Form SF 1440 SF 1440 Application for Partial Payment

OMB No.: 9000-0012
Expires: 05/31/98

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For use by Prime Contractor or Subcontractor under contracts terminated for the convenience of the Government
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CONTRACTOR WHO SENT NOTICE OF TERMINATION
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IF CONTRACTOR HAS GUARANTEED LOANS OR HAS ASSIGNED
MONEYS DUE UNDER THE CONTRACT, GIVE THE FOLLOWING:

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SECTION I - STATUS OF CONTRACT OR ORDER AT EFFECTIE DATE OF TERMINATION
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UNFINISHED OR NOT
COMMENCED
ON HAND
PRODUCTS COVERED BY TERMINATED
CONTRACT OR PURCHASE ORDER
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TOTAL
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SECTION II - APPLICANT'S OWN TERMINATION CHARGES
(Exclusive of its Subcontractors' Charges)

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ACCEPTABLE FURNISHED PRODUCT (at contract price)
WORK-IN-PROCESS
RAW MATERIALS, PURCHASED PARTS, AND SUPPLIES
GENERAL AND ADMINISTRATIVE EXPENSES
TOTAL (Sum of lines 1, 2, 3, and 4)

SPECIAL TOOLING AND SPECIAL TEST EQUIPMENT
OTHER COSTS
SETTLEMENT EXPENSES
TOTAL (Sum of lines 5, 6, 7, and 8)

 SUBCONTRACTOR SETTLEMENTS APPROVED BY CONTRACTING OFFICER OR SETTLED 
UNDER A DELEGATION OF AUTHORITY AND PAID BY APPLICANT
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D UNLIQUIDATED PARTIAL, PROGRESS, AND ADVANCE PAYMENTS RECEIVED
E DISPOSAL AND OTHER CREDITS
F TOTAL (Sum of lines a and b)
G AMOUNT OF PARTIAL PAYMENT REQUESTED
H TOTAL (Sum of lines c and d)

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SECTION III - AGREEMENT OF APPLICANT
IN CONSIDERATION OF PARTIAL PAYMENT THAT MAY BE MADE, THE APPLICANT AGREES AS FOLLOWS:
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SECTION IV - CERTIFICATE OF APPLICANT
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SECTION V - RECOMMENDATION OF FIRST REVIEWING CONTRACTOR
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SECTION VI - RECOMMENDATION OF OTHER REVIEWING CONTRACTORS
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IDENTIFICATION OF
YOUR CONTRACT

SIGNATURE OF OFFICER, PARTNER,
OR OWNER







(Where the space provided for any information is insufficient, continue on a separate sheet.)
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