36C77618Q9237-007.docx

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HR Development and Program Evaluation COR Ralph Robert PO 101C81082 Federal contract opportunity
Solicitation number
36C77618Q9237
Issued by
Department of Veterans Affairs Office of Information Service Center

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36C77618Q9237 S02 - Attachment - 7 NCHC Screening Notification.docx

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Revised June 2011 Revised July 2011

Department of Veterans Affairs VHA Service Center 6100 Oak Tree Blvd #500 Independence, OH 44131

Fingerprint Check - National Criminal History Check completion notice

Contractor Information

Contracting Officer/Specialist:

Prime Contractor POC Name & Phone:

Comments:
Employees are eligible for access to federal facilities based on a

favorably adjudicated fingerprint screening. Employees will not be fully functional if they require a full PIV badge. Employees will not be issued a permanent PIV badge until their investigation is scheduled.

Contractor/Employee Fingerprint check (National Criminal History Check) Information

Employee Name (Full Legal Name)

Closed Date
Screening Decision
Date of Decision
Badge Type

Form #NCHC1 This information is provided pursuant to Public Law 93-579 (Privacy Act of 1974), December 31, 1974, for individuals completing Federal Investigative Forms.

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