Attachment 0001_SOW APPENDIX 2.7.5 JBMHH Installation Access Request.pdf

This is a form (JBM-HH Form 190-16x) used for requesting installation access to Joint Base Myer-Henderson Hall. The form is administered by the Directorate of Emergency Services and is used to determine eligibility for access to the base.

The form collects visitor and applicant information including name, date of birth, gender, race, Social Security number, driver's license or state ID number, residential address, and phone numbers. Applicants must declare U.S. citizenship status, visa or passport information, and work authorization documentation (Form I-766, Form I-551, or Alien Registration Number). The form requests the applicant's category (non-DOD affiliate visitor, Gold Star family member, foreign military member, family care provider, employee, volunteer, guest, DRMWR member, event attendee, thrift shop employee, taxi/limo/Uber or lift driver, commercial delivery, moving company, or tow truck driver) and the requested duration of access, not to exceed one year. For contractor and vendor applicants, the form requires company name, phone number, contract number, address, point of contact, and contractor category (CAC eligible or non-CAC eligible). Section C requires applicants to authorize criminal records release and certify the accuracy of provided information. Section D captures sponsor information for government employees or active duty military sponsors. Section E is completed by Security Force personnel and documents background verification results, including NCIC-III check, TSDB check, and ALERTS check status. Section F documents the type and validity dates of the pass issued (24-hour visitor pass, 30-day pass, 60-day pass, 90-day pass, 6-month card, or 1-year card). Information is retained for two years following the disposition requirement.