Attach. 2 Base Access Request Template.docx
DOCX document 177 KB Posted
- Attached to
- B216 Vindicator Motion Sensors
- Solicitation number
- FA480326Q0045
About this file
This is a Base Access Request Template for Shaw Air Force Base, used by the 20th Fighter Wing (ACC) to process visitor and contractor access. The form captures personal information including full legal name, date of birth, Social Security number, driver's license number, and U.S. citizenship status, which is submitted to the 20th Security Forces Squadron (20 SFS/S-5V) for criminal background history checks and DBIDS pass issuance.
The template establishes sponsor responsibilities and access control procedures, requiring that sponsors maintain accountability for all individuals granted base access, retrieve or deactivate passes when personnel terminate or no longer require access, and ensure all visitors comply with Real ID Act identification requirements. Non-U.S. citizens must submit supporting documentation including foreign visas, permanent resident cards, or employment authorization cards prior to visiting the Visitor Control Center (VCC). All requests must originate from the sponsor's government email and be sent to the designated 20 SFS/S-5V email addresses or fax number, or the request will not be processed. The form includes explicit statements acknowledging Privacy Act protections and consequences for abuse of approved access privileges.
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Text version
CUI
CUI
DEPARTMENT OF THE AIR FORCECUI
20th FIGHTER WING (ACC)
SHAW AIR FORCE BASE SOUTH CAROLINA
DATE: 12-Mar-26
MEMORANDUM FOR 20 SFS/S-5V
FROM:
SUBJECT:
WHO:
WHAT FOR:
WHERE:
If base wide give justification:
WHEN (ACCESS DATE/DAYS/TIMES):
SPONSOR NAME:
DOD EDPI:
CONTACT INFO:
The information below is protected under Privacy Act 1974 and will only be used to process Criminal Background History Checks to grant or deny access to Shaw AFB. It is further understood that anyone abusing approved privileges could, at a minimum, lose said privilege and possibly face criminal charges.
Full Legal Name (Last, First MI) Date Of Birth (Year/Mo/Day) Social Security Number
(XXX-XX-XXXX)
ST-DL #
(REAL ID Y/N)
U.S.
Citizen (Y/N)
PLEASE READ THE STATEMENTS BELOW
1. I UNDERSTAND THAT AS THE SPONSOR I AM RESPONSIBLE FOR THE PERSON(S) LISTED ON THIS FORM, AND FOR ENSURING THE ABOVE NAME INDIVIDUAL(S) TURNS IN THE DBIDS PASS OR RETRIEVE THE PASS ONCE THE INDIVIDUAL(S) ARE TERMINATED, QUIT, OR NO LONGER REQUIRES ACCESS. IF I AM NOT ABLE TO RETRIEVE THE PASS, I WILL NOTIFY SECURITY FORCES TO HAVE THE INDIVIDUAL(S) PASS DEACTIVATED IN DBIDS.
2. If you, as the sponsor, filled out the request and answered N for U.S Citizen please make sure you submit scanned in documents before coming to the VCC. **i.e.-FOREIGN VISA, PERMANENT RESIDENT CARD (Form I-551) & EMPLOYMENT AUTHORIZATION CARD (Form I-766) HOLDERS, ETC.
3. AS THE SPONSOR, I will inform my visitors they must have identification in compliance with the Real ID Act OR have a Federal ID in which cases they do not. If they do not, they will not be able to receive a pass from the VCC.
4. THIS FORM MUST BE SENT BY THE SPONSOR LISTED ABOVE FROM THEIR GOVERNMENT EMAIL AND RECEIVED AT THE EMAIL ADDRESSES/FAX NUMBER LISTED ABOVE IN THE 20 SFS/S-5V SECTION OR THE REQUEST WILL NOT BE PROCESSED.
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File details come from the government source that posted it. Updated .