Free SD Form 106, DoD Directives Program Coordination Record, November 2008 - Federal

- UNCLASSIFIED DoD DIRECTIVES PROGRAM COORDINATION RECORD
(Please read instructions on back before completing form.) 1. SECURITY CLASSIFICATION (X one) 2. TYPE OF DOD ISSUANCE (X one)
TOP SECRET SECRET CONFIDENTIAL UNCLASSIFIED DoDD (DoD Directive) DoDI (DoD Instruction) DoDM (DoD Manual) AI (Administrative Instruction) RESTRICTED NOT RELEASABLE DTM (Directive Type Memo)

3. TYPE OF ACTION (X one)
NEW REISSUANCE CHANGE CANCELLATION

4. DISTRIBUTION STATEMENT (X one) UNLIMITED 5. DOD ISSUANCE NUMBER (See instructions on page 2) 7. SUBJECT (Title of Issuance)

6. COORDINATION SUSPENSE DATE. DoD Directives Program Portal sets
suspenses automatically. For Directives, a suspense of 20 working days will be set from the date of posting on the Portal. Other issuances will receive a 45-day suspense from date of posting. For DTMs, a suspense of 15 working days will be assigned. Expedited coordinations must be approved by Directives Division.

8. PURPOSE AND REMARKS (Continue on back if necessary) 9. FEDERAL REGISTER PUBLICATION REQUIRED (X one)
YES OMB YES NO RCS NO IRCN

10. REPORTING REQUIREMENTS (X all that apply) 11. FORMS PRESCRIBED (X one) 12. PRIVACY REQUIREMENTS (X one)
YES NO

13.a. ACTION OFFICER NAME (Last, First, Middle Initial) (Print or type)
b. OFFICE DESIGNATION c. COMPLETE MAILING ADDRESS

14.a. ORIGINATING AUTHORIZING OFFICIAL (See instructions on page 2)
(1) SIGN (2) PRINT OR TYPE NAME d. TELEPHONE (Include Area Code) f. E-MAIL ADDRESS e. FAX NUMBER (Include Area Code) b. POSITION TITLE (Print or type) c. DATE FORM SIGNED

15. COORDINATING OFFICIALS. (Mark all that apply with either P (Primary) or C (Collateral). Mandatory coordinators are already marked with an "M." (See page 2
of this form for explanation of coordinating levels.) UNDER SECRETARY OF DEFENSE FOR ACQUISITION, TECHNOLOGY, AND LOGISTICS DUSD (ACQUISITION AND TECHNOLOGY) DUSD (LOGISTICS AND MATERIEL READINESS) DIR DEFENSE RESEARCH AND ENGINEERING ATSD NUCLEAR CHEMICAL BIOLOGICAL DEFENSE PROGRAMS DIR DEFENSE CONTRACT MANAGEMENT AGENCY DIR MISSILE DEFENSE AGENCY DIR DEFENSE LOGISTICS AGENCY DIR DEFENSE THREAT REDUCTION AGENCY DIR DEFENSE ADVANCED RESEARCH PROJECTS AGENCY DIR OFFICE OF ECONOMIC ADJUSTMENT DIR DOD TEST RESOURCE MANAGEMENT CENTER DIR DEFENSE TECHNICAL INFORMATION CENTER UNDER SECRETARY OF DEFENSE FOR POLICY PDUSD (POLICY) ASD (INTERNATIONAL SECURITY AFFAIRS) ASD (ASIAN & PACIFIC SECURITY AFFAIRS) ASD (HOMELAND DEFENSE & AMERICAS' SECURITY AFFAIRS) ASD (GLOBAL SECURITY AFFAIRS) ASD (SO/LIC & INTERDEPENDENT CAPABILITIES) DIR DEFENSE SECURITY COOPERATION AGENCY DIR DEFENSE POW/MP OFFICE DIR DEFENSE TECHNOLOGY SECURITY ADMINISTRATION UNDER SECRETARY OF DEFENSE FOR PERSONNEL AND READINESS PDUSD (PERSONNEL AND READINESS) ASD (HEALTH AFFAIRS) ASD (RESERVE AFFAIRS) DIR DEFENSE COMMISSARY AGENCY DIR DEPARTMENT OF DEFENSE EDUCATION ACTIVITY DIR TRICARE MANAGEMENT ACTIVITY DIR DEPARTMENT OF DEFENSE HUMAN RESOURCES ACTIVITY UNDER SECRETARY OF DEFENSE (COMPTROLLER)/CHIEF FINANCIAL OFFICER DIR DEFENSE CONTRACT AUDIT AGENCY DIR DEFENSE FINANCE AND ACCOUNTING SERVICE UNDER SECRETARY OF DEFENSE FOR INTELLIGENCE DIR NATIONAL SECURITY AGENCY/CHIEF, CENTRAL SECURITY SERVICE DIR DEFENSE INTELLIGENCE AGENCY DIR NATIONAL GEOSPATIAL-INTELLIGENCE AGENCY DIR DEFENSE SECURITY SERVICE DIR NATIONAL RECONNAISSANCE OFFICE DEPUTY CHIEF MANAGEMENT OFFICER DIR DEFENSE BUSINESS TRANSFORMATION AGENCY ASSISTANT SECRETARY OF DEFENSE FOR NETWORKS AND INFORMATION INTEGRATION/DoD CHIEF INFORMATION OFFICER DIR DEFENSE INFORMATION SYSTEMS AGENCY ASSISTANT SECRETARY OF DEFENSE FOR LEGISLATIVE AFFAIRS ASSISTANT SECRETARY OF DEFENSE FOR PUBLIC AFFAIRS DIR DEFENSE MEDIA ACTIVITY ASSISTANT TO THE SECRETARY OF DEFENSE FOR INTELLIGENCE OVERSIGHT GENERAL COUNSEL, DEPARTMENT OF DEFENSE DEFENSE LEGAL SERVICES AGENCY INSPECTOR GENERAL, DEPARTMENT OF DEFENSE DIRECTOR OPERATIONAL TEST AND EVALUATION DIRECTOR OF ADMINISTRATION AND MANAGEMENT, OSD DIR PENTAGON FORCE PROTECTION AGENCY DIR WASHINGTON HEADQUARTERS SERVICES DIRECTOR NET ASSESSMENT DIRECTOR PROGRAM ANALYSIS AND EVALUATION SECRETARY OF THE ARMY SECRETARY OF THE NAVY SECRETARY OF THE AIR FORCE CHAIRMAN OF THE JOINT CHIEFS OF STAFF OTHER (Identify) OTHER (Identify)

