RATT_ORCA CDRLs DD 1423 updated 260514.pdf
PDF 63 KB Posted
- Solicitation number
- N0024426R3108
About this file
This document is a PDF rendering error message, not a federal contract opportunity file. The file contains only Adobe Reader troubleshooting information and instructions for upgrading the PDF viewing software. No contract information, solicitation details, requirements, or procurement data are present in this document. The actual contract document failed to render properly and cannot be reviewed.
View the file
Other files
Show all 23
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Please wait...
If this message is not eventually replaced by the proper contents of the document, your PDF viewer may not be able to display this type of document.
You can upgrade to the latest version of Adobe Reader for Windows®, Mac, or Linux® by visiting http://www.adobe.com/go/reader_download.
For more assistance with Adobe Reader visit http://www.adobe.com/go/acrreader.
Windows is either a registered trademark or a trademark of Microsoft Corporation in the United States and/or other countries. Mac is a trademark of Apple Inc., registered in the United States and other countries. Linux is the registered trademark of Linus Torvalds in the U.S. and other countries.
PREVIOUS EDITION MAY BE USED.
DD FORM 1423, FEB 2024
Page of (Updated 20260326) Instructions
INSTRUCTIONS FOR COMPLETING DD FORM 1423
(See DoDM 5010.12 for detailed instructions.)
DD FORM 1423, FEB 2024
Page of (Updated 20260326)
CONTRACT DATA REQUIREMENTS LIST
C. CATEGORY:
14. DISTRIBUTION
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES Draft Final Reg Repro
16. REMARKS
14. DISTRIBUTION
15.TOTAL
Image of arrow pointing towards totals
FOR GOVERNMENT PERSONNEL
Item A. Self-explanatory.
Item B. Self-explanatory.
Item C. Mark (X) appropriate category: TDP - Technical Data Package; TM - Technical Manual; Other - other category of data, such as "Provisioning," "Configuration Management," etc.
Item D. Enter name of system/item being acquired that data will support (e.g., Mission Design Series (MDS) designator).
Item E. Self-explanatory (to be filled in after contract award).
Item F. Self-explanatory (to be filled in after contract award).
Item G. Name of preparer of CDRL.
Item H. Date CDRL was prepared and signature of preparer of CDRL.
Item I. Name of CDRL approval authority.
Item J. Date CDRL was approved and signature of CDRL approval authority.
Item 1. See DFARS Subpart 204.71 for proper numbering. To add or delete additional data items, point and click the plus or minus sign to the right of Block J.
Item 2. Enter title as it appears on data acquisition document cited in Item 4.
Item 3. Enter subtitle of data item for further definition of data item (optional entry).
Item 4. Identify only one Data Acquisition Document No. If a single work task generates more than one deliverable data product, prepare a separate data item for each deliverable data product.
Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work/Performance Work Statement paragraph number).
Item 6. Enter technical office responsible for ensuring adequacy of the data item.
Item 7. Specify requirement for inspection/acceptance of the data item by the Government.
Item 8. Specify requirement for approval of a draft before preparation of the final data item.
Item 9. For technical data and computer software, specify the contractor's requirement to mark the appropriate distribution statement on the technical data or computer software (ref. DoDI 5230.24).
Item 10. Specify number of times data items are to be delivered.
Item 11. Specify as-of date of data item, when applicable.
Item 12. Specify when first submittal is required.
Item 13. Specify when subsequent submittals are required, when applicable.
Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.
Item 15. Enter total number of draft/final copies to be delivered.
Item 16. Use for additional/clarifying information for Items 1 through 15. Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14; Desired medium for delivery of the data item.
Identify for which data item additional remarks are provided. When tailoring the Data Acquisition Document invoked in Item 4, identify which portions of that Document are being tailored.
Identify any referenced attachments to the form. Attachments can be added using the button at the bottom of page 1.
FOR THE CONTRACTOR
Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.
a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.
Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.
b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.
Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.
c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.
Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.
d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.
Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.
Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.
These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government’s rights to use the data shall be governed by the pertinent provisions of the contract.
