Attachment 8 - USAG-J Form 1529.pdf
PDF 827 KB Posted
- Solicitation number
- SP450026BE038
- Issued by
-
Defense Logistics Agency
About this file
This is a USAGJ Form 1529 for requesting visitor access to U.S. Army installations in Japan, specifically Camp Zama and associated facilities. The form serves as a template for sponsors to register visitors for either one-time group visits on a specific date and time, or for multiple access visits with defined effective and expiration dates. Sponsors bear sole responsibility for ensuring all required information is completed legibly in both English and Kanji, and must submit the roster to the Pass office at Camp Zama, SHA, SGD, or HB at least four working days prior to the visit; requests submitted same-day will not be processed. The sponsor must sign in guests at the gate and acknowledges responsibility for exercising total control over non-SOFA (Status of Forces Agreement) guests in accordance with USAGJ Regulation 190-13.
The form requires comprehensive sponsor information including typed name, rank, duty telephone, destination/installation, purpose of visit, organization, and signature. For each visitor, the form collects nationality, full name, address, vehicle plate number, gate assignment, passport number, driver's license number, telephone number, sex, date of birth, eye color, hair color, height, and weight. The form accommodates multiple visitors and vehicles with separate rows for each entry. A summary section captures total personnel and vehicles authorized, authorized areas (ZAMA, SGD, SHA, YND, APC, PIER6, TORII), and visit timeframes. Data collection is authorized under Title 10 U.S.C. Section 3013 for the principal purpose of providing information to Army officials responsible for monitoring and controlling visitor status to issue authorized pass numbers.
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Text version
PageONE TIME/MULTIPLE ACCESS ROSTER
JNL-SAZV2.90PREVIOUS EDITIONS ARE OBSOLETE.USAGJ FORM 1529, DEC 2020
1. INSTRUCTION
DATE OF REQUEST
of Pages
A "One Time/Multiple Access Roster" is valid for a single group visit for a specific date and time. It is the sole responsibility of the individual sponsor to include all information listed. Processing time can be reduced if each sponsor will take the time to legibly list the required information in both English and Kanji. This roster must be submitted to the Pass office at Camp Zama, SHA or SGD or HB four (4) working days might no be processed in time.
Any request that is submitted or the same day will not be processed. Sponsor must sign guest in at the gate.
The sponsor's signature services as an acknowledgment the sponsor is aware of his/her individual responsibilities as the sponsor and to exercise total control over his/her non-SOFA guests in accordance with the provisions contained in USAGJ Regulation 190-13.
a.
b.
a. TYPED NAME (Last, First MI)
e. DESTINATION/INSTALLATION
h. MULTIPLE ACCESS
EFFECTIVE DATE
f. PURPOSE
i. MULTIPLE ACCESS
EXPIRATION DATE
k. SPONSOR'S SIGNATURE
g. TYPE OF REQUEST
d. TELEPHONE NO.b. RANK c. DUTY TELEPHONE NO.
a. VISIT DAY
NATIONALITY NAME (Last, First MI) ADDRESS VEHICLE
PLATE NO.
GATE NO.
d. TOTAL (VEHICLE)c. TOTAL (PERSONNEL)
FROM
b. VISIT TIME
TO
ONE TIME MULTIPLE
2. SPONSOR INFORMATION & ACCESS DESCRIPTION
3. VISITORS INFORMATION
e. AREA(S) TO BE AUTHORIZED
ZAMA SGD SHA YND APC PIER6 TORII
PASSPORT NO.
TEL
DRIVER'S LICENSE NO.
j. SPONSOR'S ORGANIZATION
SEX DATE OF BIRTH EYE COLOR HAIR COLOR HEIGHT WEIGHT
NATIONALITY NAME (Last, First MI) ADDRESS VEHICLE
PLATE NO.
PASSPORT NO.
TEL
DRIVER'S LICENSE NO.
SEX DATE OF BIRTH EYE COLOR HAIR COLOR HEIGHT WEIGHT
NATIONALITY NAME (Last, First MI) ADDRESS VEHICLE
PLATE NO.
PASSPORT NO.
TEL
DRIVER'S LICENSE NO.
SEX DATE OF BIRTH EYE COLOR HAIR COLOR HEIGHT WEIGHT
NATIONALITY NAME (Last, First MI) ADDRESS VEHICLE
PLATE NO.
PASSPORT NO.
TEL
DRIVER'S LICENSE NO.
SEX DATE OF BIRTH EYE COLOR HAIR COLOR HEIGHT WEIGHT
GATE NO.
GATE NO.
GATE NO.
AUTHORITY:
PRINCIPAL PURPOSE:
ROUTINE USES:
DISCLOSURE:
DATA REQUIRED BY THE PRIVACY ACT OF 1974
Title 10 U.S.C., Code, Section 3013.
