APPROVED (PRAS-497) PdM TSW - Annex B - TLS-EAB_Req_for_Classified Info.docx

NOTE: DOCUMENT WILL BE CUI//PRVCY WHEN COMPLETED

ANNEX B - TERRESTRIAL LAYER SYSTEM (TLS) ECHELONS ABOVE BRIGADE (EAB)

PROJECT MANAGER ELECTRONIC WARFARE & CYBER REQUEST FOR CLASSIFIED INFORMATION

1. Please provide the following information for Government review and approval:

1.1. Company Information:

1.2. CAGE codes for all applicable locations:

1.3. Receiving/Reviewing Individual’s Social Security Numbers, email address, and phone number (this information is required to validate clearance, list all that apply):

(DODIDs are not sufficient)

1.4. NIPR, SIPR and JWICS (or equivalent) email for primary POC (this POC’s SSN must be listed in 1.3):

1.5. Primary POC responsible for proper handling of all Classified information (this POC’s SSN must be listed in 1.3):

Once this form is filled in, it must only be returned via digitally encrypted email (accessed via DOD Common Access Card or if the Contractor's company has the proper DOD-approved assurance certificates installed) or DOD SAFE (Secure Access File Exchange): https://safe.app.mil/.

Distribution Statement A: Approved for Public Release. Distribution is Unlimited. U.S. Army PdM TSW PRAS-497

NOTE: DOCUMENT WILL BE CUI//PRVCY WHEN COMPLETED