Resubmit no later than .

Signature: __________________________________________ Typed Name/Title: ___________________________________ Contracting Officer Date:

CC w/Encl.:

CC w/o Encl.:

NAWCTSD 4330/60 (3/94)

FTSS V

Attachment BC 2