9.0.0.2.20120627.2.874785 DD Form 1423, "Contract Data Requirements List"
| CurrentPage: |
| PageCount: |
| Select Classification from drop-down list.: 1 |
| CUI Indicator Information: |
| Click on this button to attach a file(s).: |
| show: |
| hide: |
| A. CONTRACT LINE ITEM NUMBER: |
| exhibit: A |
| C. CATEGORY: Select for "TDP.": 0 |
| C. CATEGORY: Select for "TM.": 0 |
| C. CATEGORY: Select for "OTHER.": 1 |
| C. CATEGORY: Enter specification for "Other.": Performance Reporting |
| System: |
| ContractNum: |
| Contractor: |
| 1. DATA ITEM NUMBER: 0001 |
| 1. DATA ITEM NUMBER: 0002 |
| 1. DATA ITEM NUMBER: 0003 |
| 1. DATA ITEM NUMBER: 0004 |
| 1. DATA ITEM NUMBER: 0005 |
| 1. DATA ITEM NUMBER: 0006 |
| 1. DATA ITEM NUMBER: 0007 |
| 1. DATA ITEM NUMBER: 0008 |
| 1. DATA ITEM NUMBER: 0009 |
| 1. DATA ITEM NUMBER: 0010 |
| 1. DATA ITEM NUMBER: 0011 |
| 1. DATA ITEM NUMBER: 0012 |
| 1. DATA ITEM NUMBER: 0013 |
| 1. DATA ITEM NUMBER: 0014 |
| 1. DATA ITEM NUMBER: 0015 |
| 1. DATA ITEM NUMBER: 0016 |
| 1. DATA ITEM NUMBER: 0017 |
| 1. DATA ITEM NUMBER: 0018 |
| 1. DATA ITEM NUMBER: 0019 |
| titleDataItem: Staffing Plan |
| titleDataItem: Team Employment Matrix |
| titleDataItem: TYCOM Visit Report and Program update |
| titleDataItem: RATT/ORCA Final Visit Report |
| titleDataItem: RATT/ORCA Shipboard Training Summary Report & Roster |
| titleDataItem: ORCA Material Deficiency Report |
| titleDataItem: ORCA AWR |
| titleDataItem: Schedule and Solicitation for Schedule Input Message |
| titleDataItem: Cost Visit/Travel Estimate |
| titleDataItem: RATT/ORCA Commanding Officer's Visit Report |
| titleDataItem: Prioritized Material Deficieicy Report |
| titleDataItem: Ship's CSMP Deficiency Report |
| titleDataItem: Burn Rate/Expenditure Report |
| titleDataItem: Class Issues Assessment Report |
| titleDataItem: Program Review Brief |
| titleDataItem: Fleet Priority Issues |
| titleDataItem: Industrial Plant Equipment Failure Root Cause Analysis Report |
| titleDataItem: Training /IPE Matrix Report and Ship Visit Report |
| titleDataItem: ORCA Data |
| subtitle: |
| 4. AUTHORITY (Data Acquisition Document Number): |
| contractRef: |
| reqOffice: CNSP N43 |
| reqOffice: CNSP N43 |
| reqOffice: CNSP N43 |
| reqOffice: CNSP N43 |
| reqOffice: CNSP N43 |
| reqOffice: CNSP N43 |
| reqOffice: CNSP N43 |
| reqOffice: CNSP N43 |
| reqOffice: CNSP N43 |
| reqOffice: CNSP N43 |
| reqOffice: CNSP N43 |
| reqOffice: CNSP N43 |
| reqOffice: CNSP N43 |
| reqOffice: CNSP N43 |
| 7. DD 250 REQUIREMENT: |
| 8. APPROVAL CODE : |
| 9. DISTRIBUTION STATEMENT REQUIRED: |
| freq: Bi-weekly* |
| freq: Weekly |
| freq: Bi-weekly |
| freq: * |
| freq: * |
| freq: * |
| freq: * |
| freq: Monthly |
| freq: * |
| freq: * |
| freq: * |
| freq: * |
| freq: Quarterly |
| freq: * |
| freq: Quarterly |
| freq: Monthly |
| freq: * |
| freq: */** |
| freq: Monthly* |
| asOfDate: |
| dateFirstSub: Sep 30, 2026** |
| dateFirstSub: Sep 30, 2026 |
| dateFirstSub: Sep 30, 2026 |
| dateFirstSub: * |
| dateFirstSub: * |
| dateFirstSub: * |
| dateFirstSub: * |
| dateFirstSub: Oct 12, 2026 |
| dateFirstSub: * |
| dateFirstSub: * |
| dateFirstSub: * |
| dateFirstSub: * |
| dateFirstSub: Oct 30, 2026 |
| dateFirstSub: * |
| dateFirstSub: Jan 29, 2027 |
| dateFirstSub: Oct 30, 2026 |
| dateFirstSub: * |
| dateFirstSub: */** |
| dateFirstSub: Oct 30, 2026 |
| dateSubseqSub: |
| 16. REMARKS: Plan to achieve and maintain 100% staffing levels. |
*Provide bi-weekly until 100% staffing is achieved, then update monthly.
