Attach. 2 Base Access Request Template.docx
DOCX document 177 KB Posted
- Attached to
- Bowling Ball Return
- Solicitation number
- FA480326Q0032
About this file
This is a Base Access Request Template used by the 20th Fighter Wing Security Forces at Shaw Air Force Base in South Carolina to process visitor and contractor access to the installation. The form serves as an administrative tool for sponsors to request base access for individuals and contains fields for personal information including full legal name, date of birth, Social Security number, driver's license number, and U.S. citizenship status. All information collected is protected under the Privacy Act of 1974 and is used exclusively for conducting criminal background history checks to determine access eligibility.
The template establishes clear responsibilities and requirements for sponsors, including accountability for pass management, ensuring visitors comply with Real ID Act identification standards or possess valid Federal identification, and notification of the Security Forces when individuals no longer require access. Importantly, the form must be submitted from the sponsor's government email address to the designated 20 SFS/S-5V email or fax number to be processed; requests submitted through other channels will not be accepted. The form includes mandatory acknowledgment statements that sponsors must read and understand regarding their obligations to manage visitor privileges and report any misuse of approved access.
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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 .