Attachment 7 - DL1818 Visitor Notification Form.pdf

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VLM Maintenance Services
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SP3300-26-Q-0186
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This is a DLA Form 1818 (Visit Notification), a template used by the Defense Logistics Agency for documenting and controlling access to DoD installations, buildings, and facilities at Fort Belvoir, Virginia.

The form is designed to collect visitor information and access control documentation across three sections. Section I captures administrative details including the activity to be visited, requestor/preparer name, office code, telephone contact, visit dates, point of contact at the facility, and purpose of visit. Section II contains visitor-specific information such as name, grade/rank, social security number, date of birth, state/country of birth, security clearance status, and type of investigation/date. Section III requires the typed name, signature, and contact information of the security representative authorizing the visit, along with the activity name and date. The form operates under Section 21, 50 U.S.C. 781 et seq. and Executive Order 10450, with the principal purpose of controlling access and movement on DoD installations. Information disclosure is voluntary but failure to provide requested information may result in denial of access. The form allows for continuation sheets when additional visitor entries are needed.

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PRIVACY ACT STATEMENT

VISIT NOTIFICATION

1. ACTIVITY TO BE VISITED

AUTHORITY:

PRINCIPAL PURPOSE:

ROUTINE USES:

DISCLOSURE:DEFENSE LOGISTICS AGENCY

8725 JOHN J. KINGMAN ROAD

FT BELVOIR, VA 22060-6220

Section 21, 50 U.S.C. 781 et seq.; Executive Order 10450.

To control access to and movement on DoD installations, buildings, or facilities.

Used by General Services Administration Protective Service Personnel for access control and for any of the Blanket Routine Uses published by DLA.

Voluntary. However, failure to provide all the requested information may result in refusal to grant access to the installation, building, or facility.

DLA PRIVACY ACT SYSTEM NOTICE S500.50 DLA-I APPLIES

SECTION I

2. NAME OF REQUESTOR/PREPARER 4. TELEPHONE3. OFFICE CODE

5. DATE(S) OF VISIT 6. POINT OF CONTACT (at facility to be visited) 7. POC TELEPHONE

8. PURPOSE OF VISIT

SECTION II

9.

NAME(S) OF VISITOR(S)

(Last, First, MI)

10.

GRADE/RANK

11.

SSN

12.

DATE OF BIRTH

13.

STATE /COUNTRY OF

BIRTH

14.

CLEARANCE/DATE

GRANTED

15.

TYPE OF INVESTIGATION/

DATE

16. TYPED NAME OF SECURITY REPRESENTATIVE

SECTION III

18. ACTIVITY 19. TELEPHONE NUMBER 20. DATE17. SIGNATURE OF SECURITY REPRESENTATIVE

DLA FORM 1818, JUL 96 (EG)

FROM: TO:

PDF (DLA)

yre9693 Inserted Text

RequesterName:
OfficeCode:
FacPOC:
Phone:
POCPhone:
VisitedActivity:
VisitPurpose:
DateTo:
Visitor:
0:
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GradeRank:
0:
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SSN:
0:
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DOB:
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StateCountry:
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ClearDate:
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InvestDate:
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DateFrom:
SecRepName:
Activity:
ActPhone:
SecRepDate:
tVisitor:
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tGradeRank:
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tcsControl:
addcsBtn:
ResetMe:
resetBtn:

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