Extraordinary Contractual Action Requests - FAR Sections Affected: 50.103-3, 50.103-4, 50.104-3, and 52.250-1

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IC Title:	Extraordinary Contractual Action Requests - FAR Sections Affected: 50.103-3, 50.103-4, 50.104-3, and 52.250-1	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 48 CFR 50.103-4 48 CFR 50.103-3 48 CFR 52.250-1 48 CFR 50.104-3

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Supply Chain Management

Subfunction: Goods Acquisition

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 28	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 99 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	165	0	165
Annual IC Time Burden (Hours)	6,848	0	6,848
Annual IC Cost Burden (Dollars)	373,890	59,184	314,706

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.