DD Form 1921-3 Contractor Business Data Report

SECURITY CLASSIFICATION
Form Approved
OMB No. 0704-0188 Expires 20221130

CONTRACTOR BUSINESS DATA REPORT

The public reporting burden for this collection of information is estimated to average 30 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, Executive Services Directorate, Information Management Division, 1155 Defense Pentagon, Washington, DC 20301-1155 (0704-0188). 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.

1. CONTRACTOR NAME/ADDRESS (Include Zip Code)

2. FPR UNIT

7. PREPARER'S NAME (Last, First, Middle Initial)

8. DEPARTMENT

DIRECT COST BY PROGRAM
Program Name
a

A/F

Contract Number
b

1.
2.
3.
4.
5.
6.
7.
8.
9.
A 10.
11. Other DoD Effort
12. Other Government Effort
13. Commercial Effort
14. Total Direct Cost and Hours Base
a. Total Direct Workers

Equivalent Units
c

3. IMPLEMENTING CONTRACT NUMBER

4. DATA PERIOD (X one) 5. FISCAL YEAR (YYYY)
Prior Year
Current Year
Future Year

9. TELEPHONE NO. (Include Area Code)

10. EMAIL ADDRESS

6. DATES IN FISCAL YEAR (YYYYMMDD)
Start Date:
End Date:

11. DATE PREPARED (YYYYMMDD)

Overhead Accumulation, Distribution, and Application
DIRECT: COST / HOURS / MANPOWER (Report dollars and hours in thousands)
Engineering
Manufacturing Operations
Other
Materials
Buyer
Workers
Dollars
Hours
Workers
Dollars
Hours
Dollars
Workers
Dollars
d
e
f
g
h
i
j
k
l
m

Hours
n

S
E
C
T
I
O
N

$0.0

INDIRECT COST CATEGORY
15. Indirect Labor
16. Employee Benefits
17. Payroll Taxes
18. Employment
19. Communication/Travel
20. Production Related
21. Facilities-Building/Land
22. Facilities-Furniture/Equipment
23. Administration
24. Future Business
B 25. Other Miscellaneous
26. Credits
27. Total Indirect Cost and Hours
28. Total G&A Cost and Hours
29. Indirect/Direct Cost Rate
30. G&A Rate/(Direct + Indirect)

0.0

0

Workers
o

Engineering
Dollars
Hours
p
q

$0.0

0.0

$0.0

$0.0

0
0
INDIRECT: COST / HOURS / MANPOWER (Report dollars and hours in thousands)
Manufacturing Operations
Other
Materials
Workers
Dollars
Hours
Dollars
Workers
Dollars
r
s
t
u
v
w

0.0

Hours
x

G&A
Dollars
Hours
y
z

S
E
C
T
I
O
N

DD FORM 1921-3, MAY 2011

$0.0

0.0

$0.0

0.0

$0.0

$0.0

0.00%

0.00%

0.0
$0.0

0.00%

0.00%

0.0

0.00%
SECURITY CLASSIFICATION

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