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NEED FOR DEVIATION/WAIVER 24. CORRECTIVE ACTION TAKEN 25. SUBMITTING ACTIVITY Last b. TITLE 26. APPROVAL/DISAPPROVAL b. APPROVAL a. RECOMMEND c. GOVERNMENT ACTIVITY APPROVED c. SIGNATURE DISAPPROVAL f. DATE SIGNED YYYYMMDD DD FORM 1694 AUG 96 EG PREVIOUS EDITION MAY BE USED. PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE ABOVE ADDRESS. RETURN COMPLETED FORM TO THE GOVERNMENT ISSUING CONTRACTING OFFICER FOR THE CONTRACT/ PROCURING ACTIVITY NUMBER LISTED IN ITEM 2 OF THIS FORM. 4. ORIGINATOR a. TYPED NAME First Middle Initial Last b. ADDRESS Street City State Zip Code 2. PROCURING ACTIVITY NUMBER 3. DODAAC 5. X one DEVIATION MAJOR 7. DESIGNATION FOR DEVIATION/WAIVER 8. BASELINE AFFECTED FUNCALLOa. MODEL/TYPE b. REQUEST FOR DEVIATION/WAIVER RFD/RFW 1. DATE YYYYMMDD Form Approved OMB No. 0704-0188 The public reporting burden for this collection of information 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 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 Directorate for Information Operations and Reports 0704-0188 1215 Jefferson Davis Highway Suite 1204 Arlington VA 22202-4302. 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 ADDRESS* RETURN COMPLETED FORM TO THE GOVERNMENT ISSUING CONTRACTING OFFICER FOR THE CONTRACT/ PROCURING ACTIVITY NUMBER LISTED IN ITEM 2 OF THIS FORM. 4. ORIGINATOR a* TYPED NAME First Middle Initial Last b. ADDRESS Street City State Zip Code 2. PROCURING ACTIVITY NUMBER 3. DODAAC 5. X one DEVIATION MAJOR 7. DESIGNATION FOR DEVIATION/WAIVER 8. BASELINE AFFECTED FUNCALLOa* MODEL/TYPE b. CAGE CODE c* SYS* DESIG* d. DEV. /WAIVER NO. TIONAL CATED PRODUCT WAIVER MINOR CRITICAL 9. OTHER SYSTEM/CONFIGURATION ITEMS AFFECTED YES NO 10. TITLE OF DEVIATION/WAIVER 11. CONTRACT NO. AND LINE ITEM 12. PROCURING CONTRACTING OFFICER a* NAME First Middle Initial Last b. CODE c* TELEPHONE NO. 14. CLASSIFICATION OF DEFECT a* CD NO. b. DEFECT NO. c* DEFECT CLASSIFICATION 13. CONFIGURATION ITEM NOMENCLATURE 15. NAME OF LOWEST PART/ASSEMBLY AFFECTED 16. PART NO. OR TYPE DESIGNATION 17. EFFECTIVITY 18. RECURRING DEVIATION/WAIVER 19. EFFECT ON COST/PRICE 20. EFFECT ON DELIVERY SCHEDULE 21. EFFECT ON INTEGRATED LOGISTICS SUPPORT INTERFACE OR SOFTWARE 22. DESCRIPTION OF DEVIATION/WAIVER 23. NEED FOR DEVIATION/WAIVER 24. CORRECTIVE ACTION TAKEN 25. SUBMITTING ACTIVITY Last b. TITLE 26. APPROVAL/DISAPPROVAL b. APPROVAL a* RECOMMEND c* GOVERNMENT ACTIVITY APPROVED c* SIGNATURE DISAPPROVAL f* DATE SIGNED YYYYMMDD DD FORM 1694 AUG 96 EG PREVIOUS EDITION MAY BE USED.