<table style="width:100%;">
<colgroup>
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 34%" />
<col style="width: 0%" />
<col style="width: 8%" />
<col style="width: 0%" />
<col style="width: 3%" />
<col style="width: 8%" />
<col style="width: 15%" />
<col style="width: 2%" />
<col style="width: 0%" />
<col style="width: 19%" />
<col style="width: 0%" />
</colgroup>
<thead>
<tr class="header">
<th>1.</th>
<th colspan="4"><p><strong>Software Defect Tracking Number:</strong></p>
<p>     </p></th>
<th colspan="2">2.</th>
<th colspan="6"><p><strong>Software Name and Version:</strong></p>
<p>     </p></th>
</tr>
</thead>
<tbody>
<tr class="odd">
<td>3.</td>
<td colspan="7"><p><strong>Defect Identified by:</strong></p>
<p>     </p></td>
<td><p><strong>Phone:</strong></p>
<p>     </p></td>
<td colspan="4"><p><strong>E-mail:</strong></p>
<p>     </p></td>
</tr>
<tr class="even">
<td>4.</td>
<td colspan="5"><p><strong>Date Error or Defect
Encountered:</strong></p>
<p>     </p></td>
<td>5.</td>
<td colspan="6"><p><strong>Has Error or Defect Been
Verified?</strong></p>
<p>Yes No</p></td>
</tr>
<tr class="odd">
<td>6.</td>
<td colspan="12"><strong>Source of Error or Defect:</strong></td>
</tr>
<tr class="even">
<td></td>
<td colspan="12"> Internal to NSNFP</td>
</tr>
<tr class="odd">
<td></td>
<td colspan="12"> External to NSNFP (Supplier or Outside User)</td>
</tr>
<tr class="even">
<td colspan="13"></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="4"></td>
<td colspan="2"></td>
<td colspan="6"></td>
</tr>
<tr class="even">
<td>7.</td>
<td colspan="12"><p><strong>Description of the</strong>
<strong>Defect:</strong></p>
<p>     </p></td>
</tr>
<tr class="odd">
<td>8.</td>
<td colspan="12"><strong>Description of Impact On Previous
Work:</strong></td>
</tr>
<tr class="even">
<td colspan="2">a.</td>
<td colspan="11">Defect creates a condition adverse to quality? Yes
No</td>
</tr>
<tr class="odd">
<td colspan="2">b.</td>
<td colspan="11"><p>Explanation of Quality Impact Determination:</p>
<p>     </p></td>
</tr>
<tr class="even">
<td colspan="2">c.</td>
<td colspan="11"><p>Deficiency Report number:</p>
<p>     </p></td>
</tr>
<tr class="odd">
<td>9.</td>
<td colspan="12"><p><strong>Description of Software Defect
Resolution:</strong></p>
<p>     </p></td>
</tr>
<tr class="even">
<td>10.</td>
<td colspan="12"><strong>User or Developer:</strong></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="2">     </td>
<td></td>
<td colspan="6"></td>
<td></td>
<td>     </td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td colspan="2">Print/Type Name</td>
<td></td>
<td colspan="6">Signature</td>
<td></td>
<td>Date</td>
<td></td>
</tr>
<tr class="odd">
<td>11.</td>
<td colspan="12"><strong>Document Control Coordinator:</strong></td>
</tr>
<tr class="even">
<td></td>
<td colspan="12"><p>Affected users or organizations (different from the
initiator of this notification) have been notified of the contents of
the report.</p>
<p>Pertinent information has been included on the software
listing</p></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="2">     </td>
<td></td>
<td colspan="6"></td>
<td></td>
<td>     </td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td colspan="2">Print/Type Name</td>
<td></td>
<td colspan="6">Signature</td>
<td></td>
<td>Date</td>
<td></td>
</tr>
<tr class="odd">
<td>12.</td>
<td colspan="12"><strong>Responsible Technical Lead:</strong></td>
</tr>
<tr class="even">
<td></td>
<td colspan="12">The identified defect has been resolved and appropriate
corrective actions have been completed.</td>
</tr>
<tr class="odd">
<td></td>
<td colspan="2">     </td>
<td></td>
<td colspan="6"></td>
<td></td>
<td>     </td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td colspan="2">Print/Type Name</td>
<td></td>
<td colspan="6">Signature</td>
<td></td>
<td>Date</td>
<td></td>
</tr>
</tbody>
</table>

+-----+---+--------------------------------------------------------------+
| *   |   |                                                              |
| *So |   |                                                              |
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| are |   |                                                              |
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| t** |   |                                                              |
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| one |   |                                                              |
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| dev |   |                                                              |
| elo |   |                                                              |
| pme |   |                                                              |
| nt. |   |                                                              |
| T   |   |                                                              |
| his |   |                                                              |
| f   |   |                                                              |
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| is  |   |                                                              |
| com |   |                                                              |
| ple |   |                                                              |
| ted |   |                                                              |
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| the |   |                                                              |
| per |   |                                                              |
| son |   |                                                              |
| id  |   |                                                              |
| ent |   |                                                              |
| ify |   |                                                              |
| ing |   |                                                              |
| the |   |                                                              |
| d   |   |                                                              |
| efe |   |                                                              |
| ct, |   |                                                              |
| wh  |   |                                                              |
| ene |   |                                                              |
| ver |   |                                                              |
| a   |   |                                                              |
| so  |   |                                                              |
| ftw |   |                                                              |
| are |   |                                                              |
| d   |   |                                                              |
| efi |   |                                                              |
| cie |   |                                                              |
| ncy |   |                                                              |
| is  |   |                                                              |
| ve  |   |                                                              |
| rif |   |                                                              |
| ied |   |                                                              |
| to  |   |                                                              |
| be  |   |                                                              |
| att |   |                                                              |
| rib |   |                                                              |
| uta |   |                                                              |
| ble |   |                                                              |
| to  |   |                                                              |
| a   |   |                                                              |
| so  |   |                                                              |
| ftw |   |                                                              |
| are |   |                                                              |
| err |   |                                                              |
| or. |   |                                                              |
| If  |   |                                                              |
| mu  |   |                                                              |
| lti |   |                                                              |
| ple |   |                                                              |
| d   |   |                                                              |
| efe |   |                                                              |
| cts |   |                                                              |
| are |   |                                                              |
| add |   |                                                              |
| res |   |                                                              |
| sed |   |                                                              |
| col |   |                                                              |
