Dd Form 1716 is a Department of Defense form that is used to request access to classified information. This form is used by individuals who need to clear, or be cleared for, access to classified information in order to perform their duties. The Dd Form 1716 must be completed and submitted to the personnel security office at the appropriate level of clearance prior to being granted access to classified information. In order for an individual's name to appear on the United States Security Clearance Database (SCD), the Dd Form 1716 must be approved by the Department of Defense.
| Question | Answer |
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| Form Name | Dd Form 1716 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | 12a, 11a, Xd, PCO |
CONTRACT DATA PACKAGE RECOMMENDATION/DEFICIENCY REPORT
1. CONTROL NUMBER
SECTION I - FOR COMPLETION BY REPORTING ELEMENT
2.THRU (ACO):
3.TO (PCO):
4.FROM:
4a. REPORTING ELEMENT ("X" appropriate box)
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CA |
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S&FM |
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P |
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Q |
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OTHER |
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5. |
PRIORITY FOR ACO OR PCO REPLY |
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6. CONTRACT NUMBER |
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14 DAY REPLY |
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30 DAY REPLY |
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45 DAY REPLY |
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NO REPLY |
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(Future PCO action) |
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7. |
NSN |
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8. CONTRACTORS NAME AND COMPLETE ADDRESS |
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7a. ITEM NOUN NAME
9.CONTRACT DATA PACKAGE PROBLEM ("X" applicable box(es) and explain below under item number 10)
A. CONTRACT AND SUPPORTING DOCUMENTATION LATE, MISSING, ILLEGIBLE, INSUFFICIENT COPIES, ETC.
B. DEFICIENT CONTRACT DATA PACKAGE (If "X’d", then "X" areas below contributing to deficiency)
(1)ITEM DESCRIPTION
(2)POINT OF INSPECTION OR ACCEPTANCE, COC OR FAST PAY
(3) GOVERNMENT PQA AND DELEGATION
(4)CODE NUMBER AND/OR ADDRESS MISSING OR INCORRECT
(5)PRESERVATION, PACKAGING, PACKING, CONSIGNMENT AND MARKING
(6)SPECIFICATIONS/DRAWINGS (Attach DD FOrm 1426)
(8) MISSING, IMPROPER OR CONFLICTING QUALITY REQUIREMENTS
(9) CONFIGURATION MANAGEMENT, TECHNICAL DATA (10) APPROPRIATION OR FINANCIAL DATA
(11) OTHER - CONTRACT ADMINISTRATION (12) OTHER - S&FM
(13) OTHER - PRODUCTION
(7) ITEM QUANTITY OR DOLLAR VALUE |
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(14) OTHER - QUALITY, SAFETY |
10.DESCRIPTION OF DEFICIENCY AND APPROPRIATE RECOMMENDATION (Key your explanations to the item numbers above, and if necessary, continue on separate sheet of paper)
11a. TYPED NAME, TITLE, TELEPHONE NO. OF INITIATOR
11b. SIGNATURE OF INITIATOR AND DATE
12a. TYPED NAME AND TITLE OF REVIEWING OFFICIAL
12b. SIGNATURE OF REVIEWING OFFICIAL AND DATE
SECTION II - FOR COMPLETION BY ADMINISTRATIVE CONTRACTING OFFICER
ACO RECOMMENDATION OR ACTION (Return to initiator if PCO action is not required)
ACO SIGNATURE
DATE SIGNED
DEFICIENCY CORRECTED BY ACO
(If "X’d", attach modification)
PCO ACTION |
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IS |
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IS NOT, REQUIRED |
SECTION III - FOR COMPLETION BY PROCURING CONTRACTING OFFICER
PCO ACTION TAKEN (Return to initiator through ACO or CAO)
PCO SIGNATURE
DATE SIGNED
DD FORM 1716, DEC 77 |
Previous edition is obsolete. |
ADOBE PROFESSIONAL 7.0
INSTRUCTIONS
Space 1. CONTROL NUMBER. To be assigned by reporting element. Enter the organizational code followed by last two digits of calendar year and suffixed by 1 and up through calendar year (Example -
Space 2. THRU (ACO)(When applicable). Process through the ACO when the problem involves a contractual change. Enter ACO name, office code, and complete address including Zip Code. Otherwise process directly to the PCO. In any event enter the contract administration office cognizant of reporting element.
Space 3. TO (PCO). Enter PCO name, office code, and complete address including Zip Code.
Space 4 & 4a. FROM. Enter organization name, office code, and complete address including Zip Code of reporting activity. Check appropriate reporting element box.
Space 5. PRIORITY FOR ACO/PCO REPLY. Check urgency in appropriate block.
Space 6. CONTRACT NUMBER. Enter contract number.
Space 7. NSN. Enter NSN, where appropriate to identify a specific line item on the report. Use space 10 when additional reporting is required.
Space 7a. ITEM NOUN NAME. Enter, where appropriate, to identify a specific line item on the report.
Space 8. CONTRACTOR’S NAME AND COMPLETE ADDRESS. Enter contractor’s name and complete address including Zip Code. Include Federal Supply Code of Manufacturers if known.
Space 9. CONTRACT DATA PACKAGE PROBLEMS. Check in appropriate blocks A or B. When B is identified, check in
Space 10. DESCRIPTION OF DEFICIENCY/RECOMMENDATION. Describe problem in detail with substantive facts including appropriate recommendations for solution.
Space 11a. TYPED NAME, TITLE, TELEPHONE NUMBER OF INITIATOR.
Space 11b. SIGNATURE OF INITIATOR AND DATE.
Space 12a. TYPED SIGNATURE AND TITLE OF REVIEWING OFFICIAL AND DATE.
Space 12b. SIGNATURE OF REVIEWING OFFICIAL AND DATE.
SECTION II - For Completion by Administrative Contracting Officer. When the DD Form 1716 is processed through an ACO because a contractual change is involved, the ACO will assure that the problem is beyond local resolution before the DD Form 1716 is forwarded, together with recommendations, to the PCO. Check appropriate blocks.
SECTION III - For Completion by Procuring Contracting Officer. Indicate action taken or to be taken with regard to the reported problem. Reply should be responsive to priority in space 5. Return to ACO or CAO as applicable.
DD FORM 1716, DEC 77 (BACK) (EF)