Contractor Data Request

Contractor User Data Request (Page 2)

This form is used by Contractors to request data from the AMCOM G-6 EDIS Repository. If you are a Government employee, choose the Government version instead.

This request is designed to provide the AMCOM G-6 Information Management Division with a detailed description of the requested technical data and adequate information to permit compliance with Department of Defense (DOD) Directive 5230.25 and DOD Directive 5230.24. Please answer each question completely and in detail, thereby providing us with all the information necessary to process your request promptly. Failure to provide a complete response to all questions, providing abstract answers such as "unknown" & "not available", etc. may unnecessarily delay the processing of your request and/or result in denial of release.

PART I - Administrative Information

Enter your information: ( denotes required field).

1. Company Name

Company Address Line One

Company Address Line Two

Company City

Company State

Company ZIP

- Point of Contact (POC) for this request -

POC Name

POC Company Email

- POC Company Telephone / Fax Number

Phone

Extension

2. Department of Defense (DoD) Certification / Registration Number. This is assigned after submittal and approval of DD form 2345, Export-Controlled Technical data Agreement. Don't have one ? Then STOP and obtain one - we cannot process your request without it. View a DD 2345 or get more information on the form.

DoD Certification Number

Current Government Contract Number (if any):

3. Requestor must submit proof of a legitimate business interest in the information requested. Examples of such are submission of your Federal Supply Code for Manufacturers (FSCM) or Federal Supply Code for Non-Manufacturers FSCNM).

FSCM aka. FSCNM

4. Is requestor a citizen of the United States ?

If "No", specify all of your citizenships

5. Has requestor obtained from the United States Department of State the appropriate approvals under the International Traffic in Arms Regulation (ITAR)?

If "Yes", enter evidence of ITAR Approval

6. Purpose - explain in detail the contemplated usage of the data requested (also enter contract solicitation number, if known):

7. Identification and address of end user (The Company Name, Address, City, State, Country and Postal (Zip) Code are required. Failure to provide all required information will result in rejection of request

8. Number of units / equipment to be manufactured

Approximate total value of units / equipment to be manufactured

Contemplated delivery period -

FROM

9. Effect on United States Government programs

Is requestor now supplying similar equipment to the United States Government ?

If Yes, provide United States Agency and Contract Number

Will contemplated activity by requestor delay deliveries to the United States under an existing contract ?

Does requestor contemplate use of manufacturing facilities or equipment now devoted to satisfying United States Government requirements?

If requestor is not currently supplying similar equipment to the United States Government, has requestor previously supplied, or does requestor contemplate supplying any services or material to the United States Government in the future ?

10. This is a request for the purpose of obtaining the following type item(s)

11. Remarks-Please be specific with dash number (-) and Doc Types. EDM Services will respond to ALL and OTHER by providing the Base Document and Parts List ONLY, if available.

12. Range of total number of individual drawings requested?