DD-1640 Request for Plant Clearance

1. DATE PREPARED (YYYYMMDD)

REQUEST FOR PLANT CLEARANCE

OMB No. 0704-0246
OMB approval expires

The public reporting burden for this collection of information is estimated to average 30 minutes 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, Washington Headquarters Services, Executive Services Directorate, Information Management Division, 4800 Mark
Center Drive, Alexandria, VA 22350-3100 (0704-0246). 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 ADDRESS IN ITEM 2.

2. TO (Include ZIP Code)

3. FROM (Include ZIP Code)

It is requested that plant clearance, including prescribed screening and disposal actions, be accomplished with respect to the contractor inventory
described in the enclosed schedules. Plant clearance authority is hereby delegated for the purpose of this referral.
4. GROSS VALUE OF INVENTORY SCHEDULES
5. SCHEDULE PARTIAL NUMBER
6. PROCUREMENT INSTRUMENT IDENTIFICATION
($)
NUMBER
7. PRIME CONTRACT END ITEM

8. SUBCONTRACT NUMBER

9. NAME AND ADDRESS OF PRIME CONTRACTOR (Include ZIP Code)

10. NAME AND ADDRESS OF SUBCONTRACTOR (Include ZIP Code)

D R A F T
11. LOCATION OF PROPERTY

12. TYPE OF CONTRACT (X one)
a. FIXED PRICE

b. COST TYPE

c. FACILITY

d. LEASE
AGREEMENT

e. FORMAL STORAGE
AGREEMENT

f. BAILMENT

13. TYPE OF INVENTORY (X one)
a. TERMINATION

b. RESIDUAL TO COMPLETED CONTRACT

d. EXCESS TO ACTIVE CONTRACT

e. PRODUCTION EQUIPMENT

c. CHANGE ORDER

14. REMARKS

15. ENCLOSURE(S) (Include Prime Contractor's Certificate of Allocability and Statement of No Further Requirements for the Property)

16. REQUESTING OFFICIAL
a. TYPED NAME (Last, First, Middle Initial)

c. SIGNATURE

d. DATE SIGNED
(YYYYMMDD)

b. TITLE

17. TO (Include ZIP Code)

FIRST ENDORSEMENT
18. FROM (Include ZIP Code)

19. DATE
(YYYYMMDD)

.

(1) Disposition will be accomplished under case number

(2) It is requested that all correspondence with this office pertaining to enclosure(s) make reference to the assigned case number.
20. PLANT CLEARANCE OFFICER
a. TYPED NAME (Last, First, Middle Initial)

c. SIGNATURE

d. DATE SIGNED
(YYYYMMDD)

b. TITLE

DD FORM 1640, 20120925 DRAFT

PREVIOUS EDITION IS OBSOLETE.

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