| lec |   |                                                              |
| tiv |   |                                                              |
| ely |   |                                                              |
| in  |   |                                                              |
| a   |   |                                                              |
| sin |   |                                                              |
| gle |   |                                                              |
| so  |   |                                                              |
| ftw |   |                                                              |
| are |   |                                                              |
| rev |   |                                                              |
| isi |   |                                                              |
| on, |   |                                                              |
| t   |   |                                                              |
| hen |   |                                                              |
| a   |   |                                                              |
| sin |   |                                                              |
| gle |   |                                                              |
| So  |   |                                                              |
| ftw |   |                                                              |
| are |   |                                                              |
| Def |   |                                                              |
| ect |   |                                                              |
| Rep |   |                                                              |
| ort |   |                                                              |
| f   |   |                                                              |
| orm |   |                                                              |
| can |   |                                                              |
| be  |   |                                                              |
| com |   |                                                              |
| ple |   |                                                              |
| ted |   |                                                              |
| w   |   |                                                              |
| ith |   |                                                              |
| a   |   |                                                              |
| ta  |   |                                                              |
| ble |   |                                                              |
| at  |   |                                                              |
| tac |   |                                                              |
| hed |   |                                                              |
| to  |   |                                                              |
| p   |   |                                                              |
| rov |   |                                                              |
| ide |   |                                                              |
| the |   |                                                              |
| re  |   |                                                              |
| lev |   |                                                              |
| ant |   |                                                              |
| inf |   |                                                              |
| orm |   |                                                              |
| ati |   |                                                              |
| on. |   |                                                              |
+-----+---+--------------------------------------------------------------+
| Bl  | I |                                                              |
| ock | n |                                                              |
| No. | s |                                                              |
|     | t |                                                              |
|     | r |                                                              |
|     | u |                                                              |
|     | c |                                                              |
|     | t |                                                              |
|     | i |                                                              |
|     | o |                                                              |
|     | n |                                                              |
|     | s |                                                              |
+-----+---+--------------------------------------------------------------+
| 1\. | O |                                                              |
|     | b |                                                              |
|     | t |                                                              |
|     | a |                                                              |
|     | i |                                                              |
|     | n |                                                              |
|     | s |                                                              |
|     | o |                                                              |
|     | f |                                                              |
|     | t |                                                              |
|     | w |                                                              |
|     | a |                                                              |
|     | r |                                                              |
|     | e |                                                              |
|     | d |                                                              |
|     | e |                                                              |
|     | f |                                                              |
|     | e |                                                              |
|     | c |                                                              |
|     | t |                                                              |
|     | t |                                                              |
|     | r |                                                              |
|     | a |                                                              |
|     | c |                                                              |
|     | k |                                                              |
|     | i |                                                              |
|     | n |                                                              |
|     | g |                                                              |
|     | n |                                                              |
|     | u |                                                              |
|     | m |                                                              |
|     | b |                                                              |
|     | e |                                                              |
|     | r |                                                              |
|     | f |                                                              |
|     | r |                                                              |
|     | o |                                                              |
|     | m |                                                              |
|     | t |                                                              |
|     | h |                                                              |
|     | e |                                                              |
|     | D |                                                              |
|     | o |                                                              |
|     | c |                                                              |
|     | u |                                                              |
|     | m |                                                              |
|     | e |                                                              |
|     | n |                                                              |
|     | t |                                                              |
|     | C |                                                              |
|     | o |                                                              |
|     | n |                                                              |
|     | t |                                                              |
|     | r |                                                              |
|     | o |                                                              |
|     | l |                                                              |
|     | C |                                                              |
