ContractDecember 25th, 2022
FiledDecember 25th, 2022MILITARILY CRITICAL TECHNICAL DATA AGREEMENT(Please read Agency Disclosure Notice and Instructions on back before completing this form.) OMB No. 0704-0207OMB approval expiresApr 30, 2011 MAIL THE ORIGINAL, COMPLETED COPY OF THIS FORM AND A COPY OF YOUR COMPANY'S INCORPORATION CERTIFICATE, STATE/ PROVINCIAL BUSINESS LICENSE, SALES TAX IDENTIFICATION FORM OR OTHER DOCUMENTATION WHICH VERIFIES THE LEGITIMACY OF THE COMPANY TO:U.S./CANADA JOINT CERTIFICATION OFFICEDEFENSE LOGISTICS INFORMATION SERVICE FEDERAL CENTER, 74 WASHINGTON AVE., NORTH BATTLE CREEK, MI USA 49037-3084 1. TYPE OF SUBMISSION (X one) a. INITIAL SUBMISSION b. REVISION c. 5-YEAR RENEWAL 2. ENTERPRISE OR INDIVIDUAL DATA (Referred to as a "certified contractor" upon acceptance of certification by the U.S./Canada - JCO) a. NAME (Name of Enterprise or Individual) b. ADDRESS (Physical address, including P.O. Box if applicable) c. NAME OF SUBSIDIARY/DIVISION/DEPARTMENT d. CAGE CODE 3. DATA CUSTODIAN a. NAME OR POSITION DE
ContractDecember 1st, 2022
FiledDecember 1st, 2022MILITARILY CRITICAL TECHNICAL DATA AGREEMENT(Please read Agency Disclosure Notice and Instructions on back before completing this form.) OMB No. 0704-0207OMB approval expiresApr 30, 2011 MAIL THE ORIGINAL, COMPLETED COPY OF THIS FORM AND A COPY OF YOUR COMPANY'S INCORPORATION CERTIFICATE, STATE/ PROVINCIAL BUSINESS LICENSE, SALES TAX IDENTIFICATION FORM OR OTHER DOCUMENTATION WHICH VERIFIES THE LEGITIMACY OF THE COMPANY TO:U.S./CANADA JOINT CERTIFICATION OFFICEDLA LOGISTICS INFORMATION SERVICE FEDERAL CENTER, 74 WASHINGTON AVE., NORTH BATTLE CREEK, MI USA 49037-3084 1. TYPE OF SUBMISSION (X one) a. INITIAL SUBMISSION b. REVISION c. 5-YEAR RENEWAL 2. ENTERPRISE OR INDIVIDUAL DATA (Referred to as a "certified contractor" upon acceptance of certification by the U.S./Canada - JCO) a. NAME (Name of Enterprise or Individual) b. ADDRESS (Physical address, including P.O. Box if applicable) c. NAME OF SUBSIDIARY/DIVISION/DEPARTMENT d. CAGE CODE 3. DATA CUSTODIAN a. NAME OR POSITION DESIGN