Form Approved
CONTRACT FACILITIES CAPITAL COST OF MONEY
OMB No. 0704-0267
Expires Jul 31, 2007
The public reporting burden for this collection of information is estimated to average 10 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 (0704-0267). 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.
RETURN COMPLETED FORM TO YOUR CONTRACTING OFFICIAL.
1. CONTRACTOR NAME
2. CONTRACTOR ADDRESS
3. BUSINESS UNIT
4. RFP/CONTRACT PIIN NUMBER
5. PERFORMANCE PERIOD
6. DISTRIBUTION OF FACILITIES CAPITAL COST OF MONEY
FACILITIES CAPITAL COST OF MONEY
c.
POOL
ALLOCATION BASE
FACTOR
AMOUNT
a.
b.
(1)
(2)
$0.00
d. TOTAL
%
e. TREASURY RATE
f. FACILITIES CAPITAL EMPLOYED
(TOTAL DIVIDED BY TREASURY RATE)
7. DISTRIBUTION OF FACILITIES CAPITAL EMPLOYED
PERCENTAGE
AMOUNT
a.
b.
%
(1) LAND
%
(2) BUILDINGS
%
(3) EQUIPMENT
100%
$0.00
(4) FACILITIES CAPITAL EMPLOYED
DD FORM 1861, AUG 2004
PREVIOUS EDITION MAY BE USED.
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