M M M

16.a. COORDINATING OFFICIAL (See instructions on page 2)
(1) SIGN (2) PRINT OR TYPE NAME b. POSITION TITLE (Print or type)
CONCUR NO COMMENT NONCONCUR WITH COMMENT

c. DATE FORM SIGNED
Adobe Professional 8.0

SD FORM 106, NOV 2008

PREVIOUS EDITION IS OBSOLETE.

- UNCLASSIFIED -

- UNCLASSIFIED 8. PURPOSE AND REMARKS (Continued)

INSTRUCTIONS FOR COMPLETING SD FORM 106
(For additional information on coordination requirements and signature levels, see Sections 6 and 7 of Enclosure 3 to DoDI 5025.010.) ITEM 1. SECURITY CLASSIFICATION Place an "X" in the appropriate box. ITEM 2. TYPE OF ISSUANCE Place an "X" in the appropriate box. DTMs shall be issued ONLY for time-sensitive actions that affect current issuances or that will become DoD issuances, and ONLY when time constraints prevent publishing a new issuance or a change to an existing issuance. ITEM 3. TYPE OF ACTION Place an "X" in the appropriate box. ITEM 4. DISTRIBUTION STATEMENT Place an "X" in the appropriate box. Unlimited: Unclassified issuance approved for public release. Restricted: Issuance approved for release through controlled internet access from the DoD Issuances Web Site on the SIPRNET. Not Releasable: Issuance shall not be released by DoD. Release shall be approved and accomplished by the cognizant Component. (See review and clearance requirements in DoDD 5230.9 and DoDI 5230.29 to determine the appropriate release and distribution option for the issuance.) ITEM 5. DOD ISSUANCE NUMBER For a new DoD issuance, enter the 4-digit number of the major subject group (See the DoD Issuance Numbering System on the DoD Issuances Web Site).. For a revision, change, or cancellation, enter the existing number of the DoD issuance. ITEM 6. COORDINATION SUSPENSE DATE The DoD Directives Program Portal sets suspenses automatically. For Directives, a suspense of 20 working days will be set from the date of posting on the portal. Other issuances will receive a 45-day suspense from date of posting. Expedited coordinations, including coordinations of DTMs, must be approved by Directives Division. ITEM 7. SUBJECT Enter the title of the issuance. It shall be no longer than two lines. ITEM 8. PURPOSE AND REMARKS Enter the reason for the action and any supplementary or background information to support it. If the issuance should be reviewed by DoD officials who are under the cognizance of an Under Secretary of Defense, an Assistant Secretary of Defense, or a Deputy Under Secretary of Defense, make recommendations in this block. ITEM 9. FEDERAL REGISTER PUBLICATION REQUIRED Place an "X" in the appropriate box. Any issuance that levies requirements on the public, Federal or Government employees outside the Department of Defense, and/or the Reserve Components, or that has public or political interest, should be considered for publication in the FR. (See AI No. 102.) ITEM 10. REPORTING REQUIREMENTS Place an "X" in all boxes that apply. (See DoD 8910.1-M.) ITEM 11. FORMS PRESCRIBED Place an "X" in the appropriate box. (See DoD 7750.7-M.) ITEM 12. PRIVACY REQUIREMENTS Place an "X" in the appropriate box. Privacy requirements apply to any issuance that addresses the collection, maintenance, use or dissemination of personal information regarding U.S. citizens or aliens admitted for permanent residence. (See DoDD 5400.11 and DoD 5400.11-R.) ITEM 13. ACTION OFFICER Enter the appropriate