J.1(b)_Attachment_5_DD1861.pdf

DD FORM 1861, AUG 2004

CONTRACT FACILITIES CAPITAL COST OF MONEY

PREVIOUS EDITION MAY BE USED.

OMB No. 0704-0267 OMB approval expires Jul 31, 2007

The public reporting burden for this collection of information is estimated to average 10 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 Directorate (0704-0267). 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 COMPLETED FORM TO THE ABOVE ORGANIZATION.

RETURN COMPLETED FORM TO YOUR CONTRACTING OFFICIAL.

1. CONTRACTOR NAME 2. CONTRACTOR ADDRESS

3. BUSINESS UNIT

4. RFP/CONTRACT PIIN NUMBER 5. PERFORMANCE PERIOD

6. DISTRIBUTION OF FACILITIES CAPITAL COST OF MONEY

a.

POOL

b.

ALLOCATION BASE

c.

FACILITIES CAPITAL COST OF MONEY

(1)

FACTOR

(2)

AMOUNT

d. TOTAL

e. TREASURY RATE %

f. FACILITIES CAPITAL EMPLOYED

(TOTAL DIVIDED BY TREASURY RATE)

7. DISTRIBUTION OF FACILITIES CAPITAL EMPLOYED

a.

PERCENTAGE

b.

AMOUNT

(1) LAND %

(2) BUILDINGS %

(3) EQUIPMENT %

(4) FACILITIES CAPITAL EMPLOYED 100%