|     | o |                                                              |
|     | o |                                                              |
|     | r |                                                              |
|     | d |                                                              |
|     | i |                                                              |
|     | n |                                                              |
|     | a |                                                              |
|     | t |                                                              |
|     | o |                                                              |
|     | r |                                                              |
|     | . |                                                              |
+-----+---+--------------------------------------------------------------+
| 2\. | I |                                                              |
|     | d |                                                              |
|     | e |                                                              |
|     | n |                                                              |
|     | t |                                                              |
|     | i |                                                              |
|     | f |                                                              |
|     | y |                                                              |
|     | t |                                                              |
|     | h |                                                              |
|     | e |                                                              |
|     | n |                                                              |
|     | a |                                                              |
|     | m |                                                              |
|     | e |                                                              |
|     | o |                                                              |
|     | f |                                                              |
|     | t |                                                              |
|     | h |                                                              |
|     | e |                                                              |
|     | s |                                                              |
|     | o |                                                              |
|     | f |                                                              |
|     | t |                                                              |
|     | w |                                                              |
|     | a |                                                              |
|     | r |                                                              |
|     | e |                                                              |
|     | a |                                                              |
|     | n |                                                              |
|     | d |                                                              |
|     | t |                                                              |
|     | h |                                                              |
|     | e |                                                              |
|     | v |                                                              |
|     | e |                                                              |
|     | r |                                                              |
|     | s |                                                              |
|     | i |                                                              |
|     | o |                                                              |
|     | n |                                                              |
|     | d |                                                              |
|     | e |                                                              |
|     | s |                                                              |
|     | i |                                                              |
|     | g |                                                              |
|     | n |                                                              |
|     | a |                                                              |
|     | t |                                                              |
|     | i |                                                              |
|     | o |                                                              |
|     | n |                                                              |
|     | t |                                                              |
|     | o |                                                              |
|     | w |                                                              |
|     | h |                                                              |
|     | i |                                                              |
|     | c |                                                              |
|     | h |                                                              |
|     | t |                                                              |
|     | h |                                                              |
|     | e |                                                              |
|     | d |                                                              |
|     | e |                                                              |
|     | f |                                                              |
|     | e |                                                              |
|     | c |                                                              |
|     | t |                                                              |
|     | p |                                                              |
|     | e |                                                              |
|     | r |                                                              |
|     | t |                                                              |
|     | a |                                                              |
|     | i |                                                              |
|     | n |                                                              |
|     | s |                                                              |
|     | . |                                                              |
+-----+---+--------------------------------------------------------------+
| 3\. | I |                                                              |
|     | d |                                                              |
|     | e |                                                              |
|     | n |                                                              |
|     | t |                                                              |
|     | i |                                                              |
|     | f |                                                              |
|     | y |                                                              |
|     | t |                                                              |
|     | h |                                                              |
|     | e |                                                              |
|     | p |                                                              |
|     | e |                                                              |
|     | r |                                                              |
|     | s |                                                              |
|     | o |                                                              |
|     | n |                                                              |
|     | w |                                                              |
|     | h |                                                              |
|     | o |                                                              |
|     | f |                                                              |
|     | o |                                                              |
|     | u |                                                              |
|     | n |                                                              |
|     | d |                                                              |
|     | t |                                                              |
|     | h |                                                              |
|     | e |                                                              |
|     | d |                                                              |
|     | e |                                                              |
|     | f |                                                              |
|     | e |                                                              |
|     | c |                                                              |
|     | t |                                                              |
