Attachment 03 - EAL Form - 12.3.25.pdf

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CRAC Maintenance and Repair Service Offutt AFB
Solicitation number
FA460026Q0004
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This document is a For Official Use Only (FOUO) Offutt Air Force Base Entry Authority List form for a CRAC Maintenance IDIQ Visit. The event is scheduled for 12/15/2025, with a time window of 9:00-11:00 AM, and the location is 55 CES (Civil Engineering Squadron). The form is a standard security document used to authorize installation entry, requiring detailed visitor information including legal name, gender, date of birth, driver's license details, and U.S. citizenship status. The form includes a Privacy Act Statement explaining the purpose of collecting visitor information, which is to authorize base entry and maintain security records, with potential disclosure to investigative agencies if necessary.

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Attachment 02 - CRAC Mx - 55 CES TOPR - 12.3.25.pdf PDF
Combined Synopsis Solicitation FA460026Q0004 - 12.3.25.pdf PDF
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FOUO OFFUTT AIR FORCE BASE ENTRY AUTHORITY LIST

Page of 55 SFS Form 31 (10 Apr 2015)

Event Name

Start and End Time for Each Day of Event Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Date(s) of Event (Expires Immediately After Event ) Location of Event

Sponsor Name and Rank Sponsor Phone Number(s)

PRIVACY ACT STATEMENT

Authority: 10 U.S.C. 8013 and Executive Orders 13478 and 9397 as amended.

Purpose: Information collected by Security Forces personnel will be used to authorize installation entry to persons shown on the entry authority listing for the specific purpose provided by the sponsor. Information will also be used to notify person(s) designated as the visitor sponsor of arrival and other pertinent information relating to entry on the installation.

Routine Uses: Records may be disclosed to applicable Federal, State, or local agency charged with the responsibility of investigating or prosecuting a violation or enforcing/implementing a statute, rule, regulation, order issued pursuant thereto.

Disclosure: Disclosure of requested information is voluntary. Failure to provide all or parts of information requested can result in denial of installation entry. System of records number F031 AF SF B, Security Forces Management Information System (SFMIS), Defense Biometric Identification Systems (DBIDS) applies.

**DO NOT MODIFY FORMAT**

Approval Stamp (55 SFS Use Only)

Signature of Authenticator (55 SFS Use Only)

Legal Name of Guest:

(Last, First, MI)

Gender:

(M/F)

DOB:

(1962 Jan 11)

Driver’s License# State Issued

(M19GO62BLU / MI)

United States Citizen

(Yes / No)

Tuesday:
Wednesday:
Thursday:
Friday:
Saturday:
Sunday:
Sponsor Name and Rank:
Name 1:
Gender 1:
DOB 1:
DL 1:
Citizen 1:
Name 2:
Gender 2:
DOB 2:
DL 2:
Citizen 2:
Name 3:
Gender 3:
DOB 3:
DL 3:
Citizen 3:
Name 4:
Gender 4:
DOB 4:
DL 4:
Citizen 4:
Name 5:
Gender 5:
DOB 5:
DL 5:
Citizen 5:
Name 6:
Gender 6:
DOB 6:
DL 6:
Citizen 6:
Name 7:
Gender 7:
DOB 7:
DL 7:
Citizen 7:
Name 8:
Gender 8:
Citizen 8:
DOB 8:
DL 8:
Name 9:
Gender 9:
DOB 9:
DL 9:
Gender 10:
DOB 10:
DL 10:
Citizen 10:
Name 10:
Citizen 9:
Name 11:
Gender 11:
DOB 11:
DL 11:
Citizen 11:
Name 12:
Gender 12:
DOB 12:
DL 12:
Citizen 12:
Name 13:
Gender 13:
DOB 13:
DL 13:
Citizen 13:
Name 14:
Gender 14:
DOB 14:
DL 14:
Citizen 14:
Gender 15:
DOB 15:
Citizen 15:
Name 15:
Name 16:
Gender 16:
DOB 16:
DL 15:
Citizen 16:
DL 16:
Name 17:
Gender 17:
DOB 17:
DL 17:
Citizen 17:
Gender 18:
Name 18:
DOB 18:
DL 18:
Citizen 18:
Monday: 9:00-11:00 AM
Sponser Phone Number:
Event Name: CRAC Maintenance IDIQ Visit
Date of Event: 12/15/2025
Location of Event: 55 CES

File details come from the government source that posted it. Updated .