DoD Seal DISA Seal JITC Seal
RECORDS MANAGEMENT APPLICATION (RMA)
CTE-1 Form * = Required
Updated: 5/17/2016 8:13:22 AM
COMPLIANCE TEST REQUEST
Test Campaign Number (Optional - assigned by JITC)
Date Received
 
*RMA Product Name (Baseline Product)
RMA Product GSA Number (Optional)
*Date RMA Available for Sale
*RMA Developer
INFORMATION REQUIRED FOR CONTRACT
*Test Sponsor's Legal Corporate Name
*Test Sponsor's State of Incorporation
IRS Tax Yr. (optional - mm/yyyy)
*Test Sponsor's DUNS Number
System Award Management (SAM) Expiration Date (Optional)
*Test sponsor has coordinated rights to assign licenses with: (List Rights Owners, including RMA Developer)
*Parent Company Name
*Parent Company Address
*Parent Company Country of Incorporation
*Statement of Ownership
*One Brief Paragraph on Corporate History (No Sales Talk)
CONTRACT FORMAL NOTICES POINT OF CONTACT
*Contact
*Company Name
*Street Address
*City
*State
*Zip Code
Phone Number
Fax Number (Optional)
*E-mail Address
AGREEMENTS/CONTRACTS POINT OF CONTACT
(Optional: If this Contact is blank, the Contract Formal Notices POC will be the POC for Agreements/Contracts)
Contact
Company Name
Street Address
City
State
Zip Code
Phone Number
Fax Number (Optional)
E-mail Address
LEGAL POINT OF CONTACT
(Optional: If this Contact is blank, the Agreements/Contracts POC or Contract Formal Notices POC will be the POC for Legal actions)
Contact
Company Name
Street Address
City
State
Zip Code
Phone Number
Fax Number (Optional)
E-mail Address
CONTRACT TECHNICAL POINT OF CONTACT
*Contact
*Company Name
*Street Address
*City
*State
*Zip Code
*Phone Number
Fax Number (Optional)
*E-mail Address
CONTRACT FINANCIAL COORDINATION POINT OF CONTACT
*Contact
*Company Name
*Street Address
*City
*State
*Zip Code
*Phone Number
Fax Number (Optional)
*E-mail Address
SIGNATURE BLOCK OF PERSON WHO CAN LEGALLY BIND THE CORPORATION
*Company Representative Name
*Company Representative Title
POINTS OF CONTACT FOR TEST COORDINATION
*Primary Point of Contact
*Phone Number
*E-mail Address
Alternate Point of Contact (Optional)
Phone Number (Optional)
E-mail Address (Optional)


 
Verification
 
 
Verification Image (Click To Change)

Enter Image Text (Required - Case Sensitive)


 
 
Save and Acknowledge
 
By submitting this COMPLIANCE TEST REQUEST I cerify that all the above information is correct...