Section 1
The following supply and services complete FMS case is submitted to the FMS Case Closure Executive Committee (EXCOM) for final approval and disposition instructions.
Item |
Information (entry required for all fields) |
Case Identifier (Country/IA/Designator)
|
XX-X-XXX
|
Supply/Services Completion Date
|
MM/YYYY format
|
Responsible Implementing Agency
|
Organization Name
|
Responsible IA Point of Contact Information
|
POC Name, DSN phone number, office code
|
Date Request Submitted to EXCOM
|
MM/DD/YYYY format
|
EACC Closure Suspense date (if applicable):
|
MM/YYYY format
|
Section 2
The purpose of this request is to: (Check or Mark all that apply)
-
_____ Approve Discontinued Research
-
_____ Assign Case Closure Value
-
_____ Other (elaborate with remarks here)
Section 3
The EXCOM is to be used only in extreme situations, i.e., exhaustive research was conducted with no satisfactory conclusion and/or resolution on the case closure value is not otherwise feasible through normal channels. This certifies that the following efforts were undertaken but did not result in a successful resolution of the issue, thus requiring EXCOM intervention for this FMS case: (Check or Mark all that apply, and annotate Tab numbers associated with supporting documentation. While Tabs are not required for all items below, the package is strengthened by providing the documentation that addresses each item. Omitting documentation for any item may result in EXCOM approval delay.)
-
_____ All research requirements as prescribed in the DOD FMR, Volume 3, Chapter 11 were conducted. See Tab ____ / Tab Not applicable _____
-
_____ This case qualifies for discontinued research endorsement as noted in the DOD FMR, Volume 3, Chapter 11. See Tab _____ / Tab Not applicable _____
-
_____ The un-reconciled amounts exceed the write-off thresholds allowed in the DOD FMR, Volume 3, Chapter 11 and DOD FMR, Volume 15, Chapter 3 or write-off procedures do not apply. See Tab _____ / Tab not applicable _____
-
_____ The DOD FMR and Security Assistance Management Manual were thoroughly researched, yet those policies were insufficient to allow for timely closure of this case. (This item must be checked after verification of its accuracy.) Tab ___ is a brief description of where the policies were determined to be insufficient.
-
_____ The nature of the un-reconciled and/or unresolved amounts is documented in Tab _______. (Note: Tab required for this item. This documents the core problem the EXCOM is being requested to address.)
-
_____ Documentation for the following systems at a minimum are provided at Tab _____: DIFS, IA legacy system, IA accounting system(s). (Note: Tab required for this item, unless it is included in the Tab for item E. above.)
-
_____ Documentation evidencing efforts to resolve with DCMA and DCAA are attached at Tab _____ / Not applicable (i.e., contractual issues not contributing to reconciliation problems) _____.
-
_____ Other extenuating circumstances that helped obstruct resolution of this case are documented at Tab _____.
-
_____ The financial closeout of contracts policy described in Chapter 4 of the RCG, Appendix 7 of DSCA 5105.38-M, does _____ / does not _____ resolve the issues impeding closure of this case. (Note: this item must be completed.) The reasons this policy does / does not resolve problems concerning this case/line are the following: (list separately here)
Section 4
The following actions/decisions are recommended by the proponent IA to the EXCOM:
Item |
Recommendation
(entry required for all fields) |
Further research efforts
|
|
Adjusted net case closure value (excludes CAS, LSC, Admin, Accessorials)
|
|
CAS value – entire case
|
|
LSC value – entire case
|
|
Admin value – entire case
|
|
Accessorials value – entire case
|
|
Total case closure value – entire case
|
|
ULO value (ACCP only) – entire case
|
|
Section 5
I certify the above information to be accurate and correct, to the best of my knowledge.
______________________________________________
Signature
|
______________________________________________
Date Submitted
|
______________________________________________
Name and Title of Authorizing Official (Typed)
|
|
List each Tab/Attachment separately.
Section 6 - TO BE COMPLETED BY EXCOM ONLY
EXCOM Decision:
-
_____ Agree with all IA recommendations
-
_____ Agree with intent to resolve; but IA recommendations modified as shown below: (insert table depicting EXCOM differences from recommendations identified above).
-
_____ Returned to IA for further action for the following reason(s): identify those here.
Section 7 - TO BE COMPLETED BY EXCOM ONLY
EXCOM Signatures
DSCA (DBO/FPA)
|
______________________________________________
Signature
|
OUSD (C)
|
______________________________________________
Signature
|
DFAS
|
______________________________________________
Signature
|
ARMY
|
______________________________________________
Signature
|
NAVY
|
______________________________________________
Signature
|
AIR FORCE
|
______________________________________________
Signature
|
______________________________________________
Date of EXCOM Decision
|
|
______________________________________________
Date of Expected Case Closure (if applicable):
|
|
______________________________________________
Date Force Closure Otherwise Occurs (if applicable):
|
|
|