The Department of Defense (DoD) Form 1106 is a report used to identify and track contract actions. It also documents the status of each action and any associated risks. The form is divided into six sections: Contract Action, Contractor, Government Points of Contact (POC), Scope of Work, Implementation Schedule, and Risks/Mitigation Plan. Each section must be completed in order to submit the form. The Contract Action section includes information such as contract number, contracting officer, place of performance, and delivery order number. The Contractor section lists company name and street address. POCs are listed in the Government POC section along with their contact information and role in the contract action. The Scope of Work section details what work will
| Question | Answer |
|---|---|
| Form Name | Da Form 1106 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | 16a, 16b, IDENIFICATION, 16c |
RECOMMENDATION TO DECLARE ARMY EMERGENCY RELIEF LOAN UNCOLLECTIBLE
For use of this form, see AR
PRINT IN BLACK INK, OR TYPE ALL INFORMATION
PART I - LOAN TO BE DECLARED UNCOLLECTIBLE
1. TO:
HQ, Army Emergency Relief
200 Stovall Street
Alexandria, VA
2.FROM: (AER Officer)(Include ZIP Code)
3. AER SECTION NO.
4. NAME OF BORROWER (Last, First, MI)
5. GRADE
6. CLIENT IDENIFICATION NUMBER
7. CURRENT ADDRESS (Include ZIP Code)
8. SOLDIER STATUS
ACTIVE
RETIRED
SEPARATED
9. DATE OF LOAN |
10. |
AMOUNT OF LOAN |
11. |
AMOUNT REPAID |
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$ |
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$ |
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12. DATE OF LAST PAYMENT |
13. |
AMOUNT TO BE DECLARED UNCOLLECTIBLE |
14. |
DATE OF LAST COLLECTION EFFORT |
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$ |
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PART II - SECTION ACTION
15a. Recommend the above loan(s) be declared uncollectible on the basis that the borrower: (Check appropriate reason and enter date.)
DIED ON
WAS DISHONORABLY DISCHARGED ON
WAS DISCHARGED UNDER OTHER THAN HONORABLE CONDITIONS ON
WAS DROPPED FROM THE ROLLS AS A DESERTER ON
15b. SIGNATURE AND TITLE OF AER OFFICER/ASSISTANT AER OFFICER |
15c. DATE |
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PART III - LEVEL 3 APPROVAL AUTHORITY ACTION
16a. THRU: (Level 3 Approval Authority)
16b. Recommend the above loan(s) be declared uncollectible on the basis of undue hardship on the soldier because:
16c. SIGNATURE AND TITLE OF LEVEL 3 APPROVAL AUTHORITY
16d. DATE
PART IV - HQ AER ACTION
17a. Recommended action is:
APPROVED
DISAPPROVED |
UNCOLLECTIBLE NO. |
17b. Declared uncollectible in the amount of $ |
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on |
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(Date). |
18. PROCESSED BY
19. REVIEWED AND APPROVED BY
DA FORM 1106, SEP 2009 |
PREVIOUS EDITIONS ARE OBSOLETE. |
APD PE v1.00 |