information. ITEM 14. ORIGINATING AUTHORIZING OFFICIAL Obtain the signature of the official authorized to start coordination. PRINT OR TYPE THE OFFICIAL'S NAME BENEATH THE SIGNATURE. ENTER THE OFFICIAL'S POSITION TITLE in block 14.b. and the signature date in block 14.c. Positions authorized to start coordination are listed below by type of issuance. Any delegation of signature authority must be provided to the DA&M in writing. DoDDs, DoDIs and DTMs that Establish Policy: - THE HEADS OF THE OSD COMPONENTS - THEIR PRINCIPAL DEPUTIES DoDIs and DTMs that Implement Policy, DoDMs, and AIs: - THE HEADS OF THE OSD COMPONENTS - THEIR PRINCIPAL DEPUTIES - THE OSD PRESIDENTIALLY APPOINTED, SENATE-CONFIRMED (PAS) OFFICIALS* ITEM 15. COORDINATING OFFICIALS Mandatory Coordinators: Pre-filled (IG DoD; GC, DoD; DA&M). Primary Coordinators: Have equity or interest in the issuance. Response required; however, if no response is received by the suspense date, the issuance approval process shall continue. Collateral Coordinators: Are provided the issuance for information only. No response required, but comments received will be included. Other: Other Federal agencies such as the Department of Homeland Security. (If the Issuance should be reviewed by DoD officials who are under the cognizance of an Under Secretary, an Assistant Secretary, or Deputy Under Secretary of Defense, make recommendations in Item 8.) ITEM 16. COORDINATING OFFICIAL Obtain the signature of the official authorized to coordinate. PRINT OR TYPE THE OFFICIAL'S NAME BENEATH THE SIGNATURE. ENTER THE OFFICIAL'S POSITION TITLE in block 16.b. and the signature date in block 16.c. Positions authorized to coordinate are listed below by type of issuance. Authority may be delegated to a position at the level of a General or Flag Officer, Senior Executive Service member, or Senior-Level employee. Any delegation of coordination authority must be provided to the DA&M in writing. DoDDs, DoDIs and DTMs that Establish Policy: - THE HEADS OF THE OSD COMPONENTS AND THEIR PRINCIPAL DEPUTIES. - THE SECRETARIES, UNDER SECRETARIES, ASSISTANT SECRETARIES, GENERAL COUNSELS, AND ADMINISTRATIVE ASSISTANTS OF THE MILITARY DEPARTMENTS. - THE CHAIRMAN AND VICE CHAIRMAN OF THE JOINT CHIEFS OF STAFF AND THE DIRECTOR AND VICE DIRECTOR OF THE JOINT STAFF. DoDIs that Implement Policy, DoDMs, and AIs: - Any of the officials authorized to coordinate on DoD Directives and DoD Instructions that establish policy. - The OSD PAS officials.* - The Deputy Under Secretaries and Deputy Assistant Secretaries of Defense. - The DoD Deputy General Counsels and Deputy Inspectors General. DTMs: Shall be coordinated with the mandatory coordinators, at a minimum. DTMs that establish policy shall be coordinated at the same level as DoDDs and policy DoDIs. DTMs that implement policy shall be coordinated at the same level as non-policy DoDIs. *The OSD PAS officials are: the USDs; the DUSD (Acquisition and Technology): DUSD (Logistics and Materiel Readiness); PDUSD (Policy); PDUSD (Personnel and Readiness); Director, Research and Engineering; the ASDs; the GC, DoD; the Director, Operational Test and Evaluation; the IG DoD; and the Assistant to the Secretary of Defense for Nuclear and Chemical and Biological Defense Programs.

SD FORM 106 (BACK), NOV 2008

- UNCLASSIFIED -

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