REQUEST FOR VARIANCE (RFV) FORM DD1694.pdf

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Attached to
WIRING HARNESS, BRANCHED Federal contract opportunity
Solicitation number
SPRDL1-25-R-0168
Issued by
Defense Logistics Agency Land and Maritime

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FORM WILL NOT WORK CORRECTLY WITHOUT JAVASCRIPT

** PLEASE ENABLE JAVASCRIPT **

PREVIOUS EDITION IS OBSOLETE

DD FORM 1694, APR 2017

Page of AEM LiveCycle Designer

REQUEST FOR VARIANCE

(RFV)

OMB No. 0704-0188 OMB approval expires November 30, 2022 The public reporting burden for this collection of information, 0704-0188, is estimated to average 2 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 the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. 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 THIS ADDRESS. RETURN COMPLETED FORM TO THE ACQUIRER ISSUING CONTRACTING OFFICER FOR THE CONTRACT/PROCURING ACTIVITY NUMBER LISTED IN BLOCK 22 OF THIS FORM.

5. VARIANCE PRE OR POST-PRODUCTION:

6. BASELINE AFFECTED:

7. SYSTEM INFORMATION

10.a. OTHER EXTERNAL SYSTEM AFFECTED?:

11. IDENTIFICATION OF VARIANCE

11.a. VARIANCE CLASSIFICATION:

16. RECURRENCE

16.a. RECURRING VARIANCE?:

21. CONTRACT INFORMATION

22. CONTRACTING OFFICER

23. ORIGINATING ACTIVITY

BELOW TO BE COMPLETED BY THE APPROVING ACTIVITY

25.a. RECOMMENDATION:

26.a. DISPOSITION: (Configuration Approval Authority)

27. LIST OF ATTACHMENTS

9.0.0.2.20120627.2.874785 DD1694, "Request for Variance" List Of Attachments

CurrentPage:
PageCount:
Enter the date using the format DD-Mon-YYYY:
rfvNumber:
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distStatmt:
titleOfVar:
preProd:
postProd:
functional:
allocated:
product:
modelTypeDesign:
sysConfigItemNom:
endItemCageCode:
affectItemNom:
partNoAffectItems:
yes:
no:
block10b:
critical:
major:
minor:
defectNo:
docDefDefect:
descriptOfVar:
needForVar:
correctActTaken:
effectOnPerform:
yes2: 0
no2: 0
provRationale:
block17effectivity:
perUnitCostImpact:
totalCostImpact:
effectOnSched:
supplier:
contractNoLineNo:
nameContractOff:
telephone:
email:
nameOrigAct:
telephoneOrigAct:
cageCode:
emailOrigAct:
address:
submitAuth:
nameTitle:
submitAuthSign:
approval:
approvalWithMod:
Disapproval:
recommendModDescript:
recommendSign:
Enter the date using the format DD-Mon-YYYY:
approved:
approvedWithMod:
Disapproved:
dispositionModDescript:
nameTitle2:
dispositionSign:
attachmentsList:
AddAttachment:
ViewAttachment:
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