Attachment_A.3.2.2_REE_NEIS_PII_SHEET 1 .docx

REE NEIS PII SHEET

Instructions:

Enter the information below for the applicant. Enter the applicant’s complete name and address as it appears on their government-issued ID, such as a driver’s license or passport. If the information doesn’t match, the non-employee will encounter problems during the enrollment process and may have to reapply.

Cooperator (i.e Colorado State University)

Agreement Number/Contract Number, and Effective and Expiration Dates/DUNS #

ADODR/COR

Existing Background Investigation?

Has the United States government ever investigated your background and/or granted you a security clearance? Please answer Yes/No/Don’t know. If you believe you have previously been through the background investigation process, please respond with the agency name (i.e Treasury, Energy, Commerce).

Social Security Number

Name: First, Middle (if any), Last (if any)

Date of Birth (mm/dd/yyyy)

Gender

Place of Birth: City/State; if outside U.S. enter City/Country

Business Email:

This is for enrollment notification. If the applicant does not have a business email address, enter the address of the person who will manage enrollment activities, e.g. Security Officer, Supervisor, or Human Resources Manager.

Country of Citizenship Enter the applicant’s country of citizenship.

Non-Employee Type:

Enter one of the following: Contractor, Volunteer, Intern, Employee performing under grants or cooperative agreement. Other Non-Federal Employee

Home Address:

Enter the applicant’s home address Remember that it is strongly recommended that you enter the applicant’s as shown on their government-issued ID, such as a driver’s license or passport.

Work Address:

Enter the applicant’s work address

Accounting Code (for BI/NACI Billing)

Please hand carry or send securely

PRIVACY ACT INFORMATION"

This form is privileged and confidential. It contains information that requires protection in compliance with the Privacy Act of 1974.

This information is Personal Data and is FOR OFFICIAL USE ONLY (FOUO).

LincPass Process for non-Federals for North Atlantic Area

Either the secretary or Administrative Officer will complete a NEIS PII Sheet when it is known that a non-Federal will be working six months or longer and needs access to facilities or ARS IT Systems.

· The information needed is :

· Cooperator (i.e. Colorado State University)

· Agreement Number/Contract Number with effective and Expiration Dates

· ADODR/COR

· SSN

· Legal Name

· DOB

· Gender

· Place of Birth

· Business Email

· Country of Citizenship

· Home Address

· Work Address

· Accounting code to charge the background investigation NEIS PII sheet is sent via encrypted email to NAA-NEIS@ars.usda.gov where, Jean Silvasy/Maria Dallara will enter data into the NEIS system which includes the following:

· Adding the Contractor/Cooperator (You will need the DUNS number)

· Adding the Contract or Agreement

· Adding the Individual’s personal information

· Associate the individual to the contract

· Save record In addition, the information from the NEIS PII sheets is entered into an encrypted spreadsheet by Jean Silvasy/Maria Dallara and forwarded to Lisa Bailey in the Personnel Security Staff at Headquarters so that she can initiate the NACI process in eQIP.

Jean Silvasy/Maria Dallara (Sponsor Role) will copy and save the information in the GSA Portal; the sponsored individual will then receive notification from the system to enroll.

Once the NACI has been adjudicated by Personnel Security Staff at HQs, and the adjudication notice has been received, it is forward securely to the NEIS Adjudicator Role (Lu Anne Wright).

NEIS Adjudicator Role – adjudicates the individual and saves the record in NEIS.

NEIS Adjudicator goes into the GSA Portal and saves the record. This will allow the LincPass to be printed and shipped.

Individual will receive notification from system to pick up card.

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