To provide information to officials of the Army responsible for monitoring/controlling visitor's status.
Information is used to record and assign authorized pass numbers to allow authorized visitors onto U.S. Army installations.
Voluntary. Failure to disclose the required information will result in authorized pass numbers not being issued; therefore, causing the applicants to have to meet and escort on and off the installation their visitors.
V2.90
FMO
USAGJ FORM 1529
Mitsue-Miller, Yukiyo
ONE TIME/MULTIPLE ACCESS ROSTER
09 DEC 2020
DEC 2020
Page
ONE TIME/MULTIPLE ACCESS ROSTER
JNL-SAZ
V2.90
PREVIOUS EDITIONS ARE OBSOLETE.
USAGJ FORM 1529, DEC 2020
1. INSTRUCTION
DATE OF REQUEST
of Pages A "One Time/Multiple Access Roster" is valid for a single group visit for a specific date and time. It is the sole responsibility of the individual sponsor to include all information listed. Processing time can be reduced if each sponsor will take the time to legibly list the required information in both English and Kanji. This roster must be submitted to the Pass office at Camp Zama, SHA or SGD or HB four (4) working days might no be processed in time.
Any request that is submitted or the same day will not be processed. Sponsor must sign guest in at the gate.
The sponsor's signature services as an acknowledgment the sponsor is aware of his/her individual responsibilities as the sponsor and to exercise total control over his/her non-SOFA guests in accordance with the provisions contained in USAGJ Regulation 190-13.
a.
b.
a. TYPED NAME (Last, First MI)
e. DESTINATION/INSTALLATION
h. MULTIPLE ACCESS EFFECTIVE DATE
f. PURPOSE
i. MULTIPLE ACCESS EXPIRATION DATE
k. SPONSOR'S SIGNATURE
g. TYPE OF REQUEST
d. TELEPHONE NO.
b. RANK
c. DUTY TELEPHONE NO.
a. VISIT DAY
NATIONALITY
NAME (Last, First MI)
ADDRESS
VEHICLE PLATE NO.
GATE NO.
d. TOTAL (VEHICLE)
c. TOTAL (PERSONNEL)
FROM
b. VISIT TIME
TO
2. SPONSOR INFORMATION & ACCESS DESCRIPTION
3. VISITORS INFORMATION
e. AREA(S) TO BE AUTHORIZED
PASSPORT NO.
TEL
DRIVER'S LICENSE NO.
j. SPONSOR'S ORGANIZATION
SEX
DATE OF BIRTH
EYE COLOR
HAIR COLOR
HEIGHT
WEIGHT
NATIONALITY
NAME (Last, First MI)
ADDRESS
VEHICLE PLATE NO.
PASSPORT NO.
TEL
DRIVER'S LICENSE NO.
SEX
DATE OF BIRTH
EYE COLOR
HAIR COLOR
HEIGHT
WEIGHT
NATIONALITY
NAME (Last, First MI)
ADDRESS
VEHICLE PLATE NO.
PASSPORT NO.
TEL
DRIVER'S LICENSE NO.
SEX
DATE OF BIRTH
EYE COLOR
HAIR COLOR
HEIGHT
WEIGHT
NATIONALITY
NAME (Last, First MI)
ADDRESS
VEHICLE PLATE NO.
PASSPORT NO.
TEL
DRIVER'S LICENSE NO.
SEX
DATE OF BIRTH
EYE COLOR
HAIR COLOR
HEIGHT
WEIGHT
GATE NO.
GATE NO.
GATE NO.
AUTHORITY: PRINCIPAL PURPOSE: ROUTINE USES: DISCLOSURE:
DATA REQUIRED BY THE PRIVACY ACT OF 1974
Title 10 U.S.C., Code, Section 3013. To provide information to officials of the Army responsible for monitoring/controlling visitor's status. Information is used to record and assign authorized pass numbers to allow authorized visitors onto U.S. Army installations. Voluntary. Failure to disclose the required information will result in authorized pass numbers not being issued; therefore, causing the applicants to have to meet and escort on and off the installation their visitors.
| NumericField1: 1.00000000 |
| NumericField1: 1.00000000 |
| DateField1: |
| TextField1: |
| TextField2: |
| TextField2: |
| TextField2: |
| TextField2: CAC# |
| TextField2: |
| TextField2: |
| TextField2: |
| TextField2: |
| TextField2: |
| TextField2: |
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| TextField2: |
| CheckBox1: 0 |
| CheckBox1: 0 |
| NumericField2: |
| TimeField1: |
| TimeField1: |
| SignatureField1: |
| CheckBox-Zama: 0 |
| CheckBox-SGD: 0 |
| CheckBox-SHA: 0 |
| CheckBox-YND: 0 |
| CheckBox-APC: 0 |
| CheckBox-PIER6: 1 |
| CheckBox-TORII: 0 |
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