|     | i |                                                              |
|     | n |                                                              |
|     | t |                                                              |
|     | h |                                                              |
|     | e |                                                              |
|     | s |                                                              |
|     | o |                                                              |
|     | f |                                                              |
|     | t |                                                              |
|     | w |                                                              |
|     | a |                                                              |
|     | r |                                                              |
|     | e |                                                              |
|     | . |                                                              |
+-----+---+--------------------------------------------------------------+
| 4\. | I |                                                              |
|     | d |                                                              |
|     | e |                                                              |
|     | n |                                                              |
|     | t |                                                              |
|     | i |                                                              |
|     | f |                                                              |
|     | y |                                                              |
|     | t |                                                              |
|     | h |                                                              |
|     | e |                                                              |
|     | d |                                                              |
|     | a |                                                              |
|     | t |                                                              |
|     | e |                                                              |
|     | w |                                                              |
|     | h |                                                              |
|     | e |                                                              |
|     | n |                                                              |
|     | t |                                                              |
|     | h |                                                              |
|     | e |                                                              |
|     | d |                                                              |
|     | e |                                                              |
|     | f |                                                              |
|     | e |                                                              |
|     | c |                                                              |
|     | t |                                                              |
|     | o |                                                              |
|     | r |                                                              |
|     | e |                                                              |
|     | r |                                                              |
|     | r |                                                              |
|     | o |                                                              |
|     | r |                                                              |
|     | w |                                                              |
|     | a |                                                              |
|     | s |                                                              |
|     | f |                                                              |
|     | i |                                                              |
|     | r |                                                              |
|     | s |                                                              |
|     | t |                                                              |
|     | e |                                                              |
|     | n |                                                              |
|     | c |                                                              |
|     | o |                                                              |
|     | u |                                                              |
|     | n |                                                              |
|     | t |                                                              |
|     | e |                                                              |
|     | r |                                                              |
|     | e |                                                              |
|     | d |                                                              |
|     | . |                                                              |
+-----+---+--------------------------------------------------------------+
| 5\. | T |                                                              |
|     | h |                                                              |
|     | i |                                                              |
|     | s |                                                              |
|     | f |                                                              |
|     | o |                                                              |
|     | r |                                                              |
|     | m |                                                              |
|     | i |                                                              |
|     | s |                                                              |
|     | c |                                                              |
|     | o |                                                              |
|     | m |                                                              |
|     | p |                                                              |
|     | l |                                                              |
|     | e |                                                              |
|     | t |                                                              |
|     | e |                                                              |
|     | d |                                                              |
|     | w |                                                              |
|     | h |                                                              |
|     | e |                                                              |
|     | n |                                                              |
|     | e |                                                              |
|     | v |                                                              |
|     | e |                                                              |
|     | r |                                                              |
|     | t |                                                              |
|     | h |                                                              |
|     | e |                                                              |
|     | u |                                                              |
|     | s |                                                              |
|     | e |                                                              |
|     | r |                                                              |
|     | o |                                                              |
|     | r |                                                              |
|     | d |                                                              |
|     | e |                                                              |
|     | v |                                                              |
|     | e |                                                              |
|     | l |                                                              |
|     | o |                                                              |
|     | p |                                                              |
|     | e |                                                              |
|     | r |                                                              |
|     | d |                                                              |
|     | e |                                                              |
|     | t |                                                              |
|     | e |                                                              |
|     | r |                                                              |
|     | m |                                                              |
|     | i |                                                              |
