Attachment 11 - Standard Form 701 - Example.pdf
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- Solicitation number
- W91ZLK-25-R-0002
About this file
This is Standard Form 701, an Activity Security Checklist template used for daily security inspections of work areas. The form includes five key security items that must be checked: 1) Security containers being locked and checked, 2) Ensuring desks, wastebaskets and surfaces are free of classified material, 3) Verification of locked windows and doors where appropriate, 4) Proper storage of typewriter ribbons and ADP devices containing classified information, and 5) Activation of security alarms and equipment where applicable.
The form provides space for 31 daily entries corresponding to each day of the month, with rows for recording initials and time of inspection. It requires identification of the division/branch/office and room number where the inspection takes place, and includes fields for routing information (To/From/Through) if required. This is a standard government form (SF 701) with NSN 7540-01-213-7899, prescribed by GSA/ISOO under 32 CFR 2003.
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Text version
1ITEM
1. Security containers have been locked and checked.
2. Desks, wastebaskets and other surfaces and receptacles are free of classified material.
3. Windows and doors have been locked (where appropriate).
4. Typewriter ribbons and ADP devices (e.g., disks, tapes) containing classified material have been removed and properly stored.
5. Security alarm(s) and equipment have been activated (where appropriate).
2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
INITIAL FOR DAILY REPORT
TIME
STANDARD FORM 701 (8-85)
Prescribed by GSA/ISOO
32 CFR 2003
701-101
NSN 7540-01-213-7899
Statement
I have conducted a security inspection of this work area and checked all the items listed below.
ACTIVITY SECURITY CHECKLIST
DIVISION/BRANCH/OFFICE ROOM NUMBER MONTH AND YEAR
TO (If required) FROM (If required) THROUGH (If required)
Irregularities discovered will be promptly reported to the designated Security Office for corrective action.
Form designed using PerForm Pro software.
| div: |
| roomno: |
| month: |
| to: |
| from: |
| through: |
| add6: |
| add7: |
| add8: |
| add9: |
| add10: |
| Reset: |
File details come from the government source that posted it. Updated .