Dd Form 1921 - Cost Data Summary Report - 2007
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1SECURITY CLASSIFICATION
Form Approved
COST DATA SUMMARY REPORT
OMB No. 0704-0188
The public reporting burden for this collection of information is estimated to average 8 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 Department of Defense, Washington Headquarters Services, Executive Services 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 COMPLETED FORM TO THE ABOVE ORGANIZATION.
1. PROGRAM
2. PRIME MISSION PRODUCT
3. CONTRACTOR TYPE
(X one)
4. NAME/ADDRESS
(Include ZIP Code)
5. APPROVED PLAN NUMBER
a. MDAP:
PRIME/ASSOCIATE
b. PHASE:
DIRECT-REPORTING SUBCONTRACTOR
6. CUSTOMER
7. CONTRACT TYPE
8. CONTRACT PRICE
9. CONTRACT CEILING
10. TYPE ACTION
(Direct-Reporting Subcontractor Use Only)
a. CONTRACT NO.:
c. SOLICITATION NO.:
b. LATEST MODIFICATION:
d. NAME:
11. PERIOD OF PERFORMANCE
12. APPROPRIATION
13. REPORT CYCLE
(X one)
14. SUBMISSION NUMBER
15. RESUBMISSION NUMBER
16. REPORT AS OF
(YYYYMMDD)
RDT&E
INITIAL
a. START DATE (YYYYMMDD):
PROCUREMENT
INTERIM
b. END DATE (YYYYMMDD):
O&M
FINAL
17. NAME
(Last, First, Middle Initial)
18. DEPARTMENT
19. TELEPHONE NUMBER
(Include Area Code)
20. EMAIL ADDRESS
21. DATE PREPARED
(YYYYMMDD)
COSTS INCURRED TO DATE
COSTS INCURRED AT COMPLETION
WBS
NUMBER OF
NUMBER OF
WBS REPORTING ELEMENTS
ELEMENT
UNITS
UNITS AT
NONRECURRING
RECURRING
TOTAL
NONRECURRING
RECURRING
TOTAL
CODE
TO DATE
COMPLETION
B
D
E
F
H
I
J
A
C
G
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
22. REMARKS
DD FORM 1921, APR 2007
PREVIOUS EDITION IS OBSOLETE.
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SECURITY CLASSIFICATION
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Parent category: Business