A10 - DL1818 Visitor Notification Form.pdf

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VLM Maintenance for DDSP - SP3300-26-Q-0202
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This is a DLA Form 1818, a Visit Notification form used by the Defense Logistics Agency to control access to and movement on Department of Defense installations, buildings, and facilities. The form is issued under the authority of Section 21, 50 U.S.C. 781 et seq., and Executive Order 10450.

The form is structured in three sections. Section I collects administrative information including the activity to be visited, the name and office code of the requestor/preparer, the dates of visit, the point of contact at the facility, telephone numbers, and the purpose of the visit. Section II captures visitor information including the visitor's name, grade/rank, Social Security Number, date of birth, state/country of birth, and clearance or date granted, along with the type of investigation and date. Section III requires the typed name, signature, and telephone number of the security representative, the activity code, and the date of the visit notification. The Privacy Act Statement indicates that disclosure of information is voluntary; however, failure to provide all requested information may result in denial of access to the installation, building, or facility. Visitor information is used by General Services Administration Protective Service Personnel for access control purposes and is governed by DLA Privacy Act System Notice S500.50 DLA-I.

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PRIVACY ACT STATEMENT

VISIT NOTIFICATION

1. ACTIVITY TO BE VISITED

AUTHORITY:

PRINCIPAL PURPOSE:

ROUTINE USES:

DISCLOSURE:DEFENSE LOGISTICS AGENCY

8725 JOHN J. KINGMAN ROAD

FT BELVOIR, VA 22060-6220

Section 21, 50 U.S.C. 781 et seq.; Executive Order 10450.

To control access to and movement on DoD installations, buildings, or facilities.

Used by General Services Administration Protective Service Personnel for access control and for any of the Blanket Routine Uses published by DLA.

Voluntary. However, failure to provide all the requested information may result in refusal to grant access to the installation, building, or facility.

DLA PRIVACY ACT SYSTEM NOTICE S500.50 DLA-I APPLIES

SECTION I

2. NAME OF REQUESTOR/PREPARER 4. TELEPHONE3. OFFICE CODE

5. DATE(S) OF VISIT 6. POINT OF CONTACT (at facility to be visited) 7. POC TELEPHONE

8. PURPOSE OF VISIT

SECTION II

9.

NAME(S) OF VISITOR(S)

(Last, First, MI)

10.

GRADE/RANK

11.

SSN

12.

DATE OF BIRTH

13.

STATE /COUNTRY OF

BIRTH

14.

CLEARANCE/DATE

GRANTED

15.

TYPE OF INVESTIGATION/

DATE

16. TYPED NAME OF SECURITY REPRESENTATIVE

SECTION III

18. ACTIVITY 19. TELEPHONE NUMBER 20. DATE17. SIGNATURE OF SECURITY REPRESENTATIVE

DLA FORM 1818, JUL 96 (EG)

FROM: TO:

PDF (DLA)

RequesterName:
OfficeCode:
FacPOC:
Phone:
POCPhone:
VisitedActivity:
VisitPurpose:
DateTo:
Visitor:
0:
1:
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3:
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GradeRank:
0:
1:
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8:
SSN:
0:
1:
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4:
5:
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7:
8:
DOB:
0:
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StateCountry:
0:
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ClearDate:
0:
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InvestDate:
0:
1:
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7:
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DateFrom:
SecRepName:
Activity:
ActPhone:
SecRepDate:
tVisitor:
0:
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tGradeRank:
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tSSN:
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tDOB:
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tStateCountry:
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tClearDate:
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tInvestDate:
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tcsControl:
addcsBtn:
ResetMe:
resetBtn:

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