Form DD1921-5 Sustainment Functional Cost-Hour Report

SECURITY CLASSIFICATION

Unclassified

SUSTAINMENT FUNCTIONAL COST-HOUR REPORT

OMB No. 0704-CSDR Expires: X/XX/XXXX

The public reporting burden for this collection of information is estimated to average 16 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 the Department of Defense, Washington Headquarters Services, at [email protected]. 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. MAJOR PROGRAM

a. NAME:

b. PHASE/MILESTONE

2. PRIME MISSION PRODUCT

3. REPORTING ORGANIZATION TYPE

4. NAME/ADDRESS (Include Zip Code)

5. APPROVED PLAN NUMBER

Pre-A

B

C-FRP

PRIME / ASSOCIATE CONTRACTOR

DIRECT-REPORTING SUBCONTRACTOR

GOVERNMENT

a. PERFORMING ORGANIZATION

b. DIVISION

A

C-LRIP

O&S

6. CUSTOMER (Direct-Reporting Subcontractor Use Only)

7. TYPE ACTION

a. CONTRACT NO.:

c. SOLICITATION NO.:

e. TASK ORDER/DELIVERY ORDER/LOT NO.:

b. LATEST MODIFICATION:

d. NAME:

8. PERIOD OF PERFORMANCE

9. REPORT CYCLE

10. SUBMISSION NUMBER

11. RESUBMISSION NUMBER

12. REPORT AS OF (YYYYMMDD)

a. START DATE (YYYYMMDD):

INITIAL

b. END DATE (YYYYMMDD):

INTERIM

FINAL

13. NAME (Last, First, Middle Initial)

14. DEPARTMENT

15. TELEPHONE NO. (Include Area Code)

16. EMAIL ADDRESS

17. DATE PREPARED (YYYYMMDD)

18. WBS ELEMENT CODE

19. WBS REPORTING ELEMENT

20. NUMBER OF UNITS

21. APPROPRIATION

a. TO DATE

b. AT COMPLETION

RDT&E

PROCUREMENT

O&M

SUSTAINMENT FUNCTIONAL DATA ELEMENTS

COSTS AND HOURS INCURRED TO DATE (thousands of U.S. Dollars or thousands of hours)

COSTS AND HOURS INCURRED AT COMPLETION (thousands of U.S. Dollars or thousands of hours)

A. NONRECURRING

B. RECURRING

C. TOTAL

D. NONRECURRING

E. RECURRING

F.TOTAL

ENGINEERING

(1) DIRECT ENGINEERING LABOR HOURS

(2) DIRECT ENGINEERING LABOR DOLLARS

(3) ENGINEERING OVERHEAD DOLLARS

(4) TOTAL ENGINEERING DOLLARS

PROGRAM MANAGEMENT

(5) DIRECT PROGRAM MANAGEMENT LABOR HOURS

(6) DIRECT PROGRAM MANAGEMENT LABOR DOLLARS

(7) PROGRAM MANAGEMENT OVERHEAD DOLLARS

(8) TOTAL PROGRAM MANAGMENT DOLLARS

MAINTENANCE OPERATIONS

(9) TOUCH MAINTENANCE LABOR HOURS

(10) TOUCH MAINTENANCE LABOR DOLLARS

(11) TOUCH MAINTENANCE OVERHEAD DOLLARS

(12) SUPPORT MAINTENANCE LABOR HOURS

(13) SUPPORT MAINTENANCE LABOR DOLLARS

(14) SUPPORT MAINTENANCE OVERHEAD DOLLARS

(15) TOTAL MAINTENANCE OPERATIONS DOLLARS

MATERIALS

(16) RAW MATERIAL DOLLARS

(17) PURCHASED PARTS DOLLARS

(18) PURCHASED EQUIPMENT DOLLARS

(19) MATERIAL HANDLING/OVERHEAD DOLLARS

(20) TOTAL DIRECT-REPORTING SUBCONTRACTOR DOLLARS

(21) TOTAL MATERIAL DOLLARS

OTHER COSTS

(22) OTHER COSTS NOT SHOWN ELSEWHERE (Specify in Remarks)

SUMMARY

(23) TOTAL COST (Direct and Overhead)

22. REMARKS

DD FORM 1921-5, DEC 2015

SECURITY CLASSIFICATION

Unclassified