Attachment 7 - Gatekeeper Request Form.pdf

253 CACG GATEKEEPER REQUEST

All visits to the 253 CACG in-garrison location must be coordinated and approved through the appropriate Commander first.

AUTHORITY: 10 U.S.C. 8013, Secretary of the Air Force; 18 U.S.C. 92.

PURPOSE: The system is the primary host of all United States Air Force (USAF) visitor pass and authorization tracking.

ROUTINE USE: DoD "Blanket Routine Uses" apply.

DISCLOSURE: Information requested on the form is voluntary. Failure to provide all of the requested information will result in non-issuance of the AF Form 75, Visitor Pass.

UNIT SPONSOR'S INFORMATION:

253 CACG/153 CACS/253 SPTS/ 253 SFS POC or OFFICE (Rank, Last Name, First Name)

REQUESTOR'S INFORMATION:

DATE OF REQUEST REQUESTER'S NAME/VISITING ORGANIZATION/EMAIL

VISIT INFORMATION:

START DATE END DATE

RANK/TITLE FIRST, LAST NAME RANK/TITLE FIRST,LAST NAME RANK/TITLE FIRST, LAST NAME

RANK/TITLE FIRST, LAST NAME RANK/TITLE FIRST,LAST NAME RANK/TITLE FIRST, LAST NAME

RANK/TITLE FIRST, LAST NAME RANK/TITLE FIRST,LAST NAME RANK/TITLE FIRST, LAST NAME

PURPOSE OF VISIT/AGENDA ITEMS/ADDITIONAL PERSONNEL

253 CACG SUPPORT REQUESTED (Personnel/technicians required, tools and/or equipment needed, etc.)

Provide the required information for equipment/vehicle(s) that need access onto the 253CACG installation on the last page.

SUBMIT DISS VISIT REQUEST 7 DAYS PRIOR OF VISIT TO SMO CODE: 153CAC-SSR-WY-2

Send all requests unencrypted to 153 CACS/SCXP MOC-Plans <153CACS.SCXP.MOC-Plans1@us.af.mil>

ARE PLATFORM ACCOUNTS REQUIRED? IF SO, USER OR ADMINISTRATOR?

v1.3 26JAN22

ATTACHMENT 7

SOLICITATION FA461323Q1023