** Initial submission due ten days after award date.
| 16. REMARKS: Team Roster with visit employment, including training for the next six months. |
| 16. REMARKS: Update of scheduled and completed visits and program update. |
| 16. REMARKS: Detailed report of visit accomplishments, including training conducted, training roster, readiness status and recommendations. |
* Five working days following the completion of a ship visit
16. REMARKS: Report of shipboard training conducted and training rosters.
* Five working days following the completion of a ship visit
16. REMARKS: Compete listing of material deficiencies identified during ORCA visit.
* Five working days following the completion of a ship visit.
16. REMARKS: AWR's generated based on deficiencies identified during the ORCA ship visit and provided to the ship POC.
* Five working days following the completion of a ship visit
16. REMARKS: Input provided to TYCOM concerning RATT schedule availability and solicitation for scheduling of RATT team training events for Fleet distribution via Navy message.
Input provided to TYCOM concerning OCRA schedule availability and solicitation for scheduling of OCRA visits for Fleet distribution via Navy message.
16. REMARKS: Cost estimate of each overseas/OCONUS visit (submitted 30 days prior), with detailed team composition submitted for approval.
* 30 days prior to planned overseas/OCONUS travel.
16. REMARKS: Complete visit report provided to the CO, covering all aspects of the visit to include training completed, training roster, discrepancies noted and recommendations.
* Five working days following the completion of a ship visit
16. REMARKS: A complete listing of material deficiencies identified during the ship visit. Provided as an enclosure to CDRL 0010.
* Five working days following the completion of a ship visit
16. REMARKS: A complete listing of CSMP material deficiencies identified during the ship visit. Provided as an enclosure to CDRL 0010.
* Five working days following the completion of a ship visit
| 16. REMARKS: Detailed expenditure report to include all Labor and ODC CLINs with graphical depiction. |
| 16. REMARKS: Prioritized listing of ship class issues/deficiencies discovered during the ship visit. Part of |
CO's Visit Report, CDRL 0011.
* Five working days following the completion of a ship visit
| 16. REMARKS: Detailed RATT program review brief (face-to-face preferred) to include past and future visit schedule detail, technical issues and financial performance, trends, overall program health and future program enhancement initiatives, etc. |
| 16. REMARKS: A review of the status of Fleet priority issues and recommendations. |
Note: A listing of Fleet Priority issues will be provided to the contractor Program Manager (PM) to assess during ship visits and report on, as a means of establishing trends and informing TYCOM leadership decision making.
16. REMARKS: Detailed analysis of the plant equipment failure to include root cause and recommend remedy for repair/restoration by the dedicated ORCA Analyst.
* Preliminary report due within 20 working days of ship visit. Final report due within 30 calendar days of ship visit.
16. REMARKS: Identify Navy training relative to standard afloat Industrial Plant Equipment (IPE).* During ship visits identify training deficiencies relative to standard/installed IPE.**
Per ship visit, identify training gaps relative to IPE. **
* One time submission within 60 days of award, with updates as necessary.
** Due within 20 working days of ship visit. Final report due within 30 calendar days of ship visit.
16. REMARKS: ORCA data related to IPE and training deficiencies, and Root Cause Analysis, provided in Excel format for the purpose of government third party analysis and dashboard development.