|     | n |                                                              |
|     | e |                                                              |
|     | s |                                                              |
|     | t |                                                              |
|     | h |                                                              |
|     | a |                                                              |
|     | t |                                                              |
|     | t |                                                              |
|     | h |                                                              |
|     | e |                                                              |
|     | r |                                                              |
|     | e |                                                              |
|     | i |                                                              |
|     | s |                                                              |
|     | a |                                                              |
|     | n |                                                              |
|     | a |                                                              |
|     | p |                                                              |
|     | p |                                                              |
|     | a |                                                              |
|     | r |                                                              |
|     | e |                                                              |
|     | n |                                                              |
|     | t |                                                              |
|     | d |                                                              |
|     | e |                                                              |
|     | f |                                                              |
|     | e |                                                              |
|     | c |                                                              |
|     | t |                                                              |
|     | i |                                                              |
|     | n |                                                              |
|     | t |                                                              |
|     | h |                                                              |
|     | e |                                                              |
|     | s |                                                              |
|     | o |                                                              |
|     | f |                                                              |
|     | t |                                                              |
|     | w |                                                              |
|     | a |                                                              |
|     | r |                                                              |
|     | e |                                                              |
|     | . |                                                              |
|     | T |                                                              |
|     | h |                                                              |
|     | i |                                                              |
|     | s |                                                              |
|     | b |                                                              |
|     | o |                                                              |
|     | x |                                                              |
|     | i |                                                              |
|     | s |                                                              |
|     | c |                                                              |
|     | h |                                                              |
|     | e |                                                              |
|     | c |                                                              |
|     | k |                                                              |
|     | e |                                                              |
|     | d |                                                              |
|     | Y |                                                              |
|     | e |                                                              |
|     | s |                                                              |
|     | o |                                                              |
|     | n |                                                              |
|     | l |                                                              |
|     | y |                                                              |
|     | a |                                                              |
|     | f |                                                              |
|     | t |                                                              |
|     | e |                                                              |
|     | r |                                                              |
|     | t |                                                              |
|     | h |                                                              |
|     | e |                                                              |
|     | r |                                                              |
|     | e |                                                              |
|     | i |                                                              |
|     | s |                                                              |
|     | a |                                                              |
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+-----+---+--------------------------------------------------------------+
| 6\. | T |                                                              |
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|     | . |                                                              |
+-----+---+--------------------------------------------------------------+
| 7\. | D |                                                              |
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|     | . |                                                              |
+-----+---+--------------------------------------------------------------+
|     |   |                                                              |
+-----+---+--------------------------------------------------------------+
| 8\. | a | Assess the impact on previous work and determine if the      |
|     | \ | defect creates a condition adverse to quality.               |
|     | . |                                                              |
+-----+---+--------------------------------------------------------------+
|     | b | Summarize the basis for the determination, how the error     |
|     | \ | relates to appropriate software engineering elements, impact |
|     | . | on past and present use of the software by an organization,  |
|     |   | and how the corrective action impacts previous development   |
|     |   | activities.                                                  |
+-----+---+--------------------------------------------------------------+
|     | c | If the defect creates a condition adverse to quality, report |
|     | \ | and disposition the defect according to NSNFP Procedure      |
|     | . | 16.02.                                                       |
+-----+---+--------------------------------------------------------------+
| 9\. | D |                                                              |
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|     | . |                                                              |
+-----+---+--------------------------------------------------------------+
| 1   | T |                                                              |
| 0\. | h |                                                              |
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|     | . |                                                              |
+-----+---+--------------------------------------------------------------+
| 1   | I |                                                              |
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|     | s |                                                              |
|     | . |                                                              |
+-----+---+--------------------------------------------------------------+
| 1   | W |                                                              |
| 2\. | h |                                                              |
|     | e |                                                              |
|     | n |                                                              |
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+-----+---+--------------------------------------------------------------+