CDRL_A020_-_Shipment_to_Restricted_Country_-_Approval_Necessary.pdf

DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-0188). 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 form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

SHIPMENT TO RESTRICTED COUNTRY

Shipping Activity:

Requisition/Document Number:

DODAAC:

FMS Case Code:

Priority:

RDD:

Project Code:

Destination:

NSN:

Nomenclature:

Material classification (CIIC):

Quantity:

Mode of Transportation:

Mark for Address:

Ship To Address:

Submitted by:

Date:

Validate Data by:

Validation by DLA Distribution J4-BT:

Provide completed approval request to the COR. The COR will obtain the Distribution Commander/Director's signature and forward to DLA Distribution.

Block 7 - Inspection and acceptance requirements:

The COR will review and provide approval/disapproval of the request after coordination with J-4 Transportation Team within 1 working day.

Block 14 - Distribution - Contractor to submit original to COR and copy to the Contract Specialist.