* Based on completed ship visits
| Click to add/remove continuation field for Remarks: |
| Click to delete CURRENT data items for 1 through 18, unless this is the only data item.: |
| Click to add a page of data items for 1 through 18 immediately following the current page.: |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: TA |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: COR |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: TA |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: COR |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: TA |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: COR |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: TA |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: COR |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: Ship CO/XO |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: TA |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: COR |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: Ship CO/XO |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: TA |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: COR |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: CO/XO |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: CO/XO |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: TA |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: COR |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: TA |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: COR |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: CO/XO |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: CO/XO |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: CO/XO |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: TA |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: COR |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: TA |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: COR |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: CO/XO |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: TA |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: COR |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: TA |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: COR |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: TA |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: COR |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: TA |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: COR |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: CO/XO** |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: TA |
| 14. DISTRIBUTION - a. ADDRESSEE, new line: COR |
| 15.TOTAL - Total draft copies is automatically calculated.: 0 |
| 15.TOTAL - Total draft copies is automatically calculated.: 0 |
| 15.TOTAL - Total draft copies is automatically calculated.: 0 |
| 15.TOTAL - Total draft copies is automatically calculated.: 0 |
| 15.TOTAL - Total draft copies is automatically calculated.: 0 |
| 15.TOTAL - Total draft copies is automatically calculated.: 0 |
| 15.TOTAL - Total draft copies is automatically calculated.: 0 |
| 15.TOTAL - Total draft copies is automatically calculated.: 0 |
| 15.TOTAL - Total draft copies is automatically calculated.: 0 |
| 15.TOTAL - Total draft copies is automatically calculated.: 0 |
| 15.TOTAL - Total draft copies is automatically calculated.: 0 |
| 15.TOTAL - Total draft copies is automatically calculated.: 0 |
| 15.TOTAL - Total draft copies is automatically calculated.: 0 |
| 15.TOTAL - Total draft copies is automatically calculated.: 0 |
| 15.TOTAL - Total draft copies is automatically calculated.: 0 |
| 15.TOTAL - Total draft copies is automatically calculated.: 0 |
| 15.TOTAL - Total draft copies is automatically calculated.: 0 |
| 15.TOTAL - Total draft copies is automatically calculated.: 0 |
| 15.TOTAL - Total draft copies is automatically calculated.: 0 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 2 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 2 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 2 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 3 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 3 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 3 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 2 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 2 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 0 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 0 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 2 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 3 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 2 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 2 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 2 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 3 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 1 |
| 15.TOTAL - Total final regular copies is automatically calculated.: 2 |
| 15.TOTAL - Total final reproducible copies is automatically calculated.: 0 |
| 15.TOTAL - Total final reproducible copies is automatically calculated.: 0 |
| 15.TOTAL - Total final reproducible copies is automatically calculated.: 0 |
| 15.TOTAL - Total final reproducible copies is automatically calculated.: 0 |
| 15.TOTAL - Total final reproducible copies is automatically calculated.: 0 |
| 15.TOTAL - Total final reproducible copies is automatically calculated.: 0 |
| 15.TOTAL - Total final reproducible copies is automatically calculated.: 0 |
| 15.TOTAL - Total final reproducible copies is automatically calculated.: 0 |
| 15.TOTAL - Total final reproducible copies is automatically calculated.: 0 |
| 15.TOTAL - Total final reproducible copies is automatically calculated.: 0 |
| 15.TOTAL - Total final reproducible copies is automatically calculated.: 0 |
| 15.TOTAL - Total final reproducible copies is automatically calculated.: 0 |
| 15.TOTAL - Total final reproducible copies is automatically calculated.: 0 |
| 15.TOTAL - Total final reproducible copies is automatically calculated.: 0 |
| 15.TOTAL - Total final reproducible copies is automatically calculated.: 0 |
| 15.TOTAL - Total final reproducible copies is automatically calculated.: 0 |
| 15.TOTAL - Total final reproducible copies is automatically calculated.: 0 |
| 15.TOTAL - Total final reproducible copies is automatically calculated.: 0 |
| 15.TOTAL - Total final reproducible copies is automatically calculated.: 0 |
| priceGrp: |
| estTotalPrice: |
| remarks_cont: |
| preparedBy: |
| H. SIGNATURE: H. SIGNATURE |
| H. SIGNATURE: |
| approvedBy: |
| J. SIGNATURE: J. SIGNATURE |
| J. SIGNATURE: |
| Click to add additional data items 1 through 18 to the end of the form.: |
File details come from the government source that posted it. Updated .