CMC4 Technical Library Request Form.pdf

OBTAINING ACCESS TO EXPORT CONTROLLED CONTENT:

Individuals requesting access to the export controlled scientific and technical information must provide the following information to the Contracting Officer through an authorized manager of their company’s Security or Human Resources Offices. That authorized individual shall verify that the information provided to NASA is correct, complete, and accurate. Companies are responsible for ensuring their compliance with all U.S. export regulations:

1. Full Company Name:

2. Company Address:

3. Is this a corporation, business association, partnership, society, trust, or any other entity, organization or group that is incorporated to do business in the United States? Yes [ ] No [ ]

4. Commercial and Government Entity (CAGE) Code:

5. Company Security or Human Resources Point of contact(s) providing/verifying information about the individual requesting access

a. Name and Title:

b. Phone Number:

c. e-mail:

6. List the names of all individuals requesting access to the export-controlled data including:

a. Name:

b. The individual named above is [ ] or is not [ ] a U.S. person as defined in Title 22, Code of Federal Regulations, Section 120.15

c. If the individual is not a U.S. person what is their citizenship? _________

ALTERNATE 6b: Citizenship: Specify Citizenship [ ]

Non-U.S. Persons must list any other countries to which individual claims citizenship __________

List Place of Birth: _______________

All foreign nationals from designated countries covered by a Programmatic Technology Transfer Control Plan (P-TTCP) or requiring access to export controlled information are required to have an Individual Technology Transfer Control Plan (I-TTCP) with a Non-Disclosure Agreement (NDA).

Foreign nationals from non-designated countries requiring access to export-controlled information covered by a P-TTCP are required to comply with the International Partner or Foreign National Certification contained in the P-TTCP.

Point of Emphasis:

The Company is responsible for ensuring compliance with the export regulations.

Points of Contacts:

Organization Export Control Representative if assigned.