Attachment 5-DHS Form 11055 FN Screening.pdf

This is DHS Form 11055, the Foreign National Screening Request Form used to screen foreign nationals being considered for access to DHS information, personnel, systems, and facilities. The form contains three main sections: Foreign National Information (collecting personal/biographical data, passport/visa details, and employment information), Sponsor Information (for internal DHS use), and Visit/Event Information (documenting visit specifics and access requirements).

The form requires mandatory completion of all fields and allows multiple individuals to be included for the same visit/event. Key requirements include providing detailed information about the foreign national's citizenship, residence, employment, and travel documentation, as well as specifics about the purpose and nature of the DHS facility access being requested. The form is authorized under 6 U.S.C. § 341 and related DHS directives, with information being used by DHS security personnel and potentially shared through the Foreign Access Management System (FAMS). While completion is voluntary, failure to provide information may result in denied access to DHS facilities.